Grzegorz wrote

Chciałbym jednak wiedziec czy chorobę tą można skutecznie wyleczyć, i
> czy leczenie jest długotrwałe.
>
> Grzegorz
How Is Cushing's
Syndrome
Treated?

Treatment depends on the specific reason for
cortisol excess and may
include surgery, radiation, chemotherapy or the use
of cortisol-inhibiting
drugs. If the cause is long-term use of
glucocorticoid hormones to treat
another disorder, the doctor will gradually reduce
the dosage to the
lowest dose adequate for control of that disorder.
Once control is
established, the daily dose of glucocorticoid
hormones may be doubled
and given on alternate days to lessen side effects.

Pituitary Adenomas
Several therapies are available to treat the
ACTH-secreting pituitary
adenomas of Cushing's disease. The most widely used
treatment is
surgical removal of the tumor, known as
transsphenoidal
adenomectomy. Using a special microscope and very
fine instruments,
the surgeon approaches the pituitary gland through a
nostril or an
opening made below the upper lip. Because this is an
extremely delicate
procedure, patients are often referred to centers
specializing in this type
of surgery. The success, or cure, rate of this
procedure is over 80
percent when performed by a surgeon with extensive
experience. If
surgery fails, or only produces a temporary cure,
surgery can be
repeated, often with good results. After curative
pituitary surgery, the
production of ACTH drops two levels below normal.
This is a natural,
but temporary, drop in ACTH production, and patients
are given a
synthetic form of cortisol (such as hydrocortisone
or prednisone). Most
patients can stop this replacement therapy in less
than a year.

For patients in whom transsphenoidal surgery has
failed or who are not
suitable candidates for surgery, radiotherapy is
another possible
treatment. Radiation to the pituitary gland is given
over a 6-week
period, with improvement occurring in 40 to 50
percent of adults and
up to 80 percent of children. It may take several
months or years
before patients feel better from radiation treatment
alone. However, the
combination of radiation and the drug mitotane
(LysodrenŽ) can help
speed recovery. Mitotane suppresses cortisol
production and lowers
plasma and urine hormone levels. Treatment with
mitotane alone can be
successful in 30 to 40 percent of patients. Other
drugs used alone or in
combination to control the production of excess
cortisol are
aminoglutethimide, metyrapone, trilostane and
ketoconazole. Each has
its own side effects that doctors consider when
prescribing therapy for
individual patients.

Ectopic ACTH Syndrome
To cure the overproduction of cortisol caused by
ectopic ACTH
syndrome, it is necessary to eliminate all of the
cancerous tissue that is
secreting ACTH. The choice of cancer
treatment--surgery,
radiotherapy, chemotherapy, immunotherapy, or a
combination of these
treatments--depends on the type of cancer and how
far it has spread.
Since ACTH-secreting tumors (for example, small cell
lung cancer)
may be very small or widespread at the time of
diagnosis,
cortisol-inhibiting drugs, like mitotane, are an
important part of
treatment. In some cases, if pituitary surgery is
not successful, surgical
removal of the adrenal glands (bilateral
adrenalectomy) may take the
place of drug therapy.

Adrenal Tumors
Surgery is the mainstay of treatment for benign as
well as cancerous
tumors of the adrenal glands. In Primary Pigmented
Micronodular
Adrenal Disease and the familial Carney's complex,
surgical removal of
the adrenal glands is required.