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Transsphenoidal surgery (TSS) performed at experienced centers is the first-line treatment for acromegaly. The aim of surgery is to remove the adenoma completely if possible, relieve any compression on surrounding tissues, and normalize growth hormone (GH) levels. Microsurgical or endoscopic techniques are usually used, accessing the pituitary adenoma via the sphenoid sinus through a transnasal approach.
Medical therapy (somatostatin analogs, dopamine agonists, and GH receptor antagonists) is the next step for patients in whom the adenoma cannot be completely removed surgically and GH levels remain elevated, although reduced. However, medical therapy may be the first-line option for patients at high risk for anesthesia (e.g., those with severe heart failure or respiratory distress) or very elderly patients. The choice of medication, dosage adjustments, and the use of combination therapy are determined by the attending endocrinologist.
Radiation therapy is generally reserved for patients who fail to respond to post-operative medical therapy and have only very small residual adenoma tissue.
How is acromegaly treated?
Medical therapy (somatostatin analogs, dopamine agonists, and GH receptor antagonists) is the next step for patients in whom the adenoma cannot be completely removed surgically and GH levels remain elevated, although reduced. However, medical therapy may be the first-line option for patients at high risk for anesthesia (e.g., those with severe heart failure or respiratory distress) or very elderly patients. The choice of medication, dosage adjustments, and the use of combination therapy are determined by the attending endocrinologist.
Radiation therapy is generally reserved for patients who fail to respond to post-operative medical therapy and have only very small residual adenoma tissue.