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The two- to three-fold increased mortality associated with active acromegaly can be significantly decreased and even normalised with effective treatment to reduce growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels to within normal limits. This article addresses the advances in surgical techniques, new approaches in radiotherapy and the choice of medical treatments that make it possible to achieve biochemical remission and improve signs and symptoms of disease in almost every patient with acromegaly. The literature is reviewed with regard to the relative merits of each treatment method, recent controversies such as the role of radiotherapy and primary octreotide therapy are discussed and a treatment algorithm is proposed to provide a guide to management.

Advances in Our Understanding of Acromegaly – Is There an Optimal Management Regimen?