The long-term impact of
acromegaly on subjective well-being
after treatment of GH excess is unclear. Therefore, we evaluated quality of life by validated questionnaires in a cross-sectional study of 118 successfully treated acromegalic patients. The initial treatment was transsphenoidal surgery in most patients (92%), if necessary followed by
radiotherapy or
octreotide. All patients were in remission at the time of assessment (GH, <1.9 mug/liter; normal
IGF-I for age). General perceived well-being was reduced compared with controls for all subscales (P < 0.001) as measured by the Nottingham Health Profile and the Short Form-36. Acromegalic patients also had lower scores on
fatigue (Multidimensional
Fatigue Index) and anxiety and depression (Hospital Anxiety and Depression Scale).
Radiotherapy was associated with decreased quality of life in all subscales except for the Hospital Anxiety and Depression Scale, and worsened quality of life significantly, according to the
fatigue scores.
Somatostatin analog treatment was not associated with improved quality of life. Independent predictors of quality of life were age (physical subscales and Nottingham Health Profile), disease duration (social isolation and personal relations), and
radiotherapy (physical and
fatigue subscales). In conclusion, patients cured
after treatment for
acromegaly have a persistently decreased quality of life despite long-term biochemical cure of GH excess.
Radiotherapy especially is associated with a reduced quality of life.