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Cushing's Disease
Treatment

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.

Related Information

UCSF Clinics & Centers

Endocrinology

Endocrinology Clinic at Mount Zion
2200 Post St., Suite C-432
San Francisco, CA 94115
Phone: (415) 885–7574
Fax: (415) 885–7724
Appointment information

Endocrinology Clinic at Parnassus
400 Parnassus Ave., Suite A-550
San Francisco, CA 94143
Phone: (415) 353–2350
Fax: (415) 353–2337
Appointment information

Pituitary Disorders Center
400 Parnassus Ave., Eighth Floor
San Francisco, CA 94143
Phone: (866) 559-5543
or (415) 353-7500
Fax: (415) 353-2889
Appointment information