Endocrine Abstracts

Introduction: Prior to and since the onset of my Doctorate study in 2019, a plethora of on-going research including my own has been conducted into the diagnosis, treatment, and management of Cushing syndrome (CS), and disease (CD). These conditions continue to challenge physicians not only in the diagnosis but how to treat their patients. The wide clinical spectrum of CS and CD produces a medical dilemma as patients’ symptoms, can vary. The typical Cushingoid features which are referred to as the classic symptoms are not always obvious when a patient presents. There are population groups which have increased incidence of CS which includes obesity, diabetes, and osteoporosis. The diagnostic approach is a 3-step investigative process and includes a) a physician’s knowledge of the signs and symptoms, which is crucial to make b) a definitive diagnosis of CS. The third step of this process is c) to identify the reason for excess cortisol.

Learning Process: The learning process during this study has been exponential and led to a clearer understanding as to why it took so long for my physicians to make a definitive diagnosis of initially CS and then CD. This personal Cushing’s journey of study revealed the reasons for the twists and turns on the ‘bumpy,’ road to diagnosis, treatment and then remission. Comparing other patients experiences during my study with my own, provided an understanding why we experience pain, changes in our personality, fatigue, a reduction in quality of life (QoL), and in most cases, irreversible comorbidities, my own being osteoporosis. During the process of study, I endeavoured to use my knowledge and skills as a Health Professional, promoting awareness through conference presentations and publications. On the long road to remission, I discovered the importance for Health Professionals, particularly General Practitioners and the public, to recognise patients’ unmet needs.

Study Conclusions: By taking a more patient-centred approach including time to listen to their patients, in parallel with the well-established biochemical and imaging tests would increase early diagnosis and treatment.

Recommendations: Recommendations included identifying target audiences, examples women’s clinics, and methods of screening obese and diabetic patients. Increase in using advanced technologies such as artificial intelligence in identifying early signs, example osteoporosis. Virtual learning platforms for educating Health Professions, extensive use of thematic analysis in QoL questionnaires and media coverage to raise awareness.