Acromegaly is an increased production of growth hormone (somatotropin) in adults. The pathology leads to the coarsening of facial features, an enlargement of the hands and feet, affects the functioning of the cardiovascular and nervous systems, and causes metabolic disorders. The source of hormones is a pituitary adenoma – a benign tumor of glandular tissue. You can undergo your diagnostics and treatment of acromegaly in Germany. The specialists in this country perform minimally invasive operations to remove the pituitary adenoma through the nose and radiation therapy and drug therapy.
Content
- Surgical treatment
- Drug therapy
- Radiation therapy
The disease is usually successfully cured by surgery. Radiation therapy can be an alternative to surgery. The growth hormone levels in the blood can also be controlled with drug therapy.
You can undergo your treatment in the following hospitals: University Hospital of Ludwig Maximilian University of Munich, University Hospital Carl Gustav Carus Dresden, or Hospital Neuperlach Munich.
You do not have to worry about any organizational issues, as the Booking Health company will take care of them. Our specialists will recommend the best clinic and doctor, help you apply for a visa, provide medical insurance, book an appointment for the desired date, and provide interpreting services. In addition, a personal medical coordinator will always be in touch with you.
Surgical treatment
The best treatment option is surgery. It allows the doctors to eliminate the pressure of the tumor on the surrounding structures, reduce the hormone levels in the blood, and achieve a cure or a long-term remission of the disease. The resection of pituitary adenoma can be performed using different techniques.
Endoscopic transsphenoidal surgery. This is a minimally invasive surgery with the use of an endoscope. The operation is performed through a small incision in the nose or on the upper lip. The advantage of using the endoscope is that the tumor can be better visualized in a panoramic mode. As a result, the risk of the incomplete removal of the adenoma is reduced.
Transsphenoidal microscopic surgery. The tumor is visualized directly with a microscope. This is the classical method of transsphenoidal surgery. The efficiency of this technique is comparable to endoscopic surgery.
Craniotomy. This is a surgical procedure performed with the opening of the skull. This approach is used for the adenomas with suprasellar extensions, that is, to remove tumors located outside the sella turcica.
German doctors mainly perform modern minimally invasive endoscopic surgeries. In most patients, acromegaly can be successfully treated with surgery.
Drug therapy
Drug therapy may be the main one in the following cases:
- a patient has contraindications for surgery;
- a patient refuses the operation;
- the tumor is unresectable;
- adenoma recurrence after its surgical resection.
Drug therapy can also be used in addition to surgery. Some studies have proved that neoadjuvant treatment with somatostatin analogs prior to the tumor resection leads to an increased chance of achieving remission.
Somatostatin analogs bind to somatostatin receptors, which leads to the suppression of growth hormone production by both the normal pituitary gland and the adenoma. The drugs also act at the level of the liver, inhibiting the action of the growth hormone, reducing its binding to hepatocytes (liver cells), and reducing the production of IGF-1 (insulin-like growth factor). These drugs not only control hormone levels but also inhibit tumor growth. The healthcare professionals in Germany use second-generation drugs, which have a higher affinity for receptors and provide a better therapeutic result.
Dopamine receptor agonists are less effective than somatostatin analogs. This is usually adjuvant therapy. These medications can be prescribed for a slight increase in the growth hormone levels and mild symptoms without using any other drugs.
Growth hormone receptor antagonists are a new type of drug that has only recently begun to be used in countries with developed medicine. Therefore, they block receptors and eliminate the manifestations of acromegaly, even though the levels of growth hormone in the blood may remain elevated.
Radiation therapy
Radiation therapy can be used in the following cases:
- drug therapy did not help;
- adenoma recurrence after surgery;
- recurrence prevention (adjuvant radiation therapy).
Radiation therapy is non-invasive and does not require any rehabilitation measures. However, the production of pituitary hormones may be impaired in patients who have undergone radiation therapy, so they need constant monitoring to detect and eliminate a hormonal imbalance promptly.
Here are some of the radiation therapy options used in German medical centers:
Radiotherapy involves a course of irradiation that lasts 5-6 weeks. It is mainly used as an adjunct to surgery for recurrence prevention or when the effect of the operation is insufficient (target hormone levels in the blood are not achieved). The remission after radiation therapy lasts up to 10 years.
Stereotactic radiosurgery is a single exposure to a high radiation dose with minimal risk of damage to the healthy brain tissue. While using this method, the adenoma must be a few millimeters away from the optic nerve to avoid its lesions. The remission rate reaches 50%, and drug therapy is not required for 2-5 years.
If you are going to have your treatment in Germany, the services of the Booking Health company will be beneficial. On our website, you can compare the cost of treatment in different hospitals and book your treatment at a favorable price. The Booking Health company specialists will help you find the best clinics in Germany and arrange your trip abroad.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
NORD - National Organization for Rare Disorders
MedicineNet
PubMed
