Radiation

Radiation Options

Radiation Therapy

Radiation therapy is usually reserved for people who have some tumor remaining after surgery and do not respond to medications. Because radiation leads to a slow lowering of GH and IGF-I levels, these patients often also receive medication to lower hormone levels. The full effect of this therapy may not occur for many years.

The two types of radiation delivery are conventional and stereotactic. Conventional radiation delivery targets the tumor with external beams but can damage surrounding tissue. The treatment delivers small doses of radiation multiple times over 4 to 6 weeks, giving normal tissue time to heal between treatments. Stereotactic delivery allows precise targeting of a high-dose beam of radiation at the tumor from varying angles. The patient must wear a rigid head frame to keep the head still. The types of stereotactic radiation delivery currently available are proton beam, linear accelerator (LINAC), and gamma knife. With stereotactic delivery, the tumor must be at least 5 mm from the optic chiasm to prevent radiation damage. This treatment can sometimes be done in a single session, reducing the risk of damage to surrounding tissue.

All forms of radiation therapy cause a gradual decline in production of other pituitary hormones over time, resulting in the need for hormone replacement in most patients. Radiation also can impair a patient's fertility. Vision loss and brain injury are rare complications. Rarely, secondary tumors can develop many years later in areas that were in the path of the radiation beam.

Center for Image-Guided Neurosurgery

Gamma Knife:

http://www.neurosurgery.pitt.edu/imageguided/gammaknife/index.html

Gamma Knife surgery represents one of the most advanced means available to manage brain tumors; arteriovenous malformations and pain or movement disorders. The procedure is unique because, with the Gamma Knife, no surgical incision is performed to expose the target.

The Gamma Knife can destroy deep-seated blood vessel malformations in the head and brain tumors once considered inoperable. It can also eliminate pain conditions and certain movement disorders, as well as silence malfunctioning areas of the brain precisely, to stop seizures or ease disabling pain problems that have not responded to other management strategies.

The Center for Image-Guided Neurosurgery at the University of Pittsburgh Medical Center installed the first North American Gamma Knife in 1987 and subsequently introduced and pioneered each succeeding generation of technological improvement. Staffed by a highly skilled and productive team, we seek to provide rapid screening, scheduling, and completion of Gamma Knife radiosurgical procedures.

During UPMC's first 20 years of experience, more than 8,500 patients have undergone radiosurgery in the department's Gamma Knife units. In May of 2004 our center added a third Gamma Knife unit, becoming the only center in the world with three operating units. In September of 2007, the new Perfexion® Gamma Knife unit -- encompassing the latest advances in radiosurgical technology -- was installed.

The Gamma Knife Unit

The Gamma Knife contains up to 201 cobalt-60 sources of approximately 30 curies each, placed in a circular array in a heavily shielded unit. The unit directs gamma radiation to a target point. Such target points selected in the brain can be placed at the center of the radiation focus, allowing a tumoricidal radiation dosage to be delivered in one treatment session. The Gamma Knife has proved effective for thousands of patients with benign or malignant brain tumors, vascular malformations, pain or other functional problems.

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Combination Therapy Study for Acromegaly

This is a 12 month study. During the first 6 months, patients receive combination therapy (Somatostatin Analog + Pegvisomant) and during the second 6 months, they are on Pegvisomant only.

Somatostatin analogs and Pegvisomant lower GH (Growth Hormone), by two very different mechanisms. In this study, we are investigating, the most effective way to combine these drugs, in order to determine the combination that has maximum efficacy, least side-effects, and is most cost-effective.

The study is being performed at Cedars Sinai Medical Center in Los Angeles. Participants will be required to travel to Cedars Sinai Medical Center in Los Angeles 3 times over the 12 month study period (at the study initiation, middle(6 months) and end of the study(12 months). All travel/accommodation costs for the visits are covered by the study. Monthly blood tests will be done at a local quest lab in the patient’s hometown.  Pegvisomant will be shipped to the patient’s home and dose adjustments will be made, depending on the blood test results.

Visits, monthly blood tests, drug dose adjustments and drug shipment will be coordinated by physicians and research staff at Cedars Sinai Medical Center.

To participate in the Combo Study, please email This email address is being protected from spambots. You need JavaScript enabled to view it..

Travel

Travel Assistance

Travel

The cost of treating Acromegaly doesn't only involve the medical costs, we also need to consider travel costs, including hotel stays, flights to and from appointments, and additional extra and unexpected costs that are travel related. Some patients are restricted to which medical team they choose because travel costs are unaffordable. The majority of these patients do not live near a larger metropolitan area which limits which doctors they have at their disposal, leaving them to choose from doctors who have never worked with, let alone heard of, Acromegaly. In order to get the best care possible, many patients travel outside of their hometown, or even their home state, to get the best care possible. For some patients,the travel resources below may help get better care by getting travel assitance.

Miracle Flights

Miracle Flights has the cure for distance. Miracle Flights is a nonprofit organization that helps sick children fly to distant medical care. Since 1985, Miracle Flights has established itself as the nation’s leading nonprofit health and welfare flight organization, providing financial assistance for flights so that those with serious illnesses may receive life-altering, life-saving medical treatment and valuable second opinions from experts and specialists throughout the United States. Flights are coordinated through commercial airlines at no cost to families and as many times as necessary: Whether it's a one-time flight to obtain a proper diagnosis or several flights for ongoing treatment, there is no limit to the number of times Miracle Flights will fly patients, free of charge, to receive the medical care they require. Through the support of generous community partners and individual donors, Miracle Flights gives hope to families that their children and loved ones may live longer, healthier lives. For additional information, please visit www.miracleflights.org

To request a flight, please call 800-359-1711 and speak with a Flight Specialists to see if you meet the income eligibility requirements. Flights can be requested 60 days prior to their appointment, but no later than 14 days before it. 

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Acromegaly does not define us. We do not let our diagnosis hold us back from living a full and enriched life. Some have found passion, purpose, and inspiration through their diagnosis. These people bring inspiration, and we call this our "Faces of Hope".

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