Treatment for acromegaly involves surgery, medication and, more rarely, radiation therapy.

• Surgical treatment

Surgical treatment is the preferential treatment for acromegaly, with the aim of removing the benign pituitary tumor causing hypersecretion of GH. It can only be performed in very experienced hands, in this case those of neurosurgeons specializing in pituitary gland surgery.

Today, it is done nasally (so-called trans-sphenoidal route), either in microsurgery (using a microscope), or by endoscopy. If this approach is the most logical, it is also difficult and a potential source of side effects. In some cases, prior medical treatment is carried out; in other cases, it involves removing as much of the tumor mass as possible (so-called tumor reduction surgery) to improve the subsequent response to medical treatment.

• Medical treatment

Medical treatment can either supplement surgery or replace it when intervention is not possible. Several drugs from the somatostatin inhibitor class are now prescribed for acromegaly. Depot forms are currently available which allow spaced injections. There is also an analogue of GH which, “by taking the place of the latter”, makes it possible to stop its action, but this requires several daily injections. Other drugs, such as dopaminergics, can also be used in acromegaly.

• Radiotherapy

Radiation therapy to the pituitary gland is only rarely prescribed today, due to these side effects. Nevertheless, there are now techniques where the rays are very targeted, which greatly limit the harmful consequences of radiotherapy (GammaKnife, CyberKnife for example), and which can possibly complement medical and / or surgical treatment.