In many cases, surgical treatment is the first option recommended for patients with acromegaly. While the idea of surgery can be frightening, removing or reducing the size of the pituitary tumor can be an important step toward managing the disease.
However, depending on the size and location of the tumor, its complete or partial removal isn’t always possible. For patients who cannot have surgery—and even for many patients who do—additional treatment is often needed to help normalize growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels.
Radiation therapy is sometimes used when tumor cells remain after surgery or if the tumor extends into the structures next to the pituitary. Radiation therapy destroys the remaining tumor cells and slowly reduces GH levels. However, it may take years for this treatment to noticeably improve acromegaly symptoms.
Many patients with acromegaly—including some who have had surgery—need to take medication throughout their lives in order to control their GH and IGF-1 levels. Currently, there are 3 types of medications commonly used for treating acromegaly.
Patients respond differently to each medication, and the side effects they experience may also vary. It’s important to discuss your medication options and the potential side effects of each medication with your doctor before beginning any treatment.
Somatostatin analog (SSA)
This type of drug works at the source of acromegaly—the pituitary tumor—to control the amount of GH that is released into the bloodstream. After surgery or for patients who are not candidates for surgery, SSAs are the first type of medication doctors use to treat acromegaly.
SSAs act by reducing the flow of GH from the pituitary gland, which can reduce IGF-1 production. Typically, the long-acting versions of these medications require an injection every 4 weeks. Somatuline Depot is an SSA treatment option for patients with acromegaly.
Growth hormone receptor antagonist (GHRA)
A GHRA does not work directly at the site of pituitary tumors and doesn’t directly reduce excessive GH production. This type of medication reduces the effects of GH once it is in the bloodstream to help lower IGF-1 levels. Currently, there is only one GHRA available for prescription for the treatment of acromegaly. It requires daily injections.
Dopamine agonist (DA)
This type of drug works on dopamine receptors, which are located within pituitary tumors. While DAs are used less frequently than the other drugs in managing GH and IGF-1 levels, they can be helpful to some patients. They may be used in people with tumors that secrete both GH and prolactin. In general, they are taken orally once daily.