Adrenal Cancer

What is adrenal cancer?

Adrenal cancer, known as adrenocortical cancer, is a rare form of cancer that can form at the top of one or both of your adrenal glands (top of your kidneys). These glands are crucial in hormone production, influencing the functioning of nearly every organ and tissue in your body.

This type of cancer can affect individuals at any age, but it is most commonly seen in children under 5 and adults in their 40s and 50s. When detected early, there is a chance for a cure, but if the cancer has spread beyond the adrenal glands, the prospects for a complete cure are lowered. Treatment options are available to help manage and potentially delay the progression or recurrence of the disease.

It is worth noting that most growths in the adrenal glands are noncancerous, including benign tumours such as adenomas and pheochromocytomas.

What causes adrenal cancer?

The exact causes are not yet fully understood. However, recent advances in medical research have progressed on how specific DNA changes can trigger the development of cancerous cells within the adrenal gland. DNA influences both your physical traits and your susceptibility to certain diseases, including cancer.

Key genetic factors can include:

• Oncogenes: oncogenes facilitate uncontrolled cell growth and division.
• Tumour suppressor genes: tumour suppressor genes are responsible for slowing down cancer cell division or prompting them to die at the right time.

Although these DNA mutations can increase your cancer risk, in most cases, these mutations can occur in your lifetime without any discernible external trigger and only rarely cause adrenal cancer. 

What are the symptoms of adrenal cancer?

Symptoms include:

• Weight gain (especially in your face, neck, and trunk)
• Weak muscles
• Noticeable pink or purple stretchmarks on your skin
• Hormonal changes in women: excess in facial hair, hair loss, and/or irregular menstrual cycles
• Hormonal changes in men: shrinking testicles and enlarged breast tissue
• Vomiting
• Nausea
• Abdominal bloating
• Back pain
• Fever
• Loss of appetite
• Unintended weight loss
• Reaching puberty earlier
• High blood pressure
• High blood sugar

If you suspect you have symptoms or are concerned about your adrenal health, consult with an endocrinologist for a proper evaluation and diagnosis.

Is adrenal cancer painful?

In the early stages, when the tumor size is small, it is completely painless and asymptomatic. The most common presentation would be a mass detected on imaging in the adrenal gland.  In later stages, when the size enlarges or the tumor spreads to other structures, it can cause some degree of pain. As the adrenal cancer grows, it may exert pressure on nearby organs and tissues. This can cause discomfort near the tumour, a sense of abdominal fullness, and/or difficulty eating due to feeling full faster than usual.

The extent of pain and discomfort you can feel varies between individuals and depends on the stage of your cancer and its spread.

Who is at risk of adrenal cancer?

This cancer can affect anyone. This can be of varying ages and backgrounds. While it is a rare form of cancer, several factors may increase your risk of developing the condition.

• Age: certain age groups have a higher chance of developing it in their lifetime, especially those between the ages of 40 and 50 and even children under the age of 5. 
• Genetic conditions: certain genetic conditions or hereditary syndromes, such as familial adenomatous polyposis (FAP), hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndrome, Lynch syndrome, multiple endocrine neoplasia syndrome, Beckwith-Wiedemann syndrome, Carney complex, and Li-Faumeni syndrome can increase the risk of developing adrenal cancer.

If you are experiencing symptoms and are concerned about your risk of developing it, make an appointment with ACE Specialist Surgery and Endoscopy to get proper medical assessments for early detection of cancer cell growth.

How is adrenal cancer diagnosed?

Adrenal cancer can be diagnosed in the following ways:

• Blood and urine tests: you may be required to get blood and urine to detect if your adrenal glands are producing abnormal levels of hormones (these include cortisol, aldosterone, and androgens). Further testing may need to be done if your hormone levels show abnormalities.
• Imaging tests: you may need to undergo ultrasound, computed tomography (CT) scans, magnetic resonance imaging (MRI), or PET scans for a comprehensive view of any growths in your adrenal glands for your endocrinologist to assess whether the cancer has extended to other regions of your body, such as your lungs or liver.
• Adrenal gland biopsy:     Image-guided Needle biopsies are almost never recommended to diagnose primary adrenal cancer. They are only helpful to detect adrenal metastasis from cancers elsewhere in the body. The imaging characteristics of the tumor on dedicated scans will raise suspicion and in cases whichbare resectable, surgical removal is the only definitive modality of treatment and cure for early cancers. 

What are the treatment options for adrenal cancer?

Treatment options largely depend on the stage of your cancer and the extent of it.

• Laparoscopic: this keyhole surgery is usually done to remove your adrenal gland to eradicate cancer. This is often the primary treatment and involves removing the affected adrenal gland and enlarged lymph nodes (if present). Debulking surgery may be done to remove as much of the tumour as possible in Stage IV and to relieve symptoms in recurrent cases.
• Radiation therapy: for all stages and recurrent cases. Radiation therapy may be suggested following surgery if necessary.
• Drug therapy: chemotherapy drugs such as mitotane may also be used following surgery, if necessary.

If you are suffering from an adrenal gland disorder, have a family history of adrenal disorders, or are concerned about developing adrenal cancer, schedule an appointment with ACE Surgery and Endoscopy for a detailed examination and individualised treatment plan.

Frequently Asked Questions