For patients with persistent GH and IGF-1 elevations 3 months or more after surgery, octreotide or lanreotide treatments are generally indicated.
Octreotide (given three times a day by injection or by one monthly injection), or lanreotide (deep subcutaneous injections every 4 weeks) achieve long-term suppression of GH in about 70% of patients.
Lanreotide and octreotide also cause tumor shrinkage in 30-50% of patients, and improve soft tissue swelling, headache, joint pains and sleep apnea.
Preoperative use of octreotide and lanreotide may facilitate tumor removal and lessen risks of general anesthesia.
Side effects may include loose stools, malabsorption, cholelithiasis (gall stones), and local pain at the injection site. Pegvisomant, a GH receptor antagonist, is also effective in lowering IGF-1 levels although it does cause an elevation in GH levels.
In patients who have GH-secreting adenomas that also co-secrete prolactin, the dopamine agonists cabergoline or bromocriptine can be combined to help normalize GH and prolactin levels and halt tumor growth.
Where invasive GH-secreting tumors cannot be completely removed by surgery, we have highly experienced endocrinologists as well as clinical studies for patients with persistent acromegaly.