Acromegaly is a chronic disorder in adults in which the pituitary gland produces too much growth hormone or GH. It is caused by a somatotroph adenoma of the pituitary gland and is associated with increased morbidity and mortality. This makes parts of the soft tissues of the body swell first, like the hands, feet, and face. This also affects the heart and bones and if left untreated, it can lead to severe illness and death.
Symptoms of acromegaly begin with the swelling and enlargement of hands and feet. The features in the face begin to grow larger, swollen, and broader. Other symptoms of acromegaly may include achy joints, possibly leading to arthritis, hoarser, deeper voice, thick and rough skin, headaches, erectile dysfunction in men and changes in the menstrual cycle and breast discharge in women. Acromegaly can also affect heart and body pressure.
Treatment can help the patient with acromegaly, but this condition can't be cured. Treatments for acromegaly will be determined by the physician based on the age, overall health, and medical history, extent of the disease and personal tolerance of medicines and opinions. There are basically three ways to treat acromegaly. These are surgery, medicine, and radiation. The doctors first begin with surgical treatment for people with large tumors affecting vital areas. The surgeon will remove the tumor from the base of the brain and this treatment works well in most of the cases for patients to reverse the symptoms of acromegaly. To help bring back the secretion of growth hormone levels back to normal, doctors prescribe medicines like Somatostatin analogs, Growth hormone receptor antagonists or Dopamine agonists. If even after surgery, parts of the tumor is left, radiation treatment is used. It can help stop the tumor from growing and the body from making too much growth hormone.
The doctor first will diagnose the disease. A thorough check up of the medical history and also physical examinations need to be carried out. The doctor may recommend the following tests like GH and IGF-I measurement, Growth hormone suppression test, etc. Elevated results of these tests indicate acromegaly. Also, imaging procedure, such as magnetic resonance imaging (MRI), help to pinpoint the location and size of a tumor of the pituitary gland.
Treatment of acromegaly focuses on lowering the production of growth hormones in the body, as well as reducing the negative effects of the tumor on the pituitary gland and surrounding tissues. Surgical treatments can be used to remove pituitary tumors, this is called transsphenoidal surgery. In this procedure, your surgeon will make a small cut in the nose or the inside of the upper lip and work through it to extract the pituitary tumor. Removing the tumor can normalize the growth hormone or GH production and eliminate the pressure on the tissues surrounding the pituitary gland. This helps to relieve associated signs and symptoms of acromegaly.
Sometimes when surgical operations leave behind a part of the tumor inside the body, doctors prescribe drugs to help it shrink. Medicines are also taken to control the secretion of hormones from the gland. Somatostatin analogues like octreotide (Sandostatin) and lanreotide (Somatuline Depot) are synthetic versions of the brain hormone somatostatin. They help to produce rapid declines in GH levels by interfering with the excessive secretion of GH by the pituitary gland. Dopamine agonists like cabergoline and bromocriptine (Parlodel) are taken as pills. These drugs can lower levels of GH and IGF-I and aid the decrease in size of the tumor. Growth hormone antagonist like pegvisomant (Somavert) acts to block the effect of GH on body tissues.
Doctors recommend radiation treatment to destroy any remaining tumor cells and slowly reduce GH levels. There are three ways of treating acromegaly with the radiation method and it may take years for this treatment to noticeably improve acromegaly symptoms. The methods include Conventional radiation therapy, Proton beam therapy and tereotactic radiosurgery which is also known as Gamma Knife radiosurgery.
A patient should seek medical assistance and treatment when any of the symptoms of acromegaly show up and lasts for more than a few weeks. Serious symptoms such as shortness of breath or chest pain warrant immediate attention.
If there are no symptoms of acromegaly and the person is fit and fine even with greater height than average, then there lies no need to go for a treatment. Many people have a higher secretion rate of growth hormones, but there may occur no severity because of it. Then it is not required for the person to undergo any treatment.
Treatment of acromegaly do not cause major side effects. Long term medications may cause some side effects in people but they don't last long. The most common side effects are constipation, dizziness, diarrhea, gas, and nausea, lightheadedness, headaches etc. Some people may develop compulsive behaviors, such as gambling, while taking these medications. These fade away with time when the body gets used to the drugs.
Acromegaly is a lifelong disease and cannot be cured permanently. Hence, even after successful therapy, the person will need to see his or her health care provider regularly to have the levels of growth hormone and IGF-1 checked. Also, medicines should be followed and taken as advised.
Time to recover after the treatment of acromegaly varies depending on the type of treatment. It is not curable and lasts life-long but its symptoms can be reduced. The full effect of conventional radiation therapy may require 10 or more years after treatment to give the necessary results. Proton beam therapy requires less time for recovery while stereotactic radiosurgery may bring growth hormone levels back to normal within three to five years.
Treatment of acromegaly may require a long time and thus, the usual expenditure is pretty high. Treatments of pituitary gland tumors require surgeries and radiation therapies apart from drugs. Thus, the cost of treating acromegaly is higher than average.
Acromegaly is a chronic disorder and cannot be cured permanently. However, the symptoms can be lessened and patients can be restored to normal health after treatment. Treatments usually take a little longer time to enact fully and effectively but benefits from surgery and drug therapy are often seen within days or weeks. After successful treatment, the person will find his or her hands and feet becoming less swollen and it will also decrease in size gradually. Headaches and other symptoms of acromegaly are also brought under control.
There is no alternate way to treat acromegaly. Homeopathy medicines can help treat the end results of the disease process but it does not effectively help in treating the symptoms of acromegaly. The best way to treat this chronic hormonal disorder is to undergo surgeries and therapies.
Relative Risk: High
Side Effects: Medium
Time For Recovery: High