Adrenal cancer is a rare cancer that develops in the small, triangular glands located on top of your kidneys (adrenal glands). Adrenal glands produce hormones that give instructions to virtually every organ and tissue in your body.
Adrenal cancer is often aggressive. When found early, adrenal cancer can be cured. But if the cancer has spread to areas beyond the adrenal gland, cure becomes less likely. Treatment can be used to delay progression or recurrence.
Noncancerous (benign) adrenal tumors, such as adenomas or pheochromocytoma, also can develop in the adrenal glands. The majority of adrenal tumors are benign adenomas, meaning they are not cancerous. In fact, only about one person out of every million people worldwide will develop a cancerous adrenal tumor. When cancer starts in the cortex, it is called adrenocortical carcinoma. When cancer starts in the medulla it is called neuroblastoma or pheochromocytoma, depending on which cells it arises from. About 10 percent of cases of pheochromocytoma occur in children.
People with an adrenal gland tumor may experience the following symptoms or signs. Sometimes, people with an adrenal gland tumor do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not a tumor.
- High blood pressure
- Low potassium level
- Heart palpitations
- Feelings of anxiety or panic attacks
- Excessive perspiration
- Abdominal pain
- Unexplained weight gain or weight loss
- Abdominal stretch marks
- Excessive hair growth
- Unusual acne
- Change in libido (sex drive)
Scientists do not know exactly what causes adrenal cancer.
- Blood and urine tests (including hormone level tests):
- Adrenal angiography
- Computed tomographic (CT) scans: CT scans generate two-dimensional images of the body that may reveal whether cancer has invaded other tissues or organs.
- Magnetic resonance imaging (MRI): MRI technology uses magnetic fields and radio waves to identify small abnormalities in the adrenal glands. MRI scans are also used to determine if cancer has spread to other organs. The scan can help distinguish cortical from medullary tumors, and some malignant tumors from benign tumors.
- Nuclear scintigraphy: Nuclear scintigraphy can be used to show the differences between certain types of adrenal gland tumors. Technicians inject a compound containing radioactive iodine into the body and then take images that show the parts of the body where the iodine builds up. This helps to determine whether cancer exists in the body.
- Positron emission tomography (PET) scan: PET scans create three-dimensional views of the adrenal gland. PET scans may point out locations of high metabolic energy within body cells, often occurring in cancerous tissue. PET scans can provide information about whether cancer has spread outside the adrenal gland.
Occasionally, other tests may be conducted.
The prognosis of adrenal cancer depends on the stage. Unfortunately, 60 to 70% of patients have stage III or IV disease at the time of diagnosis. The 5-year survival refers to the percent of patients on average who are alive 5 years after their diagnosis.
After a recurrence of adrenal cancer, virtually all patients die within five years. Treatment options for recurrent tumor include re-operation if all of the tumor can be removed. However, the tumor often cannot be completely removed, and so systemic therapy using mitotane with or without additional therapy such as cis-platinum-based chemotherapy regimens may be the best option.
Adrenal cancer can be cured if the treatment is given early on. Some methods of adrenal cancer treatment are as follows:
- Laparoscopic adrenalectomy is done when a surgeon makes small incisions in the abdomen and removes the tumor using a small camera.
- Transabdominal surgery involves a large incision in the abdomen and removal of the tumor. The surgeon will check the surrounding organs for cancer.
- Posterior surgery involves an incision being made in the back for tumor removal.
- Thoracoabdominal surgery is done to remove a particularly large tumor. It involves an incision through the abdomen and chest.
If the tumor has metastasized or spread to other parts of the body, it may be treated with radiation or chemotherapy. For tumors that are too big to be removed safely, cryoablation, or the destruction of tumor cells with freezing, may be performed. Medication like mitotane, which prevents the adrenal glands from producing steroid hormones, may also be prescribed if you have stage II, III, or IV adrenal cancer.