Acromegaly treatment: Effective options and what to expect

Acromegaly often hides for years but it is treatable. If you or your doctor suspect acromegaly, acting sooner reduces complications. This guide explains the main treatment options, how they work, and what to expect from each step so you can speak confidently with your care team.

How acromegaly is treated

First-line treatment is usually pituitary surgery. A surgeon removes the growth hormone–secreting tumor via a transsphenoidal approach through the nose. Surgery often works best for small or well-defined tumors and can normalize hormone levels quickly. Risks include bleeding, infection, and possible damage to nearby structures, but modern techniques keep complications low. Recovery often takes weeks and requires follow-up hormone testing.

If surgery can’t remove the whole tumor or isn’t an option, medications are the next step. Somatostatin analogs like octreotide and lanreotide reduce growth hormone release and shrink tumors for many patients. These drugs are given by injection, usually monthly, and can improve symptoms such as headaches and sweating. Dopamine agonists such as cabergoline work for some people, especially those with mild hormone elevations. For patients who need direct blockade of growth hormone action, pegvisomant, a growth hormone receptor antagonist, can normalize IGF‑1 levels even when other drugs fail.

Radiotherapy is another tool when surgery and drugs don’t fully control the disease. Modern radiotherapy techniques, including stereotactic radiosurgery, deliver focused doses to the pituitary tumor. Radiotherapy can take years to lower hormone levels and may cause pituitary hormone deficits that require lifelong replacement. Doctors balance the long-term benefits against the slower response and risks.

What to expect and how to monitor

Treatment usually means ongoing follow up. Doctors track IGF‑1 and GH levels to judge response, plus MRI scans to check tumor size. Symptoms like joint pain, sleep apnea, and enlarged hands or feet may improve more slowly than lab numbers. Side effects vary by therapy: injections can cause gallstones and glucose intolerance; pegvisomant may affect liver enzymes; radiotherapy can lower other pituitary hormones. Ask your team about monitoring schedules and dose adjustments.

Living with treatment takes small, practical steps. Control blood pressure, manage sleep apnea, stay active, and get regular dental and joint care. Mental health support can be valuable—acromegaly affects appearance and energy, and counseling or support groups often help. If you’re planning pregnancy, tell your specialist; treatment choices may change.

Quick checklist for your visit: bring a list of symptoms, prior test results, and current medications. Ask whether surgery is feasible, what drug options match your situation, and how quickly they expect labs to improve. Knowing the likely timeline makes decision making easier.

If results are unclear, don’t hesitate to seek a pituitary specialist or an endocrinologist at a tertiary center. Getting imaging reviews and hormone tests rechecked often clarifies the best path and reduces delays. Also ask about trials.

Acromegaly is a chronic condition but many people achieve good control. With the right mix of surgery, medication, and monitoring, you can limit complications and feel better day to day.