Acromegaly and gigantism are due to overproduction of Growth hormone (GH) usually caused by a GH-secreting pituitary adenoma— a disorder of unequal skeletal, tissue, and organ growth. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. High GH and insulin-like growth factor-I (IGF1) levels lead to comorbidities including arthritis, facial changes, hypertension, diabetes mellitus, and heart and respiratory failure. If the condition is not diagnosed and treated early, its disabling effects leads to increase in morbidity and reduced life expectancy. The diagnosis is based on clinical features and confirmed by measuring growth hormone levels after oral glucose tolerance test and the estimation …show more content…
Radiation therapy destroys any lingering tumor cells and slowly reduces GH levels. It may take years for this treatment to noticeably improve acromegaly symptoms Radiation treatment can be done in two ways:
Conventional radiation therapy: This type of radiation therapy is usually given every weekday over a period of four to six weeks. One may not realize the full effect of conventional radiation therapy for 10 or more years after treatment.
Stereotactic radiosurgery: Also known as Gamma Knife radiosurgery, stereotactic radiosurgery can deliver a high dose of radiation to the tumor cells in a single dose while limiting the amount of radiation to the normal surrounding tissues. This type of radiation may bring GH levels back to normal within three to five years. Stereotactic radiosurgery is available at only a few U.S. medical centers and is not recommended for all people undergoing radiation for acromegaly.
Even after initial treatment, acromegaly requires periodic monitoring by a clinician to make sure that one is functioning properly. This follow-up care may last for the rest of one’s life.
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Nachtigall L., et al. 2008. Changing patterns in diagnosis and therapy of acromegaly over two decades. J. Clin. Endocrinol. Metab. 93:2035-2041.
III. Molitch M.E. 1992. Clinical manifestations of acromegaly. Endocrinal. Metab. Clin. North Am.21:597-614.
IV. Melmed A., “Acromegaly pathogenesis and treatment,” Journal of Clinical Investigation, vol. 119, no. 11, pp. 3189–3202, 2009.
V. Killinger K., Payer, J., Lazúrová, I. et al., “Arthropathy in acromegaly,” Rheumatic Disease Clinics of North America, vol. 36, no. 4, pp. 713–720, 2010.
VI. Giustina A., Barkan A., Casanueva F. F., et al., “Criteria for cure of acromegaly: a consensus statement,” Journal of Clinical Endocrinology and Metabolism, vol. 85, no. 2, pp. 526–529, 2010
VII. Cordero R. A., and Barkan A. L., “Current diagnosis of acromegaly,” Reviews in Endocrine and Metabolic Disorders, vol. 9, no. 1, pp. 13–19, 2008.
VIII. Arafat A.M., Möhlig M., Weickert M.O., et al., “Growth hormone response during oral glucose tolerance test: the impact of assay method on the estimation of reference values in patients with acromegaly and in healthy controls, and the role of gender, age, and body mass index,” Journal of Clinical Endocrinology and Metabolism, vol. 93, no. 4, pp. 1254–1262,
The New England Journal of Medicine -- February 1, 1996 -- Vol. 334, No. 5
Eftekhari, N., Mirzaei, F., & Karimi, M. (2008). The prevalence of hyperprolactinemia and galactorrhea in patients with abnormal uterine bleeding. Gynecological Endocrinology,24(5), 289-291.
Congenital Adrenal Hyperplasia (CAH) is an inherited condition that affects hormone production in the adrenal gland. The individual lacks enzymes to make cortisol, and hormones are instead are shifted away to make other hormones, specifically androgens. This results in the deficiency of cortisol and the abundance of testosterone.
...A1c: Should recommendations in adults be extrapolated to adolescents? The Journal of Pediatrics, 158, 947-952.
In July of this year, the FDA announced growth hormones, traditionally reserved for people with growth disorders, will be made available for use by children who are naturally short (Bailey). According to Bailey, “pediatric endocrinologists are permitted to prescribe HGH for children whose predicted adult height is below 4 feet 11 inches for women and 5 feet 3 inches for men” (Bailey). HGH is not a new drug; it has been used for years and prescribed for those with growing disorders. The number of patients for whom the drug is prescribed is expected to increase because of the new FDA ruling. The FDA ruling states use of the drug is no longer just for those with growth disorders (Bailey).
Acromegaly is a pituitary gland disorder that is an unusual and rare disease that comes from the hypersecretion of growth hormone during adulthood. It is rare in that acromegaly occurs in about 5 cases per million per year (Lugo 2011). Acromegaly if often labeled as a prolonged metabolic condition that is characterized by steady enlargement or elongation of facial bones and extremities (Thibodeau, 2013). This paper will explain the disease and how it affects the body, how one who has the disease might act and how to diagnose the disorder, and how to treat the disorder and ways for prevention of acromegaly.
Hegedus L, Bonnema SJ, Bennedek FN. Management of Simple Nodular Goiter. Endocrine Reviews, February 2003, 24(1):102–132.
Whether doctors solely use radiation therapy or use a combination of treatments, radiotherapy has been notoriously helpful in increasing the lifespan of many individuals worldwide.
... Clinical Evidence." Archives of Gynecology & Obstetrics 287.6 (2013): 1137-1149. Academic Search Premier. Web. 5 Oct. 2013.
Another treatment that is used to help a cancer patients overcome the disease is radiation therapy. Although very affective and used commonly, thi...
Type 1 diabetes has a genetic onset that often occurs in adolescence (Porth, 2005). It is an autoimmune disease in which the insulin-producing beta cells within the liver are destroyed (Dorman, 1993). This causes a deficiency in insulin secretion, which ultimately leads to high blood glucose levels, also referred to as hyperglycemia (Guthrie & Guthrie, 2004). The mechanism for insulin deficiency leading to hyperglycemia is described in more detail in the following section and in Figure 1.
Ware, Mark. Canadian Medical Association Journal. webmd.com. N.p. 30 August 2010. Web. 4 May 2014.
Kasman, D. L. (2004). When is medical treatment futile? Journal of General Internal Medicine, 1053-1056.
Radionuclide therapy is the use of ionizing radiations in the management of cancer. The primary goal of the therapy is to kill the cancerous cells completely or cause damage to the DNA of the tumor cells, thereby preventing these cells from undergoing further development, division, and growth (Bolus & Brady, 2011). Radionuclide therapy can have a curative effect if the target cancer cells are localized to a specific region of the body and have not spread. It is also used as a component of adjuvant therapy, where it is used to prevent the possibility of tumor cells that have been removed through surgery from recurring again. Radiation can also be done together with chemotherapy before, during, or after the procedure in cancers that are very susceptible (Schulz-Ertner, Jakel & Schlegel, 2006). The purpose of this discussion is to give an introduction about radionuclide therapy, its types and uses, and to compare it with radiation therapy and chemotherapy.
Gamma radiation therapy kills cancer cells by damaging their individual DNA. Therapy can either damage DNA directly or create charged particles (free radicals) within the cells that can in turn damage the DNA. Damaged cancer cells either stop dividing or die. They are then broken down and eliminated by natural processes inside of the body. However radiation therapy can also damage normal cells. The amount of radiation that normal tissue can safely receive is known for all parts of the body. Doctors use this information to help them decide where to aim radiation during treatment.