Adrenal Cancer: Symptoms, Causes, Risk Factors, Types, Diagnosis, Treatments, Outlook

Medically Reviewed by Dr. K on 18 May 2022

Adrenal Cancer?

Adrenal cancer is a type of tumour known as a neuroendocrine tumour (NETs). This could start in any of your body's hormone-producing glands. Adrenal cancer begins in the adrenal glands, which are small glands. There are two of them, one on each part of the kidney. Cancer may develop in one or both of these organs.

Your adrenal glands produce hormones, which are chemicals that help regulate how your body functions. Hair growth, blood pressure, sex drive, and even how you manage stress are all affected by them. Often adrenal tumours produce their own hormones.

A tumour could start in the cortex, the outer layer of your adrenal glands, which your doctor may refer to as the source. The disease may also start with a tumour in the medulla, which is located in the centre of the brain.

By the time you experience symptoms, the tumour could have become rather large. However, the specialist will select from a variety of medications to combat the disease.

Discuss the medical plans with your doctor. Also, don't be afraid to reach out to the people you care about most. They're vital members of your team. Family members can be very helpful in providing assistance while you manage your wellbeing.

Symptoms

You might not experience any symptoms if you have a small tumour. Tumors may trigger a variety of symptoms as they grow, including:

  • Pain or a lump in your stomach
  • A sensation of pressure or fullness after eating.

A tumor can affect the levels of certain hormones in your body. Extra androgens may trigger the following symptoms:

  • Excess hair on the face or on the body
  • In young boys, a larger penis
  • In young girls, a larger clitoris

A tumor that makes oestrogen may cause:

  • Periods or breast growth at a young age for girls.
  • Irregular periods or a deeper voice in women.
  • Spotting in post-menopausal women
  • Male breast growth.
  • Impotence or a lack of sex drive in men.

Too much of the hormone cortisol can cause:

  • Weight gain
  • Swelling in the face
  • Face, upper back, or arms with fine hair
  • Stretch marks
  • Bones and muscles that are weaker
  • Easy bruising
  • Mood swings
  • Depression
  • Hypertension
  • Hyperglycemia – high blood sugars

Signs of extra aldosterone include:

  • Weakness
  • Muscle spasms
  • High blood pressure
  • Potassium deficiency
  • Extreme thirst
  • Peeing more often than average

Causes and Risk Factors

It is unknown why some people develop these tumours. However, if you have either of these genetic disorders, they might be more common:

  • Li-Fraumeni syndrome
  • Beckwith-Wiedemann syndrome
  • Carney Complex
  • Multiple endocrine neoplasia (MEN)
  • Lynch syndrome

Types

Malignant adrenal tumours are those that are cancerous. Many that aren't cancerous are referred to as benign. Their names are derived from the organ in which they originate. The below are examples of malignant tumours:

  • Adrenocortical carcinoma: begins in the cortex, or outer layer, of the adrenal gland. The majority of these tumours are active, which indicates they produce hormones. The remainder are referred to as nonfunctional.
  • Malignant adrenal pheochromocytoma: begins in the medulla (middle). It's very uncommon.
  • Neuroblastoma: It normally starts in the medulla in children.
  • Malignant paraganglioma: grows either inside or outside of the adrenal gland.

Benign tumors include:

  • Adenoma:  This may trigger an overproduction of cortisol, resulting in Cushing's syndrome.
  • Benign pheochromocytoma
  • Benign paraganglioma

Diagnosis

Your doctor may order tests to look for a tumour if you have symptoms or if you have a condition that puts you at risk for adrenal cancer. These tests will even reveal the cancer's stage and whether it has spread to other organs.

  • Physical exam and medical history: Your doctor will inquire about your lifestyle habits as well as any previous conditions.
  • Blood and urine tests: They look for indicators that you're producing too many sex hormones or steroids, such as low potassium levels or elevated cortisol or oestrogen levels.
  • Imaging tests: Scans look for a tumor or cancer cells. These include X-rays, ultrasounds, CT scans, MRIs, and positron emission tomography (PET) scans, which can also tell whether your disease has spread.
  • Laparoscopy: The aim of a scan is to find a tumour or cancer cells. X-rays, ultrasounds, CT scans, MRIs, and positron emission tomography (PET) scans are some of the tests that may be used to see how the disease has spread.
  • Biopsy: Your doctor uses a needle to collect a small piece of tissue to examine under a microscope for signs of cancer.
  • Adrenal angiography or venography: Your doctor injects a dye into your bloodstream and uses X-rays to check for blocked arteries or veins.

Treatments

Based on your individual case and general health, your doctor will recommend a treatment plan.

Surgery

This is the one treatment that has a chance to work for you. One or both of the adrenal glands may be removed by your doctor. They will need to remove surrounding lymph nodes if the disease has spread. Lymph nodes are tiny glands that are part of the immune system, which is the body's protection against germs.

Radiation

This treatment will either kill cancer cells or slow the growth of a tumour. It's possible that you'll have it after surgery. Your doctor may use an external machine to deliver radiation to your body, place radioactive seeds near the tumour, or insert a sealed radioactive capsule or wire into it.

Medications

Doctors also recommend mitotane (Lysodren), a medication that prevents the adrenal gland from producing hormones. It often kills cancerous cells. If there's a risk the tumour may eventually return after treatment, your doctor might suggest this.

Medications known as biologics will aid the immune system in the fight against cancer.

Hormone medications may help to restore hormone levels that have been affected by the tumour by balancing, lowering, or replacing them.

Chemotherapy

You may be given medications that eliminate cancer cells in the whole body. They have the potential to damage healthy cells as well. Drugs used in targeted therapy look for and kill cancer cells while causing little damage to healthy cells.

Tumor ablation

If the tumour has spread or returned, or if you're too sick for surgery, this method utilises heat or cold to destroy cancer cells. It will help you to feel better and improve the quality of life.

Whatever treatment you select, remember to take care of both your feelings and your body. Your doctor will be willing to recommend discussion groups where you can speak to people who are going through similar experiences. They will give you suggestions and guidance about how to stay optimistic when receiving the treatment you need.

Outlook

Your prognosis is determined by many factors, including your age, the size of the tumour at the time of diagnosis, and whether the tumour produces hormones.

Around 74% of patients with cancer who are cured until it spreads past their adrenal glands survive for at least another 5 years. If it spreads to surrounding tissues or organs, the 5-year survival rate declines to 56%. If cancer has spread to other areas of the body, your chances are around 37%.

Sources

Referenced on  3/5/2021

  1. National Cancer Institute: “Adrenocortical Carcinoma."
  2. Memorial Sloan Kettering Cancer Center: “Adrenal Tumors.
  3. M.D. Anderson Cancer Center: “Adrenal Tumors."
  4. American Cancer Society: “Signs and Symptoms of Adrenal Cancers,” “What Is Neuroblastoma?” “What is adrenal cancer?"
  5. American Society of Clinical Oncology: “Adrenal Gland Tumor.”
  6. https://www.webmd.com/cancer/adrenal-cancer

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