Treatments for Cushing's syndrome
Treatments for Cushing's syndrome
The list of treatments mentioned in various sources
for Cushing's syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Tumor treatments - various treatments aim at treating the underlying tumor causing the disease:
- Cortisol-inhibiting drugs - these may be used with tumor treatment, or sometines alone.
- Adrenal gland removal - for some of the rarer familial forms of Cushing's
- Anti-hypertension medications
- Calcium supplements - for associated osteoporosis
Cushing's syndrome: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Cushing's syndrome may include:
Hidden causes of Cushing's syndrome may be incorrectly diagnosed:
Cushing's syndrome: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Cushing's syndrome:
Drugs and Medications used to treat Cushing's syndrome:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Cushing's syndrome include:
Unlabeled Drugs and Medications to treat Cushing's syndrome:
Unlabelled alternative drug treatments for Cushing's syndrome include:
Latest treatments for Cushing's syndrome:
The following are some of the latest treatments for Cushing's syndrome:
Hospital statistics for Cushing's syndrome:
These medical statistics relate to hospitals, hospitalization and Cushing's syndrome:
- 0.008% (1,067) of hospital consultant episodes were for cushing’s syndrome in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 94% of hospital consultant episodes for cushing’s syndrome required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 24% of hospital consultant episodes for cushing’s syndrome were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 66% of hospital consultant episodes for cushing’s syndrome were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Discussion of treatments for Cushing's syndrome:
Cushing's Syndrome: NIDDK (Excerpt)
Treatment depends on the specific reason for
cortisol excess and may include surgery, radiation, chemotherapy or the
use of cortisol-inhibiting drugs. If the cause is long-term use of
glucocorticoid hormones to treat another disorder, the doctor will
gradually reduce the dosage to the lowest dose adequate for control of
that disorder. Once control is established, the daily dose of
glucocorticoid hormones may be doubled and given on alternate days to
lessen side effects.
Pituitary Adenomas
Several therapies are available to treat
the ACTH-secreting pituitary adenomas of Cushing's disease. The most
widely used treatment is surgical removal of the tumor, known as
transsphenoidal adenomectomy. Using a special microscope and very fine
instruments, the surgeon approaches the pituitary gland through a nostril
or an opening made below the upper lip. Because this is an extremely
delicate procedure, patients are often referred to centers specializing in
this type of surgery. The success, or cure, rate of this procedure is over
80 percent when performed by a surgeon with extensive experience. If
surgery fails, or only produces a temporary cure, surgery can be repeated,
often with good results. After curative pituitary surgery, the production
of ACTH drops two levels below normal. This is a natural, but temporary,
drop in ACTH production, and patients are given a synthetic form of
cortisol (such as hydrocortisone or prednisone). Most patients can stop
this replacement therapy in less than a year.
For patients in whom transsphenoidal surgery has failed or who are not
suitable candidates for surgery, radiotherapy is another possible
treatment. Radiation to the pituitary gland is given over a 6-week period,
with improvement occurring in 40 to 50 percent of adults and up to 80
percent of children. It may take several months or years before patients
feel better from radiation treatment alone. However, the combination of
radiation and the drug mitotane (Lysodren®) can help speed recovery.
Mitotane suppresses cortisol production and lowers plasma and urine
hormone levels. Treatment with mitotane alone can be successful in 30 to
40 percent of patients. Other drugs used alone or in combination to
control the production of excess cortisol are aminoglutethimide,
metyrapone, trilostane and ketoconazole. Each has its own side effects
that doctors consider when prescribing therapy for individual patients.
Ectopic ACTH Syndrome
To cure the overproduction of cortisol
caused by ectopic ACTH syndrome, it is necessary to eliminate all of the
cancerous tissue that is secreting ACTH. The choice of cancer
treatment--surgery, radiotherapy, chemotherapy, immunotherapy, or a
combination of these treatments--depends on the type of cancer and how far
it has spread. Since ACTH-secreting tumors (for example, small cell lung
cancer) may be very small or widespread at the time of diagnosis,
cortisol-inhibiting drugs, like mitotane, are an important part of
treatment. In some cases, if pituitary surgery is not successful, surgical
removal of the adrenal glands (bilateral adrenalectomy) may take the place
of drug therapy.
Adrenal Tumors
Surgery is the mainstay of treatment for
benign as well as cancerous tumors of the adrenal glands. In Primary
Pigmented Micronodular Adrenal Disease and the familial Carney's complex,
surgical removal of the adrenal glands is required.
(Source: excerpt from Cushing's Syndrome: NIDDK)
NINDS Cushing's Syndrome Information Page: NINDS (Excerpt)
Treatment of Cushing's syndrome depends on the cause of
the overproduction of cortisol. If the cause is long-term use of a
medication being used to treat another disorder, the physician may reduce
the dosage until symptoms are under control. Surgery or radiotherapy may
be used to treat pituitary adenomas. Surgery, radiotherapy, chemotherapy,
immunotherapy, or a combination of these may be used to treat ectopic ACTH
syndrome. The aim of treatment is to cure the hypercortisolism and to
eliminate any tumor that threatens the individual's health, while
minimizing the chance of endocrine deficiency or long-term dependence on
medications.
(Source: excerpt from NINDS Cushing's Syndrome Information Page: NINDS)
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Book Excerpts: Treatment of Cushing's syndrome
Treatments of Cushing's syndrome: Online Medical Books
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Adrenal crisis:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Replacement of corticosteroids, I.V. fluids, potassium, insulin
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cushing's syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment to restore hormone balance and reverse Cushing’s syndrome may necessitate radiation, drug therapy, or surgery. For example, pituitary-dependent Cushing’s syndrome with adrenal hyperplasia and severe cushingoid symptoms (such as psychosis, poorly controlled diabetes mellitus, osteoporosis, and severe pathologic fractures) may require partial or complete hypophysectomy or pituitary irradiation. If the patient fails to respond, bilateral adrenalectomy may be performed. Nonendocrine corticotropin-producing tumors require excision of the tumor, followed by drug therapy (for example, with mitotane, metyrapone, or aminoglutethimide) to decrease cortisol levels if symptoms persist.
Aminoglutethimide and ketoconazole decrease cortisol levels and have been beneficial for many cushingoid patients. Aminoglutethimide alone, or in combination with metyrapone, may also be useful in metastatic adrenal carcinoma.
Before surgery, the patient with cushingoid symptoms should have special management to control hypertension, edema, diabetes, and cardiovascular manifestations and to prevent infection. Glucocorticoid administration on the morning of surgery can help prevent acute adrenal hypofunction during surgery.
Cortisol therapy is essential during and after surgery, to help the patient tolerate the physiologic stress imposed by removal of the pituitary or adrenals. If normal cortisol production resumes, steroid therapy may be gradually tapered and eventually discontinued. However, bilateral adrenalectomy or total hypophysectomy mandates lifelong steroid replacement therapy to correct hormonal deficiencies.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cushing's syndrome:
Treatment
(Handbook of Diseases)
Primary treatment is transphenoidal hypophysectomy radiation and drug therapy, are secondary treatments used to restore hormone balance and reverse Cushing’s syndrome. For example, pituitary-dependent Cushing’s syndrome with adrenal hyperplasia and severe cushingoid symptoms — such as psychosis, poorly controlled diabetes mellitus, osteoporosis, and severe pathologic fractures — may require adenectomy or pituitary irradiation. If the patient fails to respond, bilateral adrenalectomy may be performed.
Nonendocrine corticotropin-producing tumors require excision of the tumor. Drug therapy follows (for example, with mitotane, metyrapone, or aminoglutethimide) to decrease cortisol levels if symptoms persist.
Aminoglutethimide and ketoconazole decrease cortisol levels and have been beneficial for many cushingoid patients. Aminoglutethimide alone or in combination with metyrapone may also be useful in metastatic adrenal carcinoma.
Before surgery, the patient with cushingoid symptoms should have special management to control hypertension, edema, diabetes, and cardiovascular manifestations and to prevent infection. Glucocorticoid administration on the morning of surgery can help prevent acute adrenal insufficiency during surgery.
Cortisol therapy is essential during and after surgery to help the patient tolerate the physiologic stress imposed by removal of the pituitary or adrenals. If normal cortisol production resumes, steroid therapy may be gradually tapered and eventually discontinued. However, bilateral adrenalectomy or total hypophysectomy mandates lifelong steroid replacement therapy to correct hormonal deficiencies. (See Dealing with lifelong treatment.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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