Materiały źródłowe

• #1 Acromegaly Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/acromegaly/

  Acromegaly Nursing Care Plan Management […] Primary Nursing Diagnosis […] Body image disturbance related to anxiety over thickened skin and enlargement of face, hands, and feet […] OUTCOMES. Self-esteem; Body image; Anxiety control […] INTERVENTIONS. Body image enhancement; Coping enhancement; Emotional support; Self-esteem enhancement; Support group; Anxiety reduction […] Nursing Management […] PREOPERATIVE. At the time of diagnosis, the patient requires education and emotional support. Focus education on the cause of the disease, the prescribed medical regimen, and preparation for surgery. Encourage the patient to interact with family and significant others. Reassure the patient that treatment reverses some of the physical deformities. If you note disabling behavior, refer the patient to psychiatric resources.

• #2 Acromegaly Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/acromegaly-nursing-diagnosis/

  Acromegaly is a rare endocrine disorder characterized by excessive growth hormone (GH) production, typically caused by a pituitary adenoma. This nursing diagnosis focuses on identifying and managing symptoms, preventing complications, and improving the quality of life for patients with acromegaly. […] Acromegaly presents with distinctive signs and symptoms that nurses must recognize for proper diagnosis and treatment. […] The following outcomes indicate successful management of acromegaly: The patient will demonstrate improved symptom control, The patient will maintain normal blood glucose levels, The patient will show reduced complications, The patient will report an improved quality of life, The patient will demonstrate an understanding of the medication regimen, The patient will maintain cardiovascular stability, The patient will exhibit proper self-care management.

• #3 Acromegaly Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/acromegaly/

  Nursing Diagnosis for Acromegaly […] Disturbed body image related to : enlargement of body parts as manifested by enlarged hands, feet and jaw. […] Ineffective coping related to : change in appearance as manifested by verbalization of negative feeling about the change in appearance. […] Disturbed sensory perception related to : enlarged pituitary gland as manifested by protrusion of eye balls. […] Disturbed sleeping pattern related to : soft tissue swelling as manifested by verbalization of the patient about insomnia. […] Fluid volume deficit related to : polyuria as manifested by excessive thirst of the patient. […] Anxiety related to : change in appearance and treatment as manifested by verbalization of the patient about body appearance. […] Knowledge deficit regarding development of disease and treatment as manifested by repeated questions by the patient regarding disease and treatment.

• #4 Acromegaly Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/acromegaly-nursing-diagnosis/

  Nursing Diagnosis Statement: Imbalanced Growth Pattern related to excessive growth hormone production as evidenced by enlarged extremities and facial features. […] Nursing Diagnosis Statement: Risk for Decreased Cardiac Output related to cardiovascular complications of acromegaly. […] Nursing Diagnosis Statement: Disturbed Sleep Pattern related to sleep apnea and physical discomfort as evidenced by daytime fatigue and reported poor sleep quality. […] Nursing Diagnosis Statement: Chronic Pain related to joint involvement and tissue overgrowth as evidenced by reported joint pain and decreased mobility. […] Nursing Diagnosis Statement: Deficient Knowledge related to complex treatment regimen as evidenced by questions about disease process and management.

• #5 Acromegaly & Gingatism (Hyperpituitarism) – Nurses Revision

  https://nursesrevisionuganda.com/acromegaly-gingatism-hyperpituitarism/

  Nursing interventions for acromegaly/gigantism: […] Patient Education: Educate the patient about acromegaly, its causes, treatments, and potential complications. […] Symptom Management: Help patients manage symptoms like headaches, joint pain, sleep apnea, and fatigue. […] Medication Administration: Administer medications as prescribed and monitor for side effects. […] Monitoring for Complications: Observe signs and symptoms of complications like cardiovascular disease, diabetes, and vision problems. […] Support and Emotional Care: Provide emotional support and guidance to patients and their families as they adjust to the diagnosis and treatment. […] Regular Monitoring: Includes regular IGF-1 and GH level monitoring, as well as monitoring for complications. […] Lifestyle Modifications: Weight management, exercise, and a healthy diet are important for improving overall health and managing complications.

• #6 Acromegaly Nursing Management and Interventions – Nurseslabs

  https://nurseslabs.com/acromegaly-nursing-management-2/

  Disturbed body image related to anxiety over thickened skin and enlargement of face, hands, and feet […] Ineffective coping […] Reduce production of GH to normal levels […] Stop and reverse the symptoms caused by over-secretion of GH […] Correct other endocrine abnormalities (thyroid, adrenal, sex organs) […] Reduce the tumor size […] Surgical removal of the pituitary tumor, or other tumor, that is believed to be causing acromegaly may be done. In most cases, this is the preferred treatment […] Drugs may be given to reduce the level of GH secretion from the pituitary gland. These include: Cabergoline (Dostinex) given orally […] Pegvisomant given by injections for patients not responding to other forms of treatment […] Medications must often be combined with other therapies to treat larger tumors affecting surrounding structures.

• #7 Gigantism and Acromegaly Treatment & Management: Approach Considerations, Pharmacologic Therapy, Transsphenoidal Surgery

  https://emedicine.medscape.com/article/925446-treatment

  Medical therapy should be administered only to patients with persistent postoperative disease. […] The guidelines also address the management of women with acromegaly who are pregnant or trying to conceive. […] Patients should be evaluated for any damage caused by the pituitary tumor and for the development of hypopituitarism. […] The goals of medical therapy for GH excess are as follows: Remove or shrink the pituitary mass, Restore GH secretory patterns to normal, Restore serum total IGF-I and IGF binding protein 3 (IGFBP-3) levels to normal, Retain normal pituitary secretion of other hormones, Prevent recurrence of disease. […] Somatostatin and dopamine analogues and GH-receptor antagonists are the mainstays of medical treatment for GH excess and are generally used when primary surgery fails to induce complete remission.

• #8 Acromegaly (Growth Hormone–Secreting Pituitary Adenomas) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/pituitary-tumors/pituitary-adenomas/growth-hormone-producing-tumors

  Acromegaly (called gigantism in children) is a rare condition in which the whole body or parts of the body, particularly the hands and feet, grow larger than normal. More than 95 percent of all cases of acromegaly are the result of a growth hormonesecreting pituitary adenoma. […] The primary treatment for acromegaly caused by a pituitary adenoma is surgery to remove the tumor. […] Its important to see your doctor regularly for medical checkups to prevent, detect, and treat any complications resulting from acromegaly. At Memorial Sloan Kettering, we provide long-term follow-up care for our acromegaly patients. […] Our Counseling Center offers both individual and group counseling sessions to help you and your family cope with acromegaly. These sessions can be a healthy, productive way to work through the stress and anxiety that are sometimes a part of treatment and recovery. […] Our Integrative Medicine Service can be a valuable part of your formal treatment plan. Programs we offer include massage, acupuncture, hypnotherapy, meditation, visualization, music therapy, and nutritional counseling.

• #9 Holistic nursing care in acromegaly: A case report | ECE2024 | 26th European Congress of Endocrinology | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0099/ea0099p430

  Holistic nursing care in acromegaly: A case report […] This nursing case report aims to describe the comprehensive care provided to a 64-year-old male diagnosed with acromegaly and other chronical health care problems, emphasizing the collaborative approach among healthcare professionals to address the unique challenges associated with health conditions. […] The nursing care focused on symptom management, psychoeducation, and emotional support. […] The nursing interventions encompassed monitoring and managing the patients physical symptoms, such as pain and discomfort related to acral enlargement, as well as addressing psychosocial aspects such as body image concerns and emotional well-being. […] This case report illustrates the pivotal role of nursing care in the holistic management of acromegaly. By providing patient-centered care that addresses both physical and emotional aspects, nurses contribute significantly to enhancing the overall well-being and quality of life for individuals with acromegaly. The collaborative effort among healthcare professionals is essential in ensuring comprehensive and effective care for patients with this rare endocrine disorder.

• #10 Acromegaly Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/acromegaly/

  Nursing Diagnosis: Disturbed Body Image related to the disease at the stage of development. […] Goal: Within 2-3 weeks the client will have returned positive body image. […] Nursing Interventions […] Encourage clients to want to express their thoughts and feelings about body appearance changes. […] Rationale: Information from the client can determine the location of the discomfort as well as to determine the next action. […] Help clients identify the strengths and positive aspects that can be developed by the client. […] Rationale: Positive Aspects of the client is able to foster confidence in the client. […] Collaboration of drugs. […] Rationale: Given the client with acromegaly, to reduce the size of the tumor. […] Observation of the side effects of drug delivery. […] Rationale: Orthostatic hypotension, gastric irritation, nausea, abdominal cramps, and constipation.

• #11 Acromegaly Community

  https://acromegalycommunity.org/

  OUR MISSION is to provide an emotional and communal support network for people touched by Acromegaly. […] Acromegaly can affect your body in many ways. You may feel tired, sweat a lot, or have changes to your hands and jaw. Acromegaly can also affect your heart, eyes, and even your mental health. These effects can change over time, even if you have had surgery or are taking medicine to control your acromegaly. […] Together with Acromegaly provides valuable tools for patients and caregivers to learn how to discuss treatment decisions and lifestyle changes with your doctors. The more questions you ask your doctor, the better off you’ll be at managing your disorder and making progress. […] Whether you are looking for physicians, prescription details, patient assistance with medication, travel or mental health or seeking support in organizing your appointments, diagnosis details or community support, we can help.

• #12 Acromegaly Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/acromegaly/

  Prepare the patient and family for surgery. Explain the preoperative diagnostic tests and examinations. For a patient who is undergoing a transsphenoidal hypophysectomy or a transfrontal craniotomy, explain the postoperative need for nasal packing and a mustache dressing. […] POSTOPERATIVE. Elevate the patients head to facilitate breathing and fluid drainage. Do not encourage the patient to cough, as this interferes with the healing of the operative site. Provide frequent mouth care, and keep the skin dry. To promote maximum joint mobility, perform or assist with range-of-motion exercises. Encourage the patient to ambulate within 1 to 2 days of the surgery. To assure healing of the incision site, explain the need to avoid activities that increase intracranial pressure, such as toothbrushing, coughing, sneezing, nose blowing, and bending.

• #13 Gigantism and Acromegaly Treatment & Management: Approach Considerations, Pharmacologic Therapy, Transsphenoidal Surgery

  https://emedicine.medscape.com/article/925446-treatment

  Dopamine-receptor agonists are generally used as adjuvant medical treatments for GH excess, and their effectiveness may be added to that of octreotide. […] Key adjuvant medical therapy recommendations for acromegaly from the Endocrine Society include: Patient with significant disease should receive either a somatostatin-receptor ligand (SRL) or pegvisomant as the initial adjuvant medical therapy. […] Patients who cannot be cured by surgery, have extensive cavernous sinus invasion, do not have chiasmal compression, or are poor surgical candidates should receive SRL as primary therapy. […] In general, radiation therapy is recommended if GH hypersecretion is not normalized with surgery. […] Recommendations from Endocrine Society guidelines for the use of radiation therapy in acromegaly include: Radiation therapy in the setting of residual tumor mass following surgery, and if medical therapy is unavailable, unsuccessful, or not tolerated.

• #14 Acromegaly Nursing Care Plan & Management ~ Nursing Path

  https://www.nursingpath.in/2017/01/acromegaly-nursing-care-plan-management.html

  POSTOPERATIVE. Elevate the patients head to facilitate breathing and fluid drainage. Do not encourage the patient to cough, as this interferes with the healing of the operative site. Provide frequent mouth care, and keep the skin dry. To promote maximum joint mobility, perform or assist with range-of-motion exercises. Encourage the patient to ambulate within 1 to 2 days of the surgery. To assure healing of the incision site, explain the need to avoid activities that increase intracranial pressure, such as toothbrushing, coughing, sneezing, nose blowing, and bending. […] Documentation Guidelines […] Physical findings: Respiratory rate and pattern; nasal drainage: color, amount, and presence of glucose […] Neurological status: Level of consciousness, motor strength, sensation, and vision

• #15 Acromegaly Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/acromegaly-nursing-diagnosis/

  Monitor Growth Hormone Levels: Check IGF-1 levels, Monitor growth hormone suppression test results, Track treatment response, Document medication compliance. […] Assess Cardiovascular Status: Monitor blood pressure, Check heart rate and rhythm, Assess for heart failure signs, Document ECG changes, Track exercise tolerance. […] Evaluate Metabolic Status: Monitor blood glucose levels, Check thyroid function, Assess for diabetes symptoms, Track weight changes, Monitor nutrition status. […] Check for Complications: Assess visual fields, Monitor for sleep apnea, Evaluate joint function, Check for carpal tunnel syndrome, Screen for colon polyps. […] Review Psychological Status: Assess coping mechanisms, Monitor for depression, Evaluate body image concerns, Check social support system, Document quality of life changes.

• #16 Patient education: Acromegaly (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/acromegaly-beyond-the-basics

  Patients with acromegaly need to be monitored over their lifetime to ensure that treatment is optimal and to minimize the risk of disease complications and treatment side effects. […] The blood level of insulin-like growth factor-1 (IGF-1) should be measured to monitor response to treatment. The goal is to keep the IGF-1 level in the normal range for the person’s age and gender. […] If the adenoma was initially larger than 1 cm (0.5 inch), it is important to determine if treatment has decreased its size. This is generally done by magnetic resonance imaging (MRI) of the pituitary area.

• #17 Acromegaly management in the community | Nursing Times

  https://www.nursingtimes.net/archive/acromegaly-management-in-the-community-11-01-2001/

  The nurse adviser’s liaison between the hospital and the community ensured that blood tests were ordered and taken before Mr Jones’ outpatient appointments and reinforced the importance of attending all hospital follow-up appointments. […] Mr Jones is followed up on a three to six monthly basis at the endocrine outpatient clinic. […] Overall he is happy that his acromegaly is now under control.

• #18 Acromegaly

  https://www.nhs.uk/conditions/acromegaly/

  Acromegaly may take time to be diagnosed. […] Treatments for acromegaly can include: surgery to remove the tumour, radiotherapy to target the tumour and reduce growth hormone levels, injections or tablets to reduce growth hormone levels. […] Treatment usually stops your body producing too much growth hormone and usually improves your symptoms. […] After treatment, you’ll continue to have appointments with a specialist. They can monitor how well your pituitary gland is working and check that your treatment is right for you. […] If you have acromegaly, your care team will pass information on to the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).

• #19 Gigantism and Acromegaly Treatment & Management: Approach Considerations, Pharmacologic Therapy, Transsphenoidal Surgery

  https://emedicine.medscape.com/article/925446-treatment

  Transsphenoidal surgery as the primary therapy in most patients. […] The primary goal of surgery is to normalize GH levels. […] A significant proportion of patients with acromegaly who have undergone surgery have been found to have a change in biochemical status upon long-term follow-up. […] If surgery does not normalize GH secretion, options include pituitary radiation and medical therapy. […] In a majority of cases of acromegaly, multimodal treatment with surgery, medical therapy, and radiotherapy provides biochemical control as defined by Endocrine Society guidelines. […] Patients require long-term monitoring of GH and IGF-I levels for early identification and treatment of recurrent disease. […] Patients should also be evaluated for severe GH deficiency, which may occur in more than half of all patients treated for acromegaly. […] An association exists between acromegaly and regurgitant valvular heart disease. […] Because cardiorespiratory complications are not reversed with biochemical control, patients should be screened periodically for the common cardiovascular and respiratory manifestations of acromegaly.

• #20 Acromegaly Explained

  https://resources.healthgrades.com/right-care/symptoms-and-conditions/acromegaly

  Doctors tailor a treatment plan to ease the specific symptoms present. The goal of any treatment plan is to return growth hormone levels to regular levels. Treatment aims to reduce the pituitary tumor’s size and decrease any symptoms you are experiencing. […] After surgery or radiation removal, your doctor will monitor your symptoms to ensure the increase in growth hormone does not occur. In cases of reoccurrence, doctors usually prescribe one of the following medications: octreotide, lanreotide, pasireotide, pegvisomant, dopamine antagonists. […] Acromegaly may cause other health conditions, including the following: osteoarthritis onset by increased cartilage size, increased insulin production, leading to type 2 diabetes, sleep apnea due to enlarged tongue size, heart disease, arthritis, carpal tunnel syndrome. […] Acromegaly is treatable in most situations. However, without treatment, the condition can lead to complications that may increase the mortality rate.

• #21 The care continuum in acromegaly: how patients, nurses, and physicians can collaborate for successful treatment experiences

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4524590/

  Patients with acromegaly often require pharmacological treatment. Somatostatin analogs (SSAs) such as pasireotide, lanreotide, and octreotide are frequently used as first-line medical therapy. […] Proactively managing patients expectations and providing appropriate, timely guidance are crucial for maximizing adherence, and ultimately, optimizing the treatment experience. […] We have found that involving patients, nurses, and physicians as equal partners in the treatment process optimizes treatment initiation, adherence, and persistence in acromegaly. […] Our approach to diagnosis disclosure involves two key strategies: (1) empathetic listening and (2) provision of educational and emotional resources. […] It is critical to discuss administration options before making a final treatment decision.

• #22 Acromegaly | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/acromegaly

  Acromegaly requires expert care. […] The main goal of treatment is to lower GH and IGF-1 levels to normal. […] Treatment may be surgery, radiation therapy, medication, or a combination of these options. […] If the cause of acromegaly is a pituitary tumor, surgery to remove the tumor is the first treatment. […] Complete removal of some tumors is difficult and other types of therapy are often needed to reach normal GH and IGF-1 levels. […] If your GH level isn’t normal after surgery, or if you aren’t a candidate for surgery, then radiation therapy and medication are also options. […] Radiation therapy can take a long time to bring GH levels down to normal. […] Medication may be needed until the radiation therapy takes effect. […] Drugs are also available to treat acromegaly, but they are not a cure.

• #23 Acromegaly – ThinkGenetic Foundation

  https://thinkgenetic.org/diseases/acromegaly/

  Those with acromegaly will need to be closely followed by an endocrinologist. These are doctors that specialize in hormone levels. Additionally, if surgery is indicated a neurosurgeon (someone who does brain surgery) will need to be consulted. Interventional radiology and radiation oncology are also needed if radiation treatments would be required. In general, a multidisciplinary team between several different areas of medicine. […] Once the diagnosis is confirmed and the location of the tumor is identified, then treatment can begin. Ideally, surgery is recommended to remove the pituitary tumor, if possible. The size and location of the tumor will depend on whether or not it can be removed through surgery. Usually, tumors under 10 millimeters in a good location in the pituitary can be removed. If surgery is not an option or not successful, then medical therapy can be used. This can also be used prior to a surgery to see if they are able to shrink the tumor. There are three different groups of medications that can be used. The first are somatostatin analogs (SSAs). These drugs shut off GH production and are effective in about 50-70% of patients. They also reduce the size of the tumor somewhat in up to 50% of patients. The second group of medications are the GH receptor antagonists (GHRAs). These interfere with the action of the GH. These normalize the IGF-I levels in more than 90% if of patients. The IGF-I becomes elevated in those with acromegaly due to the high GR. It is what is actually causing the enlargement of hands and feet. The third group of medications are dopamine agonist. These are least effective in lowering GH and/or IGF-I levels. Lastly is radiation therapy. This is usually used only when patients are not able to have surgery (or have tumor remaining after surgery) and do not respond to medication. Radiation therapy is given in small doses over a period of 4 to 6 weeks. As the effects of radiation therapy take time, medications are often still used in the interim while the treatment is still ongoing. […] No one treatment is effective for all patients. The options are individualized based upon hormone levels, patient age, tumor size and location.

• #24 Acromegaly Nursing Care Plan & Management ~ Nursing Path

  https://www.nursingpath.in/2017/01/acromegaly-nursing-care-plan-management.html

  Presence of postoperative complications: Diabetes insipidus, hypopituitarism, meningitis […] Psychosocial assessment: Self-esteem, coping, interpersonal relationships, and sexual dysfunction […] Discharge and Home Healthcare Guidelines Referrals […] Refer patients with advanced acromegaly who experience arthritic changes and require assist devices for ambulation and activities of daily living to a physical therapist. […] ACTIVITY RESTRICTIONS. Instruct the patient to avoid activities that increase intracranial pressure for up to 2 months after surgery. Toothbrushing can be resumed in 2 weeks. Instruct the patient to report increased nasal drainage. Incisional numbness and altered olfaction may occur for 4 months after surgery. […] MEDICATIONS. If octreotide is prescribed, the patient will need to be able to demonstrate how to administer a subcutaneous or intramuscular injection. […] FOLLOW-UP. Patients need to be monitored for development of cardiac disease, diabetes mellitus, and gallstones and a recurrence of symptoms. Advise the patient to wear a medical identification bracelet.

• #25 Acromegaly: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.acromegaly-care-instructions.ut2956

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

• #26 Acromegaly | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/acromegaly

  If surgery or radiation does not lower your GH levels, you’ll probably need to continue medications. […] The most effective medications for acromegaly are somatostatin analogs and a GH receptor antagonist. […] Another type of medication (dopamine agonists) works for some but not most patients. […] Some patients may benefit from a combination of these medicines.

• #27 Acromegaly | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acromegaly

  UCSF offers highly specialized, world-class care for pituitary disorders, such as acromegaly. […] The primary treatment for acromegaly is to remove the noncancerous pituitary tumor that is producing the excess growth hormone. […] If the tumor can’t be removed completely because it has grown into surrounding tissues, radiation therapy or medication can normalize growth hormone levels for many patients. […] The principal treatment for acromegaly is transsphenoidal surgery to remove the pituitary tumor. […] If the tumor has spread beyond the pituitary gland, radiation therapy or medication may be part of the treatment. […] Medication is prescribed to normalize growth hormone levels. […] Long-term treatment can result in normal levels of growth hormone and IGF-1 in more than half of patients with the condition. […] A newer drug, called pegvisomant, binds to growth hormone receptors and can normalize IGF-1 levels in 90 percent of patients.

• #28 The care continuum in acromegaly: how patients, nurses, and physicians | PPA

  https://www.dovepress.com/the-care-continuum-in-acromegaly-how-patients-nurses-and-physicians-ca-peer-reviewed-fulltext-article-PPA

  Patients with acromegaly face a variety of difficult challenges. […] We have found that involving patients, nurses, and physicians as equal partners in the treatment process optimizes treatment initiation, adherence, and persistence in acromegaly. […] Our approach to diagnosis disclosure involves two key strategies: (1) empathetic listening and (2) provision of educational and emotional resources. […] It is critical to discuss administration options before making a final treatment decision. […] We have found that if treatment decisions are patient-centric, the treatment is more likely to yield successful results. […] We have found that long-term adherence is maximized when the patient and nurse work together to generate an individualized treatment plan. […] It is critical that the patient can readily distinguish between uncomfortable side effects, adverse effects that should be discussed at the next clinical visit, and serious adverse events that require immediate medical attention.

• #29 Acromegaly management in the community | Nursing Times

  https://www.nursingtimes.net/archive/acromegaly-management-in-the-community-11-01-2001/

  Acromegaly is a disorder marked by progressive enlargement of peripheral parts of the body, especially the head, face, hands and feet. […] The first treatment implemented for his acromegaly was the surgical removal of the pituitary tumour via trans-sphenoidal adenomectomy surgery in March 1994. […] Mr Jones was monitored at six-monthly intervals by the consultant endocrinologist team. […] The consultant endocrinologist referred this patient to the the Pivotal Care Acromegaly Nurse Adviser Service, an independent service sponsored by the manufacturer of lanreotide. […] The acromegaly nurse adviser, experienced in caring for patients with this rare condition, was able to monitor Mr Jones’ condition closely, visiting him every two weeks. […] Regular feedback from the nurse adviser to the consultant and GP ensured that everyone involved in the care and of Mr Jones was kept updated on his progress or on the presentation of any new problems.

• #30 Acromegaly Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/acromegaly

  Acromegaly is a condition of excess growth hormone in adults. Growth hormone (GH) is secreted by the pituitary. In most cases of acromegaly, the overproduction of GH is caused by a benign tumor of the pituitary gland, and treatment most commonly consists of pituitary surgery. […] At the Department of Neurosurgery, our Pituitary Tumor Center helps patients with acromegaly and other pituitary disorders. Our team of nationally and internationally recognized experts includes neurosurgeons, neuroendocrinologists, a radiation oncologist, and a radiologist. Our coordinated approach to pituitary tumor management is unique in the New York metropolitan area. […] In most cases, neurosurgeons access and remove the pituitary tumor via the nasal passageways. The surgeons pass thin, specialized instruments through the nasal passageways to the back of the sinus and make an opening there. The pituitary gland is located just behind the sinus. The surgeons can then remove as much tumor as is safely possible.

• #31 Acromegaly | Allegheny Health Network

  https://www.ahn.org/services/neuroscience/conditions/pituitary-neuroendocrine-care/acromegaly

  Acromegaly is a hormonal condition characterized by excessive bone growth in your feet, hands, and face. […] Our team of neurosurgeons, ophthalmologists, and endocrinologists treats a large number of people with this condition. We work together to find a treatment plan that fits your symptoms and circumstances and maximizes your quality of life. […] At AHN, a team of physicians works together to evaluate and treat patients with acromegaly. […] If you have acromegaly, AHNs physicians will work together to develop a treatment plan that fits your needs. We use the latest technologies and therapies to treat patients. Well follow you over time and adapt your care plan as your symptoms or needs change. […] Acromegaly treatment options may include: […] Medications work in different ways to block or lower levels of growth hormone in the body.

• #32

  https://link.springer.com/article/10.1007/s11102-024-01397-w

  Current standards of care in PTCOEs include use of first-generation SRLs as the first medical option in about 50% of patients, as recommended by consensus guidelines. […] However, some patients are kept on this treatment despite inadequate control suggesting that cost-effectiveness, availability, patient preference, side effects, and therapeutic inertia may play a possible role also in PTCOE. […] Moreover, at odds with consensus guidelines, other monotherapies for acromegaly appear to have a marginal role as compared to combination therapies as extrapolated from PTCOE practice data. […] Presence of uncontrolled patients in each treatment category suggest that further optimization of medical therapy, as well as use of other therapeutic tools such as radiosurgery may be needed. […] In conclusion, current standards of care of acromegaly medical treatment in PTCOEs include octreotide or lanreotide as first-line option in about 50% of patients, consistent with contemporary consensus guidelines.

• #33 The care continuum in acromegaly: how patients, nurses, and physicians can collaborate for successful treatment experiences

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4524590/

  We have found that if treatment decisions are patient-centric, the treatment is more likely to yield successful results. […] We have found that long-term adherence is maximized when the patient and nurse work together to generate an individualized treatment plan. […] Successful, long-term treatment with SSAs requires that the patient, nurse, and physician effectively manage many barriers to optimal adherence and persistence. […] We recommend that the physician, nurse, and patient meet every 6 months to 1 year to discuss the biochemical, clinical, practical, and emotional aspects of SSA treatment. […] By using these communication strategies, the physician, nurse, and patient can work together to identify the treatment plan that will lead to the best possible outcome.

• #34 The care continuum in acromegaly: how patients, nurses, and physicians | PPA

  https://www.dovepress.com/the-care-continuum-in-acromegaly-how-patients-nurses-and-physicians-ca-peer-reviewed-fulltext-article-PPA

  We believe that if problems are identified early, they can be addressed before they become insurmountable barriers to medical therapy. […] By using these communication strategies, the physician, nurse, and patient can work together to identify the treatment plan that will lead to the best possible outcome.

• #35 Acromegaly Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/acromegaly/

  Discharge and Home Healthcare Guidelines Referrals […] Refer patients with advanced acromegaly who experience arthritic changes and require assist devices for ambulation and activities of daily living to a physical therapist. […] ACTIVITY RESTRICTIONS. Instruct the patient to avoid activities that increase intracranial pressure for up to 2 months after surgery. Toothbrushing can be resumed in 2 weeks. Instruct the patient to report increased nasal drainage. Incisional numbness and altered olfaction may occur for 4 months after surgery. […] MEDICATIONS. If octreotide is prescribed, the patient will need to be able to demonstrate how to administer a subcutaneous or intramuscular injection. […] FOLLOW-UP. Patients need to be monitored for development of cardiac disease, diabetes mellitus, and gallstones and a recurrence of symptoms. Advise the patient to wear a medical identification bracelet.

• #36

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2956

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] This condition can change how you look. If you have trouble dealing with these changes, talk to your doctor to find a support group. Talking to other people who are going through the same thing can be helpful. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

• #37 Acromegaly | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/acromegaly

  Acromegaly is caused by an excess of growth hormone. The most obvious signs of acromegaly arise from the overgrowth of bones in the face, hands and feet causing facial disfigurement, large hands and feet. […] Treatment reduces the swelling of the soft tissue in the face, hands and feet but cannot reverse the effects on the bones. Treatment is aimed at removing the pituitary tumour, or reducing its activity. Options may include: […] A person with acromegaly should have regular medical tests to monitor the condition. Tests may include an annual medical check-up and blood tests to measure growth hormone status.

• #38 Living with Acromegaly | Expert Surgeon | Aaron Cohen-Gadol, MD | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/acromegaly/survival/living-with-acromegaly

  Living with acromegaly poses unique challenges. The physical changes caused by excess growth hormone production can have a significant effect on daily life. […] Joint pain and limited mobility resulting from overgrown bones and cartilage can make movement and physical activities difficult. The associated health complications, such as cardiovascular problems and diabetes, further contribute to the challenges faced by people with acromegaly. […] Medications also play a role in managing acromegaly. Somatostatin analogs, including octreotide and lanreotide, are commonly administered through injections given either subcutaneously (beneath the skin) or intramuscularly (into a muscle). These medications help lower a patients growth hormone level. […] Following treatment, not all aspects of acromegaly are reversible. The physical changes caused by bony overgrowth are often permanent even after treatment. This emphasizes the importance of early treatment to limit the long-term impact of this condition. […] Living with acromegaly might require ongoing management, but with appropriate treatment and support, people with this condition can lead a fulfilling life and minimize the effects of the condition on their overall well being.

• #39 Acromegaly – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acromegaly/diagnosis-treatment/drc-20351226

  Diagnosis involves the steps that your healthcare professional takes to find out if you have acromegaly. Your healthcare professional asks about your health history and does a physical exam. You also may need the following tests: […] Acromegaly treatment aims to improve symptoms and treat or prevent complications. The goal is to lower growth hormone and IGF-1 back to their proper levels and keep them there. […] It’s common for some changes in physical features to improve with treatment. For example, swelling of soft tissue often goes down. And the skin often becomes less oily and coarse. But enlarged bones don’t return to the size that they used to be. […] If you also have other health conditions due to acromegaly, you may need other treatments to manage them. […] Your treatment plan depends on factors such as: The location and size of your tumor. How serious your symptoms are. Your age and overall health.

• #40 Patient education: Acromegaly (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/acromegaly-beyond-the-basics

  Patient education: Acromegaly (Beyond the Basics) […] Acromegaly is characterized by overgrowth of body tissues, including broadening and enlargement of facial features and an increase in the size of the hands and feet. […] Acromegaly can lead to serious illness if not treated; however, most patients can be treated successfully. […] Patients with acromegaly are treated to avoid the consequences described above, even if there are no obvious symptoms. The goals of therapy are to lower the level of growth hormone and insulin-like growth factor 1 (IGF-1) in the blood to normal, reduce tumor size, and reverse any effects of the tumor on local brain structures, such as nerves, which are important for visual function. […] If treatment is successful, the soft tissue changes will go away over a period of several months, and the risk of early death returns to normal.

• #41 Acromegaly & Gingatism (Hyperpituitarism) – Nurses Revision

  https://nursesrevisionuganda.com/acromegaly-gingatism-hyperpituitarism/

  Nursing Care Plan for Acromegaly and Gigantism […] The patient will verbalize acceptance of their appearance and demonstrate behaviors to enhance body image. […] The patient will demonstrate effective coping strategies and verbalize reduced distress. […] The patient will report a reduction in tingling and an improvement in sensory perception. […] The patient will report improved sleep quality and reduced nighttime discomfort. […] The patient will maintain adequate hydration, as evidenced by normal skin turgor and urine output. […] The patient will report reduced anxiety and demonstrate relaxation techniques. […] The patient will demonstrate an understanding of their condition and engage in appropriate self-care behaviors.

• #42 Gigantism and Acromegaly Treatment & Management: Approach Considerations, Pharmacologic Therapy, Transsphenoidal Surgery

  https://emedicine.medscape.com/article/925446-treatment

  Most experts define cure, or adequate control, of growth hormone (GH) excess as a glucose-suppressed GH concentration of less than 2 ng/mL, as determined by radioimmunoassay (1 mcg/L by IRMA), and normalization of the serum insulinlike growth factor I (IGF-I) concentration. […] For pituitary adenomas, transsphenoidal surgery is usually considered the first line of treatment, followed by medical therapy for residual disease. […] The cost of providing care for acromegaly may need to be considered. […] Surgery may lower it by avoiding lifelong pharmacologic therapy. […] Guidelines released by the Endocrine Society in 2014 address important clinical issues regarding the evaluation and management of acromegaly. […] Recommendations include the following: For most patients with acromegaly, surgical removal of the pituitary gland tumor should be considered the primary treatment.

• #43 Acromegaly | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/acromegaly.html

  Acromegaly is a hormonal disorder in which the pituitary gland produces too much growth hormone. This disorder causes very gradual abnormal enlargement of bones and tissue — most noticeably in the hands and feet. […] The Stanford Medicine Pituitary Center includes a team of highly-trained nurses who work exclusively with Pituitary patients. […] Comprehensive support services like occupational or physical rehabilitation, nutritional and emotional support to help you with your specific symptoms and the challenges of this experience. […] Surgery for acromegaly is a delicate procedure, which should be performed by highly specialized surgeons at multidisciplinary Pituitary centers. […] Medication or radiation therapy may be recommended after surgery to help normalize levels of growth hormone. […] Radiation therapy for acromegaly is usually reserved for patients who have tumor remaining after surgery. […] Clinical trials evaluate new approaches, devices, or medications in the treatment of acromegaly.

• #44 Acromegaly | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/acromegaly

  Surgery to remove the tumor is often the first step. You also may need medication and radiation therapy. Your care team will work with you to develop a treatment plan that best meets your needs. […] Long-term monitoring is also important. The hormonal imbalance caused by acromegaly can put you at risk for heart problems, colon growths and other conditions. […] Our neurosurgeons remove more than 100 tumors in and around the pituitary gland each year. As a result, we have a high level of skill and experience. […] We often use a minimally invasive technique called transsphenoidal surgery to remove the tumor through the nose. […] We will work with you to find the right medication and dose, and to manage any side effects. […] We are part of the OHSU Brain Institute, a national leader in offering clinical trials to test new treatment approaches. Your care team will talk with you about any trial that is right for you. […] Ask your care team about our acromegaly support group, led by a nurse on our team.

• #45 Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/acromegaly/diagnosis.html

  Acromegaly is a hormonal disorder in which the pituitary gland produces too much growth hormone. […] Comprehensive support services like occupational or physical rehabilitation, nutritional and emotional support to help you with your specific symptoms and the challenges of this experience. […] The Stanford Medicine Pituitary Center includes a team of highly-trained nurses who work exclusively with Pituitary patients. […] Surgery for acromegaly is a delicate procedure, which should be performed by highly specialized surgeons at multidisciplinary Pituitary centers. […] Medication or radiation therapy may be recommended after surgery to help normalize levels of growth hormone. […] Radiation therapy for acromegaly is usually reserved for patients who have tumor remaining after surgery. […] Clinical trials evaluate new approaches, devices, or medications in the treatment of acromegaly.

• #46 Chiesi Global Rare Diseases Receives FDA Approval for FILSUVEZ® (birch triterpenes) topical gel for the Treatment of Epidermolysis Bullosa

  https://chiesirarediseases.com/media/rethink-acromegaly

  Rethink Acromegaly is created by Chiesi and members of the acromegaly community to help people living with the condition, along with their caregivers and families, to make informed healthcare decisions. […] Program includes resources for healthcare professionals to optimize disease management to improve patient outcomes. […] The Rethink Acromegaly campaign provides tailored resources for the community. People living with acromegaly and their caregivers will have access to tools to support them in taking charge of their care and getting help managing their disease. […] Through the program, healthcare professionals will gain valuable insights regarding optimizing patient care through downloadable resources and treatment guidelines. […] Living with acromegaly can be grueling and the milestones along the journey from diagnosis through treatment can greatly impact patients day-to-day lives. Rethink Acromegaly sheds light on a much-needed paradigm shift in the way this disease is managed. Patient care should be viewed holistically, factoring in quality of life, and I hope that the launch of this program supports the patient community as they work with their health care providers to take charge of their care.

• #47 Acromegaly Archives – Pituitary World News

  https://pituitaryworldnews.org/category/acromegaly/

  This captivating conversation analyzes how patients can perceive acromegaly symptoms and quality of life differently than their physicians. […] Importantly, the discussion also identifies the gaps in acromegaly care, exploring whether these are potentially linked to gaps in physician training or other factors. […] Life with acromegaly can be a daunting experience, especially if it’s not diagnosed early and adequately. A whole set of related conditions can take hold, making everyday life a challenge, to say the least. […] When you deal with a chronic pituitary disease, you get close to your medications, just like you would to a friend. This was my experience with acromegaly.

• #48 Chiesi Global Rare Diseases Receives FDA Approval for FILSUVEZ® (birch triterpenes) topical gel for the Treatment of Epidermolysis Bullosa

  https://chiesirarediseases.com/media/rethink-acromegaly

  Serious health conditions associated with the progression of acromegaly include type 2 diabetes, hypertension, respiratory disorders, and cardiac and cerebrovascular disease. For many patients with acromegaly, despite being biochemically controlled with injectable somatostatin receptor ligands (iSRLs), they still experience persistent acromegaly symptoms.

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