Acromegaly

Acromegaly is caused by the hypersecretion of growth hormone in adults. It can cause serious changes in the way you look as well as complications with your metabolism (the process, through which your body breaks down food, uses or stores food components, and eliminates waste products). It also affects the cardiac system, glucose metabolism, joints and bones; symptoms of acromegaly can come on slowly over time. A relative who has not seen you in a while might notice the changes that are part of this condition.

Symptoms of acromegaly include:

• Interrupted menstrual cycle
• Deepening of the voice
• Impotence (inability to get or maintain an erection)
• Oily skin or acne
• Coarser facial features (a noticeably large nose)
• Excessive sweating
• Teeth that are spreading out
• Enlarged hands, feet, head, nose, and jaw
• Enlarged tongue and sleep apnea (interrupted breathing while sleeping)
• Depression
• Skin tags (small growths of skin that might be dark)
• Memory loss/not being able to think as well
• Thicker flesh on the palms and feet
• High blood pressure
• Fatigue
• Headaches
• Carpal tunnel syndrome (pain in wrist and hands)
• Osteoarthritis
• Colon polyps (growths)
• Peripheral vision defects (inability to see well at the edges of your vision range)
• Reduced sex drive

Treatment of acromegaly :

The best way to treat acromegaly is by removing the tumor through surgery called transsphenoidal microsurgery. This is not brain surgery and does not involve drilling a hole or cutting through your skull. Instead, the surgery is performed through the sinus passages behind your nose. Removing or reducing the pituitary tumor that causes acromegaly will reduce growth hormone levels and relieve the pressure caused by the tumor mass. Rarely a craniotomy may be required to remove tumor that cannot be removed through a transsphenoidal method.

Your surgeon might not be able to remove the entire tumor. If that happens, your hormone levels will be tested. If there is still tumor left or your hormone levels are not yet normal, medicine and/or radiation therapy may be given.

The medication of choice is octreotide, which is given most often by a monthly intramuscular injection. This therapy sometimes is given to control overproduction of growth hormone as a sole therapy after non-curative surgery, or in patients who are not surgical candidates. It also may be given while you are waiting for radiation to be effective, something that can take years.

A new medication called pegvisomant has now been approved for acromegaly. Rather than suppressing growth hormone by the pituitary tumor, it works to inhibit the hormone from acting on the body. It is given by a daily subcutaneous injection.

Disappearance of symptoms varies. With treatment, some symptoms like sweating may disappear immediately. Hypertension or abnormal glucose, when due to excess GH may also quickly subside when GH levels become normal. Others, such as thicker tissue on your palms and feet, may take longer to reverse. If you have osteoarthritis, or bone changes, they may not go away.

NOTE: Acromegaly definitely puts you at risk for colon cancer. Your doctor should screen you for colon cancer and look for pre-cancerous colon polyps (growths). Because the risk is high for this type of cancer, you should have a colonoscopy regularly.