About the expansion of knowledge

From Lewis S. Blevins, Jr, MD  –  This is an iPhone photo, through my telescope, of Jupiter and the four Galilean moons. Unfortunately, the exposure did not illustrate the beautiful banding of the planet. The moons are called such because Galileo first discovered them in 1610. Expansion of our knowledge about astronomy and the universe has been logarithmic since he employed his telescopes to record his observations of Jupiter’s and its moons.

When I think about all of this I am reminded of the unbelievable expansion of the knowledge base in the field of pituitary endocrinology since I began my study of the gland in 1988. At that time, all we had to offer a patient with acromegaly,for example, was surgery, radiotherapy, and perhaps a dopamine agonist drug, bromocriptine, that was effective in controlling IGF-I levels in about 10% of patients. Patients in that era, including a great proportion of those treated, suffered from horrible complications including cardiomyopathy, severe diabetes and hypertension, cancer, severe arthritis, severe sleep apnea, and many other problems including progressive disfigurement.

The treated natural history of the disease has changed radically in the 27 years since I encountered my first patient with acromegaly. We now have another dopamine agonist drug, three somatostatin analogues, a growth hormone receptor blocker, advances in surgical technique, better trained surgeons, more appropriate and better defined tools to deliver radiation, state of the art magnetic resonance imaging, improved diagnostic laboratory tests, and a better idea of what constitutes successful treatment or remission! Let’s not forget the power of social media and the Internet so that patients can be better informed and play a more active role in their medical care. All of this has been possible because of scientific investigation.

The same type of investigation Galileo was doing when he was developing and then peering thru his telescopes from the hills outside of Florence, Italy in 1610. Celebrate discovery!

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