The primary goal of treating acromegaly is to reduce growth hormone (GH) levels to normal, relieve symptoms, shrink or remove the tumour, and prevent long-term complications. Because each case is unique, treatment is personalised and may involve one or more of the following approaches: surgery, medication, radiation therapy, or a combination of these.
Surgery
Transsphenoidal surgery is often the first-line treatment for acromegaly. This minimally invasive procedure removes the pituitary tumour through the nasal passage, eliminating the need for external cuts. If successful, GH levels may drop to normal soon after surgery. In South Africa, this type of surgery is available at major public hospitals like Groote Schuur and Steve Biko, as well as in many private healthcare centres. It is also widely available internationally.
Medication
When surgery is not fully effective or feasible, doctors may prescribe medication to control hormone levels. The main types include:
- Somatostatin analogues (e.g., octreotide, lanreotide) – reduce the amount of GH released.
- GH receptor antagonists (e.g., pegvisomant) – block the effects of GH on the body.
- Dopamine agonists (e.g., cabergoline) – sometimes used in combination with other drugs.
These treatments are available in South Africa, though high costs may limit access in the private sector. Access within the public system can vary depending on the facility.
Radiation Therapy
Doctors may recommend radiation therapy when surgery and medication are not enough. It works by gradually destroying tumour cells. However, it can take several years to fully lower GH levels and often affects the normal function of the pituitary gland, leading to the need for lifelong hormone replacement.
Long-Term Follow-Up
Ongoing monitoring is essential to ensure treatment success. Patients usually undergo regular blood tests to check IGF-1 levels and periodic MRI scans to track tumour size. Endocrinologists typically manage long-term care, often working alongside neurosurgeons and other specialists such as cardiologists or diabetologists.
With proper treatment options for acromegaly and regular monitoring, many people with acromegaly can manage the condition effectively and lead healthy lives.
👉 Next: Complications of Acromegaly
Reviewed April 2025. Always consult a professional for individual guidance.
Cape Town Pituitary Collaborative