Treatment for Cushing's syndrome depends on the specific reason for cortisol excess and may include surgery, radiation, chemotherapy or the use of cortisol-inhibiting drugs.
- Surgery: Surgery typically involves transsphenoidal removal of the adenoma. It is one of the primary treatment method used to achieve a long-term cure of Cushing's syndrome.
- Medical Therapy: In patients who fail to recover after surgery, there are several medications available to help control cortisol levels. These include adrenal-directed medications such as ketoconazole, aminoglutethemide and metyrapone, which all help to inhibit cortisol production in the adrenal glands. All are relatively effective but each has side effects and they only work to correct the hormonal problem, not the cause of Cushing's syndrome.
- Radiotherapy: When Cushing's syndrome is not controlled with surgery, conventional external beam or stereotactic radiosurgery are effective in controlling cortisol levels and tumor growth in many patients. However, it generally takes significantly longer to lower cortisol levels with external beam radiotherapy as compared to stereotactic radiotherapy. Also, external beam radiation reliably causes loss of normal pituitary function five to 10 years after treatment. Neurologic complications such as vision loss, weakness and memory impairment rarely have been reported with both external beam and stereotactic radiotherapy.
Reviewed by health care specialists at UCSF Medical Center.