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March 5, 1982

Choosing the Best Treatment for Acromegaly

JAMA. 1982;247(9):1320. doi:10.1001/jama.1982.03320340074044

The article "Cryosurgery or Microsurgery in the Management of Acromegaly" by Teasdale et al in this issue of The Journal (p 1289) promulgates no heresy. The authors offer convincing evidence that, of the two methods evaluated, microsurgery is preferable. Since their conclusion conforms with that of many workers and many authorities who agree that cryosurgery brings with it more complications,1 Teasdale and his colleagues cannot be prosecuted or punished as heretics. In the treatment of this disease there is no orthodoxy.

As with other more or less intractable disorders, 70 or so years of clinical experience have provided physicians with an embarrassment of choices in trying to treat acromegaly; the physician may choose among 14 accredited therapies: three radiotherapeutic, five surgical, and six pharmacologic.2 This variety of options is not unique to acromegaly. By rough count there are eight ways to treat ulcerative colitis, 11 for asthma, and