Mayo Clinic doctors work to return the body's cortisol production to normal by treating the medical condition causing Cushing syndrome. Depending on the cause of the condition, surgery on the pituitary or adrenal glands may be part of the treatment.
Pituitary tumors are located at the base of the brain. The surgical removal of ACTH-secreting pituitary tumors (adenomas) is a complex, but often effective, procedure. After surgery, people usually take temporary hormone replacement therapy because ACTH production by the remaining pituitary gland drops temporarily.
If removing the pituitary adenoma is not an option, Cushing syndrome can be treated with bilateral laparoscopic adrenalectomy. Mayo Clinic surgeons perform this minimally-invasive surgical procedure to remove both adrenal glands.
Pituitary tumors may regrow, so cortisol levels must be measured regularly after surgery. If pituitary tumors return, treatment with radiation therapy, stereotactic radiosurgery or Gamma Knife radiation therapy may be needed.
Other tumors, including those of the lung, thymus, pancreas and thyroid, may secrete ACTH. Many of these tumors may be cancerous, and doctors may recommend surgery to remove tumors. Adrenal tumors that produce excessive cortisol usually can be removed using laparoscopic surgery.
When complete removal by surgery isn't possible, doctors treat cancerous tumors with radiation, chemotherapy, immunotherapy or a combination of these treatments, depending on the tumor. Treatment may also include cortisone-inhibiting drugs.