For cases of Cushing syndrome caused by taking medicine to treat another disorder, your healthcare provider will, if possible, decrease the dose slowly and carefully and then give another medication so the body can go back to making its own cortisol.
In cases where it is not possible to stop the medication, the healthcare provider will monitor the patient closely and treat symptoms that might develop, such as high blood sugar, high cholesterol levels, bone thinning, or osteoporosis.
If a tumor is the cause of Cushing, treatments may include medication, surgery, radiation, chemotherapy, or a combination of these treatments. The treatment depends on the tumor’s location and type.
The most common treatments for pituitary tumors are:
- Surgery. In most cases, a surgeon removes the tumor through a cut under the upper lip or at the bottom of the nose, between the nostrils. In rare cases, the surgeon may cut through the skull to reach the pituitary tumor.
- Radiation therapy. Radiation therapy uses X-rays to kill tumor cells or keep them from growing. It can be used if some tumor cells remain after surgery.
- Chemotherapy. Chemotherapy uses drugs that kill tumor cells or keep them from growing. Some chemotherapy drugs are taken by mouth, and some are injected.
- Drug therapy. Drugs can correct hormone imbalances or replace cortisol after another treatment.
To find out more about pituitary tumor treatments, visit the National Cancer Institute’s page on pituitary tumors.
Adrenal tumor or other tumors
If the tumor is in one or both of your adrenal glands, you may need surgery to remove it. Often, providers will remove the whole adrenal gland. After surgery to remove one adrenal gland, you may need to take drugs for several months to keep your cortisol levels up until the other adrenal gland is making enough by itself. After surgery to remove both adrenal glands, you will need to take medications to replace adrenal function for the rest of your life and take additional precautions during illness or surgery.
If your healthcare provider cannot remove the tumor, medications can help block the release of cortisol. Radiation therapy usually is not used for adrenal tumors.
- Graversen, D., Vestergaard, P., Stochholm, K., Gravholt, C. H., & JÃ¸rgensen, J. O. (2012). Mortality in Cushingâ€™s syndrome: A systematic review and meta-analysis. European Journal of Internal Medicine, 23(3), 278â€“282. Retrieved April 9, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/22385888
- MedlinePlus. (2019). Cushingâ€™s syndrome. Retrieved April 9, 2019, from http://www.nlm.nih.gov/medlineplus/cushingssyndrome.html
- Nieman, L. K., Biller, B. M. K., Findling, J. W., Murad, M. H., Newell-Price, J., Savage, M. O., & Tabarin, A. (2015). Treatment of Cushingâ€™s syndrome: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 100(8), 2807â€“2831. Retrieved March 3, 2017, from https://academic.oup.com/jcem/article/100/8/2807/2836065