For Cushing's syndrome caused by long-term corticosteroid medicine use
corticosteroid medicine is the cause of Cushing's syndrome, your doctor will help you lower your dose or
gradually stop taking it. Never stop taking
corticosteroid medicine on your own, because it might
lead to a life-threatening adrenal crisis. When you take steroids, your
adrenal glands stop making
cortisol. If you suddenly stop taking your medicine,
your adrenal glands may not be able to start making cortisol quickly enough.
This can lead to an adrenal crisis and a severe drop in blood pressure. To
avoid this, your doctor will want to gradually reduce and then stop your
One way the body keeps itself in balance is by using chemical messengers called hormones to regulate various functions. Just above each of your kidneys is a small adrenal gland. These glands make hormones essential to a healthy life. When they don't make enough of these hormones, Addison's disease is the result.
Addison's disease is a rare condition. Only one in 100,000 people has it. It can happen at any age to either men or women. People with Addison's disease can lead normal lives as long as...
Your doctor may change your corticosteroid medicine from
a longer-acting steroid (such as prednisone) to a shorter-acting one (such as
hydrocortisone). Sometimes corticosteroid medicines can be taken every other
day. Either way, the body's normal production of cortisol returns
If you must continue taking corticosteroid medicine to
control another condition, the dosage can sometimes be lowered to reduce
symptoms and the risk of complications.
If your doctor and you are
trying to reduce the dosage of your medicine and you become ill, contact your
If reducing the dosage does not make Cushing's
syndrome go away, your doctor will perform more tests to look for another cause
of your condition.
For Cushing's syndrome caused by pituitary tumors (Cushing's disease)
If you are well enough to have surgery, surgical removal
of the pituitary tumor offers the best chance for recovery. The surgery (transsphenoidal adenomectomy) requires great skill and
should be performed at a major medical center where teams of doctors specialize
in pituitary surgery.
The success of transsphenoidal adenomectomy depends on the experience of the surgeon and the size of the tumors. Surgery is successful in 80% to 90% of surgeries on smaller tumors and 50% of surgeries on larger tumors. 1
Cushing's disease returns in about 2% of adults and up
to 40% of children who have the operation.1 Surgery
can be repeated, often with good results.
Gamma knife radiosurgery
has recently been introduced in the United States. In this technique, many
small beams of
radiation are focused on the tumor to shrink and
destroy it. It does not involve a surgical incision (there is no "knife"
involved), and there is minimal damage to surrounding tissue. It can be done as
an outpatient and with
local anesthesia. Few centers in the United States
have gamma knife facilities.
Medicine therapies may be tried if
surgery is not possible or has failed.
For Cushing's syndrome caused by adrenal tumors
Doctors almost always recommend surgery to remove benign adrenal tumors
that are producing hormones. If a tumor is cancerous, the affected adrenal
gland is removed. Although chemotherapy is usually advised, there is no proven
long-term treatment for adrenal cancer. On rare occasions, both adrenal glands
must be removed. In this case, you would take daily long-term hormone