Although there is no known way to prevent acromegaly, early detection and treatment may help prevent disease complications from worsening.
Treatment options include surgery, medication and radiation, or a combination of these. The decision on which option to start with is usually based on age, the size and location of the tumor, and other existing medical conditions.
The first line of treatment for most patients is surgery to remove the pituitary tumor. If successful, removal of the tumor can quickly and effectively return growth hormone levels to normal. The success of the pituitary surgery depends on the size of the tumor and the patient’s growth hormone levels.
If surgery does not return growth hormone levels to normal, or if surgery is not an option, medication may help reduce growth hormone levels. The most common medication for acromegaly is a group of drugs known as somatostatin analogs. Currently, there are two long-acting injectable somatostatin analogs (octreotide LAR and lanreotide depot) and one short-acting octreotide (requiring injection three times daily) on the market. The long-acting injections typically require a monthly doctor’s office visit for administration. Some patients may also be prescribed a growth hormone receptor antagonist (pegvisomant) or dopamine agonist (bromocriptine or cabergoline).
According to a recent European publication, monthly somatostatin analog injections carry significant treatment burdens: 70% of patients experience pain during injection, and half of these suffer continuing injection site pain days later; injection site reactions include hardness, nodules, swelling, bruising and inflammation; approximately half of the patients report symptom breakthrough or treatment wear-off, towards the end of the monthly cycle, and one-third complain of ongoing symptoms; approximately one-third of patients feel a loss of independence due to the chronic injections, as most patients require a doctor, nurse or caregiver to administer the injection intramuscularly.
In some cases, when surgery and medication are not effective in lowering growth hormone levels, radiation may be recommended. Radiation can stop the tumor from growing and slowly lower the growth hormone levels.