scholarly journals Attitudes and preferences in patients with acromegaly on long-term treatment with somatostatin analogues

2016 ◽  
Vol 5 (4) ◽  
pp. 167-173
Author(s):  
Cecilia Follin ◽  
Sven Karlsson
Keyword(s):  
Radiation Therapy ◽  
Medical Therapy ◽  
Somatostatin Analogues ◽  
Term Treatment ◽  
The Other ◽  
Primary Therapy ◽  
Long Term Treatment ◽  
Regular Contact

Introduction Patients with acromegaly can be treated with surgery, medical therapy and/or radiation therapy. For the patients not being cured with surgery, treatment with somatostatin analogues (SSAs) is the primary therapy. SSA can be taken by self- or partner-administered injections in addition to being given by a nurse at a clinic. The aim was to assess if patients with acromegaly prefer self-injections and to investigate their attitudes towards long-term medical therapy. Method All patients in the southern medical region of Sweden with a diagnosis of acromegaly and treated with SSA were eligible for the study (n = 24). The study is based on a questionnaire asking about the patients’ attitudes and preferences for injections with SSA, including their attitudes towards self-injection with SSA. Results The patients’ (23 included) median age was 68.5 years and the patients had been treated with SSA for 13 (1–38) years. One patient was currently self-injecting. All of the other patients were receiving injections from a nurse at a clinic. Three patients preferred self-injections, one preferred partner injections and 19 patients did not prefer self- or partner injections. The most frequent arguments to not preferring self-injections were ‘feeling more secure with an educated nurse’ and ‘preferring regular contact with a specialised nurse’. Conclusion Patients with acromegaly prefer regular contact with the endocrine team to the independence offered by self-injections. These findings might mirror the patients’ desires for continuity and safety. We need to address patients’ concerns regarding injections with SSA and support them in their choices.

Long-term treatment with thiamine as possible medical therapy for Friedreich ataxia

2016 ◽  
Vol 263 (11) ◽  
pp. 2170-2178 ◽  
Author(s):  
Antonio Costantini ◽  
Tiziana Laureti ◽  
Maria Immacolata Pala ◽  
Marco Colangeli ◽  
Simona Cavalieri ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Friedreich Ataxia ◽  
Term Treatment ◽  
Long Term Treatment

A Short Acute Octreotide Test for Response Prediction of Long-term Treatment with Somatostatin Analogues in Acromegalic Patients

2008 ◽  
Vol 40 (6) ◽  
pp. 422-426 ◽  
Author(s):  
I. Halperin ◽  
J. Nicolau ◽  
R. Casamitjana ◽  
G. Sesmilo ◽  
M. Serra-Prat ◽  
...  
Keyword(s):  
Response Prediction ◽  
Somatostatin Analogues ◽  
Term Treatment ◽  
Long Term Treatment

scholarly journals Contemporary management of prolactinomas

2004 ◽  
Vol 16 (4) ◽  
pp. 1-11 ◽  
Author(s):  
James K. Liu ◽  
William T. Couldwell
Keyword(s):  
Medical Therapy ◽  
Correct Diagnosis ◽  
Term Treatment ◽  
Tumor Treatment ◽  
Gonadal Dysfunction ◽  
Long Term Treatment ◽  
Contemporary Management ◽  
Line Of Therapy ◽  
Restoration Of Fertility

Prolactin-secreting pituitary adenomas—prolactinomas—are the most common type of functional pituitary tumor. Treatment of hyperprolactinemia is indicated because of the consequences of infertility, gonadal dysfunction, and osteoporosis. Making the correct diagnosis is important because the first line of therapy is medical management with dopamine agonists. Medical therapy is effective in normalizing prolactin levels in more than 90% of patients, but long-term treatment may be required in some patients. Transsphenoidal surgery is usually indicated in those patients in whom medical therapy fails or cannot be tolerated, or in patients who harbor microprolactinomas. In experienced hands, a hormonal and oncological cure can be achieved in more than 90% of patients after transsphenoidal removal of microprolactinomas with minimal risks. Thus, surgery may be an option for microprolactinomas in a young patient who desires restoration of fertility and avoidance of long-term medical therapy. The authors review the diagnosis and management of prolactinomas, including medical therapy, surgical therapy, and stereotactic radiosurgery.

scholarly journals Active postoperative acromegaly: sustained remission after discontinuation of somatostatin analogues

2016 ◽  
Vol 2016 ◽  
Author(s):  
Cristina Alvarez-Escola ◽  
Jersy Cardenas-Salas
Keyword(s):  
Low Dose ◽  
Disease Recurrence ◽  
Somatostatin Analogues ◽  
Term Treatment ◽  
Treatment Discontinuation ◽  
Treatment Withdrawal ◽  
Prolonged Treatment ◽  
Sustained Remission ◽  
Long Term Treatment

Summary In patients with active acromegaly after pituitary surgery, somatostatin analogues are effective in controlling the disease and can even be curative in some cases. After treatment discontinuation, the likelihood of disease recurrence is high. However, a small subset of patients remains symptom-free after discontinuation, with normalized growth hormone (GH) and insulin-like growth factor (IGF1) levels. The characteristics of patients most likely to achieve sustained remission after treatment discontinuation are not well understood, although limited evidence suggests that sustained remission is more likely in patients with lower GH and IGF1 levels before treatment withdrawal, in those who respond well to low-dose treatment, in those without evidence of adenoma on an MRI scan and/or in patients who receive long-term treatment. In this report, we describe the case of a 56-year-old female patient treated with lanreotide Autogel for 11 years. Treatment was successfully discontinued, and the patient is currently disease-free on all relevant parameters (clinical, biochemical and tumour status). The successful outcome in this case adds to the small body of literature suggesting that some well-selected patients who receive long-term treatment with somatostatin analogues may achieve sustained remission. Learning points: The probability of disease recurrence is high after discontinuation of treatment with somatostatin analogues. Current data indicate that remission after treatment discontinuation may be more likely in patients with low GH and IGF1 levels before treatment withdrawal, in those who respond well to low-dose treatment, in those without evidence of adenoma on MRI, and/or in patients receiving prolonged treatment. This case report suggests that prolonged treatment with somatostatin analogues can be curative in carefully selected patients.

scholarly journals Impact of radiotherapy on long-term treatment outcomes in patients with breast cancer who have undergone simultaneous one-stage and two-stage reconstructive surgeries. Literature review

2021 ◽  
Vol 17 (3) ◽  
pp. 51-58
Author(s):  
T. S. Berestok ◽  
I. V. Reshetov ◽  
A. D. Zikiryakhodzhaev ◽  
V. N. Galkin ◽  
M. V. Ermoshchenkova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Negative Impact ◽  
Capsular Contracture ◽  
Psychological Trauma ◽  
Term Treatment ◽  
Breast Cancer Patients ◽  
Aesthetic Result ◽  
Long Term Treatment

The evolution in reconstructive breast surgery in the form of widespread use of implants allows you to abandon the “simple” mastectomy in most patients, provide faster rehabilitation and minimize the psychological trauma due to the absence of a breast. However, in most cases, radiation therapy and/or drug treatment are necessary, as they reduce the risk of relapse, disease progression and mortality. The combined or complex treatment increases the frequency of postoperative complications, such as prolonged wound healing, infection, protrusion/extrusion of the endoprosthesis, the development of capsular contracture, seroma, hematoma, etc. The greatest negative impact on the aesthetic result, both in the early and in the long-term period, is provided by remote radiation therapy. On the other hand, performing reconstructive plastic surgery may complicate radiation therapy. The issues of how long it is necessary to conduct radiation therapy, what type of reconstruction and how to conduct radiation therapy, how to minimize the frequency of complications without compromising the oncological and aesthetic results of treatment of breast cancer patients remain controversial.

scholarly journals Principles of follow-up assessments in patients with breast cancer after radical treatment

2017 ◽  
Vol 89 (3) ◽  
pp. 36-39 ◽  
Author(s):  
Diana Hodorowicz-Zaniewska ◽  
Krzysztof Herman
Keyword(s):  
Breast Cancer ◽  
Early Recurrence ◽  
Term Treatment ◽  
Social Consequences ◽  
The Other ◽  
Radical Treatment ◽  
Long Term Treatment ◽  
Review Current

A follow-up assessment plan after radical treatment is a part of a comprehensive approach to treating patients with breast cancer. Because breast cancer is the most frequent cancer both worldwide and in Poland, adequate follow-up is important not only for patients but also for economic reasons. Herein, we review current recommendations for follow-up assessments in patients with breast cancer. The main aim of such assessment is detection of early recurrence or tumor presence in the other breast, observation of long-term treatment complications, and creation of multidisciplinary infrastructure that will allow to reduce the risk of recurrence and alleviate physical, mental, and social consequences of treatment.

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