If Cushing syndrome is caused by glucocorticoid medicine taken to treat another disorder, your health care provider will slowly and carefully decrease your dose and give you another medication so that your body can go back to making its own cortisol. However, if you need to continue taking the glucocorticoid, your health care provider will closely monitor you and treat symptoms that might develop, such as high blood sugar, high cholesterol levels, bone thinning, or osteoporosis (pronounced os-tee-oh-puh-ROH-sis).
If the body is making too much cortisol because of a tumor, treatments may include medication, surgery, radiation, chemotherapy, or a combination of these treatments. Treatments will differ based on where the tumor is located.
The most common treatments for pituitary tumors are:
- Surgery. In most cases, a surgeon removes the tumor through a cut made under the upper lip or at the bottom of the nose, between the nostrils. In other cases, the doctor may cut through the skull to reach the pituitary tumor.
- Radiation therapy. Radiation therapy targets the tumor with high-energy X-rays that kill tumor cells or keep them from growing. It can be used if surgery is not successful at removing all tumor cells.
- Chemotherapy. Chemotherapy uses drugs that kill tumor cells or keep them from growing. Chemotherapy drugs can be taken by mouth or injected.
- Drug therapy. Pituitary tumors can affect hormone levels in two ways. They can produce hormones themselves or crowd out tissue that normally would produce hormones. Drugs can be prescribed to correct these hormone imbalances or reduce too much cortisol.
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 of your two adrenal glands, your doctor may attempt to remove it surgically. Often the whole gland is removed. Following surgery, the doctor may prescribe glucocorticoid replacement treatment for 9 to 12 months until the other adrenal gland takes on the functions of the removed gland.
If the tumor cannot be removed, medications can be used to help block the release of cortisol. Radiation therapy usually does not work for cancerous adrenal tumors and is not appropriate for noncancerous tumors.
- Graversen, D., Vestergaard, P., Stochholm, K., Gravholt, C. H., & Jørgensen, J. O. (2012). Mortality in Cushing’s syndrome: A systematic review and meta-analysis. European Journal of Internal Medicine, 23(3), 278-282. PMID 22385888.
- National Library of Medicine, MedlinePlus. Cushing’s syndrome. Retrieved April 8, 2012, from http://www.nlm.nih.gov/medlineplus/cushingssyndrome.html.