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It must be remembered that following and during the delivery of definitive therapy for Acromegaly (medical, surgical or radiotherapy), it may well be necessary to replace certain hormone deficiencies that have resulted from either tumor destruction of normal pituitary tissue, or as a consequence of surgery or radiotherapy or both. Evaluation of biochemical status following either surgical or medical therapy is performed at 6-12 weeks. IGF-1 normalization may lag GH improvement by several months. All patients with Acromegaly require life-long follow up:
An MRI should be performed between 6-9 months following surgery and following stabilization/normalization of GH/IGF-1 values on medical therapy. Subsequent MRI's should be done at least once a year or as necessary. Colonoscopies should be performed every 3-5 years or more frequently depending on perceived risk for colon polyps (e.g. family history, previous polyp resection). |