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Doctors' Answers to "Frequently Asked Questions" - Acromegaly

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Acromegaly [posted 1/8/99]
Question: My husband was diagnosed with acromegaly two years ago. He underwent trans. surgery and still a section of tumor remained around his optic nerve. He had gamma knife radiation one year ago. He is presently taking Sandostation TID. Does he have any other options to remove this tumor? Can he ever have 100% recovery.

Answer: They've done what is currently possible. It will depend on whether the tumor continues to grow. He may get improvement with time, hard to predict.

Question: I had acromegaly six years ago and was successfully treated by transphenoidal surgery at Emory University. My surgeon made it very clear that surgery was very difficult with a patient who had been treated with drugs. Surgery offers a cure rate of between 60 and 90 percent. Drugs can do no more than control the illness.

Answer: What would you expect a surgeon to say. There are many different types of acromegaly- depending a great deal on the size of the tumor. Many neurosurgeons insist on prior treatment to shrink the tumor. None of the current options has 100% success and physicians are consequently attempting different scenarios to achieve higher success rates. The three options are surgery, beam radiation and drugs.

Question: I am consulting you for a friend of mine here in Barcelona, Spain. He is 49, quite large, and has just been officially diagnosed as having Acromegaly, the disease arising from an overproduction of hormones which causes continuous growth. The doctors here are uncertain how to go about treatment, never having had a case before. My friend, basically, would like all the information he can gather on this disease and we can not find much here in Spain. Could you please advise on treatment and resources?

Answer: Acromegaly comes from the overproduction of human growth hormone by the pituitary. Any internist or endocrinologist could treat this easily. Drugs can be given to normalize the levels of the growth hormone (easily checked by blood tests) and bromocriptine is usually started to decrease the levels. Usually, radiation of the pituitary or trans-spenhoidal surgery to remove part of the pituitary will be necessary as well. A newer drug is octreotide and more patients than previously are getting resolution of their levels with this drug. Whether it will completely replace surgery and radiation treatment is currently not clear. If his physicians are having difficulty, get a second opinion. This is not exotic treatment, nor unusual.

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