Endocrine News Podcast · Endocrine Society

ENP94: Update on Acromegaly

November 13, 2024·34 min·10 clips

Acromegaly is the focus. The episode opens with the practical questions that usually come first in clinic: what the disorder is, what usually causes it, and why its true prevalence is still not well defined. Dr. Maria Flescheriou answers directly. She explains that most cases, about 98%, come from a pituitary tumor secreting growth hormone and notes that studies in the United States have not yet established incidence or prevalence. Diagnosis stays central. The discussion keeps returning to delayed recognition, because larger tumors and more severe comorbidity make treatment harder to stage. Treatment is layered. Surgery, medication, and radiation each have a role, and the episode treats them as part of a sequence rather than separate silos. Radiation is not simple. It may help achieve remission, but it can also create hypopituitarism, which means some patients later need replacement for steroids, thyroid hormone, or gonadotropins. That tradeoff matters. The episode spends real time on the burden of long-term care, especially when therapy continues after the initial operation. Some patients need medical therapy before surgery. That can be necessary when swelling and other comorbidities make anesthesia difficult or when the tumor is large enough that immediate surgery is not the safest first step. Aggressive disease changes the plan. When the tumor keeps growing or when the case is not controlled after surgery, the discussion returns to medication and then, if needed, radiation. Newer therapies are part of the picture. Monthly injections are mentioned as an available option in the U.S., but the episode does not treat them as a simple fix because long-term management still requires follow-up and adjustment. The evidence is still incomplete. The episode notes that current data do not clearly show the cardiovascular benefit clinicians want, and it does not yet point to improved biochemical remission after surgery.

As heard by us

A careful clinical look at diagnosis, treatment burden, and the limits of current acromegaly care.

The episode treats acromegaly as a real, messy clinical problem rather than a neat diagnosis. It moves from the tumor source of disease to recognition, prevalence, older treatment paths, and newer options, while leaving room for the fact that clinicians still do not have…

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Why you'd press play

You want a clear map of acromegaly: how it is recognized, treated, and where the evidence is still thin.

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