If you are surprised that the ring you have been wearing for years is gradually squeezing your finger, your shoe size is getting bigger, your watch is narrow on your wrist, beware! If this picture is accompanied by joint pain, excessive sweating, roughness in the facial features, numbness and weakness in the hands, the success of treatment is quite high and you may be facing a rare disease known as acromegaly.
Acromegaly is a disease that manifests itself with growth in the hands and feet and coarsening of the facial features due to the presence of excessive amounts of growth hormone in the body. It is seen in 3 to 14 out of every 100 thousand people in the world, but its incidence in our country is not yet known for sure.
“The cause of acromegaly, which can very rarely be genetically inherited, is mostly a benign tumor that comes out of the growth hormone-secreting cells of the pituitary gland and is not cancerous. Excessive amounts of growth hormone secreted from this tumor can lead to diabetes, high blood pressure, heart failure, sleep-apnea syndrome, joint pain, numbness and weakness in the hands, polyps in the large intestine, thyroid tumor and much rarer tumor formations.”
The earliest symptom of acromegaly: Growth in the hands and feet
Acromegaly has many symptoms. One of the earliest symptoms is “growth in the hands and feet due to soft tissue increase”. Other symptoms are listed as coarsening in the facial features such as the forward prominence of the eyebrow arches, the protrusion of the lower jaw, the opening of the tooth intervals, fullness in the lips, growth in the nose and tongue, numbness and weakness in the hands, thickening and increase in oiliness in the skin, excessive sweating, milk coming from the chest and joint pain. If the tumor grows and puts pressure on the surrounding tissues, it causes headaches; If it puts pressure on the visual nerve (optic chiasma), it can also cause a decrease in vision. If the tumor grows too large and presses on the intact cells of the pituitary gland that secrete other hormones, it can lead to fatigue and weakness, infertility, menstrual irregularity, decrease in sexual power in men and reluctance due to hormone deficiencies.
Easily observable growth symptoms are reflected in the patient’s daily life. For example, the patient’s ring size and shoe size are gradually growing, the watch he has been using for years squeezes his arm, his helmet starts to feel narrow on his head, the dental prosthesis is frequently changed because he squeezes it, snoring and nasal congestion continue despite surgery. Apart from these symptoms, endocrinologists explain how patients decide to apply to them: “The patient can notice this problem when an acquaintance he has not seen for a long time tells him that he has changed a lot and has become bigger. In this case, comparing the patient’s new and 7-8 years ago photos can help. Sometimes he hears about it from an acromegaly patient he meets by chance and thinks that he has this disease himself. Or he may learn that there are people in his family who have become larger and undergone brain surgery like him.”
Acromegaly is easily diagnosed
In acromegaly, which is more common between the ages of 30 and 50, the clinical findings vary from patient to patient and the disease may not be noticed for years because it develops very slowly. However, if there are typical findings, the diagnosis can be easily made by the endocrinologist. After the examination, some more hormonal tests, especially the growth hormone level, are performed and pituitary MRI method is used to visualize the tumor.
Quality of life improves with treatment
The quality of life of acromegaly patients, whose treatment process is mostly successful, increases and their life expectancy returns to normal as in healthy individuals. The first step in the treatment is to remove the tumor found by an experienced neurosurgeon in pituitary surgeries by entering through the nose. Stating that the success of the surgery depends on the size of the tumor and the experience of the neurosurgeon, Endocrinology and Metabolic Diseases Specialists said, “Generally, the removal of small tumors is more successful than large ones. In large tumors, surgery is very effective in relieving headaches and eliminating visual impairments. However, in very large tumors that cannot be completely removed, additional treatments such as postoperative medication or radiation may be required.”
Most of the time, the patient feels thinning of the face and crumbling of his hands and feet due to soft tissue regression in the first few days after surgery. The treatment aims to prevent the activity of the disease by providing hormonal control and thus cure other concomitant diseases. The most appropriate treatment method for the patient is decided by the experienced endocrinologist.
A person with acromegaly can have a healthy pregnancy
One of the questions that acromegaly patients wonder is whether pregnancy is possible. Experts say the following about this:
“As long as the tumor does not prevent the release of hormones from the cells that secrete reproductive hormone, the patient can have children. There are also patients who have children after surgery. However, surgery or radiation treatments can reduce the chances of having children. Although there are changes in the level of growth hormone during pregnancy, a normal pregnancy and a healthy birth usually occur.” It is recommended that the patient who has a pregnancy plan discuss this situation with his / her physician before treatment.