Cushing's disease is a form of Cushing's syndrome, a condition characterized by sustained high cortisol levels. Cushing's disease is caused by a brain tumor called a pituitary adenoma, a hormone-producing tumor that promotes high cortisol levels. Patients with Cushing's disease experience a number of symptoms such as excessive hair growth, central obesity, high blood pressure and fatigue. Cushing's disease can be treated with a number of techniques.
Surgery
The first-line treatment for many cases of Cushing's disease is surgery to treat the pituitary adenoma. Pituitary adenomas release a hormone called ATCH, which circulates throughout the bloodstream and signals to the adrenal glands, glands that sit atop the kidneys. The adrenal glands respond to ATCH and secrete cortisol, causing Cushing's disease. Removing the ATCH-secreting pituitary tumor decreases the levels of cortisol secreted by the adrenal gland, and therefore treats Cushing's disease. Surgery involves removal of all or part of the tumor. In some cases, surgery may be combined with other tumor therapies to treat the ATCH-secreting tumor, reports the National Cancer Institute.
Drug Therapy
In some cases, drug therapy can be used to lower cortisol levels in the body to treat Cushing's disease. An example of a drug used in Cushing's treatment is Mitotane which decreases cortisol levels by affecting the adrenal glands. Mitotane is also an effective treatment for tumors of the adrenal glands which can cause Cushing's syndrome, reports MedlinePlus.
Possible Mitotane side effects include nausea, fatigue, vision disturbances or skin rashes, according to MedlinePlus. Patients taking Mitotane must also monitor their cortisol levels with their doctor to ensure that the levels do not become too low, which can lead to serious and potentially life-threatening conditions.
Radiation
In rare cases, patients may require radiation therapy to treat Cushing's disease. Radiation may be required if the pituitary tumor comes back after surgery, if surgery was not sufficient to remove the entire tumor, or in cases where the pituitary tumor is inoperable. Radiation therapy may also be required to treat aggressive forms of Cushing's disease to treat tumors that have invaded the cavernous sinus, according to a 2002 study published in the journal "Pituitary." Radiation of the pituitary may damage healthy pituitary tissue, leading to a condition called hypopituitarism, which occurs when the pituitary gland does not secrete sufficient levels of hormones. A number of radiation therapy techniques can effectively target pituitary adenomas that cause Cushing's disease.
