Acromegaly: Treatment, Procedure, Cost and Side Effects

Adults with acromegaly have excessive growth hormone (GH) production from the pituitary gland. It has a higher morbidity and mortality rate and is brought on by a somatotroph adenoma of the pituitary gland. This causes the hands, feet, and face to swell first, as well as other soft tissues throughout the body. If neglected, this can cause serious disease and even death because it also affects the heart and bones.

The most frequent cause of acromegaly is a pituitary adenoma, a tumour in the pituitary gland that permits it to generate excessive amounts of growth hormone.

Pituitary adenomas and acromegaly:
Most pituitary adenomas (tumours) are benign. (noncancerous). You might not experience symptoms of excess GH for many years because the majority of adenomas that cause acromegaly grow slowly.

Depending on its size and location, the adenoma may press against neighbouring pituitary tissue and disrupt other hormones your pituitary gland produces. Large adenomas have the potential to press against surrounding parts of the brain, resulting in headaches and vision issues.

Non Pituitary tumours:
Acromegaly can be brought on by tumours in other organs like the pancreas or the lungs. These tumours often release GH. In some cases, the release of a hormone termed growth hormone-releasing hormone serves as a signal from the tumours to the pituitary gland to enhance GH synthesis.

Acromegaly signs and symptoms include:

• Enlarged hands or feet
• Excessive sweating
• Change in the shape of your face
• Increase in the size of lips, nose and tongue
• Deepening of voice
• Headache
• Numbness
• Vision issues
• Sleep apnea
• Carpal tunnel syndrome
• Skin tags
• Irregular menstrual cycle

Acromegaly symptoms often develop very gradually over several years. This makes its diagnosis difficult.
Your doctor could advise you to consult an endocrinologist, a doctor who specializes in diseases linked to hormones.
A diagnosis will be made using a combination of your medical history, a thorough clinical evaluation, and specialised diagnostics such as blood tests and imaging studies.
Your doctor could request additional testing if you have been diagnosed with acromegaly, to determine whether the disorder has affected any other areas of your body. These tests include:

• Echocardiogram
• Colonoscopy
• Sleep study tests
• X-ray
• IGF-I measurement

Surgery, medicine, and radiation therapy are the most often used treatment options for acromegaly.

Surgery:

Surgery used for the treatment of acromegaly is called transsphenoidal surgery. Transsphenoidal surgery is a type of surgery where the patient's nose and sphenoid sinus, a hollow area in the skull located below the brain and behind the nasal passages, are used by the surgeon to perform the procedure.

The particulars of the operation will depend on the tumour's size and location. The aim of surgery is to completely remove a tumour that is producing too much growth hormone. You might not require additional treatment if your surgeon is able to remove enough of the tumour. You might require medication or radiation therapy to stop the production of growth hormones if your surgeon is removing only a portion of the tumour.

One medication or a group of medications may be recommended by your doctor. Distinct medications have distinct mechanisms of action that help your body's growth hormone levels stay normal and reduce your symptoms. In some cases, patients may take the medicines till the tumour has shrunk and then the surgeon can safely remove it.

Radiation therapy is advised by medical professionals to eradicate any remaining tumour cells and gradually lower GH levels. The radiation approach has three different ways to treat acromegaly, and it may take months or even years for symptoms to substantially improve. The techniques include stereotactic radiosurgery, proton beam therapy, and conventional radiation therapy.

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.

You should consult an Endocrinologist for acromegaly. Endocrinologists are doctors who focus on the identification and management of metabolic and hormonal problems.

Medicines used for the treatment of Acromegaly include somatostatin receptor ligands (SRLs), GH receptor antagonists and dopamine agonists.

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.

The cost of Acromegaly treatment depends upon various factors. However, the estimated price is between Rs. 5,00,000 to Rs. 10,00,000.

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.

Acromegaly is a medical condition that affects adults, in which the pituitary gland releases excessive growth hormones. Acromegaly is frequently brought on by non-cancerous tumours. The symptoms of acromegaly include enlargement of body parts, numbness, excessive sweating, vision issues, and deepening of voice and skin tags. It can be diagnosed by various tests like echocardiogram, colonoscopy, x-ray, sleep study tests and IGF-I measurement. The treatment alternatives for acromegaly include medications, surgery and radiation therapy.