Treatment protocols for Cushing's disease reduce cortisol levels in the body, according to Mayo Clinic. Radiation therapy, medications, tumor removal and reduction of corticosteroid use are all possible options depending on the underlying cause.
Long-term use of corticosteroid medicines for such conditions as arthritis or asthma is one cause of Cushing's disease. If this is the cause, the doctor works to manage the symptoms of Cushing's while also managing the underlying conditions. Alternative medications exist that allow patients to stop using corticosteroids. Patients should not just stop taking these medications without consulting their physicians, notes Mayo Clinic.
When a tumor is the cause of Cushing's, total surgical removal is the usual recommendation. Neurosurgeons generally remove pituitary tumors through the nose, while tumors in the pancreas, lungs or adrenal glands come out through standard means. Cortisol replacement medicines are generally necessary after the surgery, reports Mayo Clinic.
If surgical removal of the tumor is impossible, radiation therapy is the next step. This takes place in a series of doses or a one-time application known as Gamma Knife radiosurgery. If both surgery and radiation fail to remove the tumor or address the Cushing's symptoms, ketoconazole, metyrapone and mitotane are the most common medications. When none of these options work, surgical removal of the adrenal glands is the last solution as of 2015, according to Mayo Clinic.