Cushing's Disease Treatment
For patients in whom transsphenoidal surgery has failed or who are not suitable candidates for surgery, radiotherapy is another possible treatment option. Radiation to the pituitary gland is given over a six-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 even years, before patients feel better from radiation treatment alone.
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 include aminoglutethimide, metyrapone, trilostane, and ketoconazole. Each has its own side effects that doctors consider when prescribing it for individual patients.
Because Cushing's disease treatment may damage healthy cells and tissues, side effects can occur. Specific side effects depend on many factors, including the type and extent of the treatment. Side effects may not be the same for each person. Before treatment starts, healthcare providers will explain possible side effects and suggest ways to manage them.
Before starting treatment, patients may want to think about taking part in a clinical trial for Cushing's disease. A clinical trial is a research study meant to help improve current treatments or to obtain information on new treatments for patients with Cushing's disease. When clinical trials show that a new Cushing's disease treatment is better than the standard treatment, the new treatment may become the standard treatment.