These should be regularly withdrawn, each year, to assess the effects of pituitary irradiation on GH secretion. At these times the residual pituitary function should also be assessed.
No treatment currently available satisfies all the requirements of an ideal therapy
Surgery, if successful, rapidly reduces GH levels to normal, but may not eradicate circulating GH and may cause hypopituitarism, particularly with large tumours. Radiotherapy is successful but takes time to act and causes hypopituitarism in a proportion of cases. Medical treatment with octreotide or bromocriptine is only rarely used alone and, although it improves symptoms, it does not always reduce GH levels to normal. Its main use is as an adjunct to ablative treatment of the pituitary tumour. Often, after careful judgement, all three types of treatment may be needed to reduce GH levels to normal.
