Acromegaly is a lifetime disease. Surgery is the first treatment for about 90% of cases. The surgical remission rate obtained with the most experienced pituitary neurosurgeons is about 80% in cases of microadenomas with a recurrence in less than 10%. However, macroadenomas represent more than 75% of cases and the surgical cure in these patients falls to 20-40%. Thus, long-term lifetime follow-up is needed. Even after successful therapy, living a healthy life with acromegaly means forming a strong partnership with your healthcare team, which includes your endocrinologist, neurosurgeon, nurse and family doctor.
Monitoring and treating acromegaly will help patients avoid health complications. Controlling symptoms will improve the quality of life, and effective treatment has been shown to improve life expectancy. Normalization of plasma GH (with OGTT testing) and IGF-1 levels are the best predictors for an acromegaly cure.
OGTT should be repeated 4-6 weeks post-operatively as listed above in the screening testing. If the GH and IGF-1 levels remain elevated, further medical treatment may be necessary to control acromegaly.
The patient should be seen by their endocrinologist every 3-6 months in order to assess the success of the treatment. A pituitary MRI should be performed 2-3 months after surgery and then annually to determine if there is a tumour remnant and potential progression.
Monitoring and treating the comorbidities, such as hypopituitarism, metabolic disorders, musculoskeletal abnormalities, respiratory and cardiac problems, and gastrointestinal disorders associated with acromegaly, are essential for improving quality of life for people with acromegaly.
Please note that all follow-up appointments and tests may differ from centre to centre. Your follow-up plan will be discussed with your endocrinologist.
Check out the true-2-me guest editorial on treatment Considerations for Acromegaly