Last reviewed 01/2018Seek expert advice.
The aim of treatment should be symptomatic control and a growth hormone concentration of less than 5 mU/l.
- if cause of acromegaly is a microadenoma then:
- treatment of choice is transsphenoidal surgical exploration
- further treatment:
- if there is symptomatic improvement, insulin-like growth factor is normal, and growth hormone concentration is less than 5 mU/l then no further treatment is indicated
- if the above conditions are not satisfied then consider external beam radiation. Also drug treatment (bromocriptine or octreotide) can be administered and withdrawn at yearly intervals in order to assess the effects of radiotherapy on growth hormone secretion
- elderly patients with acromegaly
- if patient is elderly and surgery is contraindicated then these patients seem to be more susceptible to the effects of octreotide than younger patients
- patients with macroadenomas (> 1 cm in diameter)
- transsphenoidal surgery is the treatment of choice
- other measures such as external beam radiotherapy and drug treatment may also be indicated in order to get growth hormone levels below 5 mU/l