Patients with acromegaly may also be at enhanced risk for cancer, and colon cancer is the most prevalent. This risk is particularly increased in men over 40 years with a positive family history of colon cancer and multiple skin tags. Other malignancies, including breast cancer, have been described. Although it seems likely, it is unknown whether successful treatment of acromegaly will reduce the risk of neoplasia. The primary mode of therapy for acromegaly is surgery to reverse the mass effect and attempt biochemical cure.
Surgical cure is dependent on surgical skill and experience as well as the size of the tumor.
Residual disease following transsphenoidal surgery is therefore common, indicating the need for adjuvant therapy. Hypopituitarism is a significant complication of radiation therapy therefore, in most patients, medical management may be necessary in surgically non-cured patients in lieu of or in combination with radiation. Medical management is a highly useful adjuvant therapy for patients with residual disease. Therefore, it may be reasonable to attempt a course of bromocriptine as adjuvant medical therapy but it may have limited value. In addition, large doses are often required and this therapy may be associated with significant side effects.