How is Cushings treated?
Treatment depends on the specific reason for cortisol excess and may include surgery, radiation, chemotherapy or the use of cortisol-inhibiting drugs. If the cause is long-term use of glucocorticoid hormones to treat another disorder, the doctor will gradually reduce the dosage to the lowest dose adequate for control of that disorder. Once control is established, the daily dose of glucocorticoid hormones may be doubled and given on alternate days to lessen side effects. Pituitary Adenomas Several therapies are available to treat the ACTH-secreting pituitary adenomas of Cushing’s disease. The most widely used treatment is surgical removal of the tumor, known as transsphenoidal adenomectomy. Using a special microscope and very fine instruments, the surgeon approaches the pituitary gland through a nostril or an opening made below the upper lip. Because this is an extremely delicate procedure, patients are often referred to centers specializing in this type of surgery. The success, or cure
If your Cushing’s is caused by a Pituitary tumour (Cushing’s disease), you will usually need an operation. It is carried out under a general anaesthetic and involves making a small cut – either in front of the upper teeth behind the upper lip or inside the nose. This is called Transsphenoidal surgery. By going behind the nose in this way, the surgeon can see your pituitary gland without having to operate on the main part of your head. Sometimes the back of the nose needs patching with tissue taken from under the skin of the thigh or abdomen during the operation which will leave a small scar there. (See our leaflet Pituitary Surgery.) Most people are up and about and eating normally the following day and are back home within a few days. Recovery times vary. Depending on your particular job and circumstances, you should plan for four to six weeks, maybe longer, away from work. You will need to avoid blowing your nose for three weeks or more while it heals and your front teeth may feel a
