usually reserved for patients who have tumor remaining after surgery. These patients often also receive medication to lower GH levels.
How is Acromegaly Treated? Radiation Therapy Radiation therapy is given in divided doses over 4-6 weeks. This treatment lowers GH levels by about 50% over 2 - 5 years. Patients monitored for more than 5 years show significant further improvement. Radiation therapy causes a gradual loss of production of other pituitary hormones with time. Loss of vision and brain injury, which have been reported, are very rare complications of radiation treatments.
How is Acromegaly Treated? Radiation Therapy generally used for patients whose tumors are not completely removed by surgery; for patients who are not good candidates for surgery because of other health problems or patients who do not respond adequately to surgery and medication.
How is Acromegaly Treated? No single treatment is effective for all patients. Treatment should be individualized depending on patient characteristics, such as age and tumor size. If the tumor has not yet invaded surrounding brain tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice.
How is Acromegaly Treated? After surgery, a patient must be monitored for a long time for increasing GH levels. If surgery does not normalize hormone levels or a relapse occurs, a doctor will usually begin additional drug therapy. The first choice should be bromocriptine because it is easy to administer; octreotide is the second alternative. With both drugs, long-term therapy is necessary because their withdrawal can lead to rising GH levels and tumor re-expansion.
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PROLACTIN Mammary growth and Dev’t Lactogenesis Diverse Roles in Vertebrates Role in non pregnant females and males 1928-shown pit extract could stimulate milk production in rabbits Estrogens stimulate PRL directly Hyperprolactinemia and PRL secreting pit tumors are common in women of reproductive age Serum PRL increase at puberty (FSH and LH)
PROLACTIN Effects growth and differentiation of integumental structures Hair and sebaceous glands in mammals Brood patch/feather Devt in birds Evidence to suggest a role in testicular function Hypophosectomy of adult rats causes a loss of testicular LH receptors and loss of testes response to LH PRL needed for LH receptor
PROLACTIN Plasma levels only a bit higher in women Overlap of conc. ranges in sexes Secreted episodically Half life in blood of 15-20 min Night time surge (like GH) Not identical to GH surge
PROLACTIN Found glycosylated in pit. and plasma CHO groups vary among species- this heterogeneity accounts for differences in activity Similar to GH, but different actions Breast feeding women-normal GH Acromegaly only occasionally have gallactorrhea
PROLACTIN All cells express PRL receptors although the anterior pituitary is the major source of prolactin, the hormone is synthesized and secreted in many other tissues .
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- Fall '08
- pituitary tumors