Acromegaly and Gigantism Treatment
Acromegaly And Gigantism Treatment
Acromegaly and gigantism are caused by tumors in the pituitary gland that lead to too much production of growth hormone in the individual. The goal of gigantism or acromegaly treatment is to remove the tumor and lessen growth hormone levels.
Tumor Removal for Treatment of Gigantism and Acromegaly
When possible, the best treatment for acromegaly is removal of the tumor. A procedure called transsphenoidal microsurgery is the least invasive option. This surgery is performed through the sinus passages, removing or reducing the tumor and relieving the pressure the tumor causes. Cure rates for this surgery depends on the size and location of the tumor. For small tumors, the cure rate is between 80 and 85 percent. Larger tumors have a cure rate of 50 to 60 percent.
In rare cases, acromegaly treatment will require opening a section of the skull to remove the tumor, a surgery known as craniotomy. This is only required if the tumor is not able to be removed through the sinuses.
Medication Therapy for Gigantism and Acromegaly
When patients are not good candidates for surgery, or when the doctor is unable to remove the entire tumor through surgical means, medication may be used to control hormone production. Somatostatin analog injections are one option. These injections cause tumor shrinkage in 30 to 50 percent of patients, and also help with some of the other symptoms of gigantism and acromegaly, like sleep apnea, headache and joint pain.
Sometimes the tumors themselves are not the problem targeted, but rather the effect of high levels of growth hormone on the body. Pegvisomant is a medication that stops the actions of the growth hormone on the body, without actually changing the tumor. Like somatostatin, pegvisomant is an injection.
Radiation Therapy as Treatment for Gigantism and Acromegaly
When surgery and medication are not sufficient to shrink tumors or control symptoms, patients may need radiation therapy. Stereotactic radiosurgery aims a focused beam of radiation into the tumor, helping to shrink it and lower growth hormone levels. The treatment does carry risk, but the latest technology ensures that the surrounding brain structures receive minimal radiation during therapy. However, radiation therapy is avoided in children whenever possible, as it can lead to emotional changes, learning disabilities and obesity.
Prognosis for Treatment
The prognosis for treatment, again, depends on the size of the tumor and its location. If the tumor is contained within the pituitary gland and the surgeon can remove it all through surgery, then patients have a high chance of seeing improvement of their symptoms.
The speed at which symptoms get better varies as well. Some symptoms will disappear quickly, while others, especially the thick skin on the palms and feet, will take longer to disappear. Some changes, like bone changes or extreme height, may not change at all.
If you or your child have gigantism or acromegaly, treatment is available. Talk to your doctor early about treatment options, before the tumors have a chance to grow beyond the pituitary gland. This gives you the best possible chance of a cure for the condition.