Adrenal Cancer

Adrenal cancer is one of those conditions that's hard to spot early. It starts in small glands called adrenal glands. You have two adrenal glands, one on top of each kidney, and you could get a tumor in one or both of them.

Your first sign that's something's not right might be a pain in your belly or a sense of fullness there. Or you might get symptoms that suggest something's out of whack with your hormones, like a surprising weight gain.

Sometimes, by the time you notice symptoms, the tumor may be large. But a lot of treatments, from drugs to surgery, can push back against this cancer.

For some folks, an operation to remove the tumor cures the disease. If the cancer does return, your doctor has other methods you can try that keep it in check.

Talk with your doctor about your treatment options. And don't hesitate to get some help from the people you love. They're key members of your team. Friends and family can play a huge role in giving you support while you manage your health.

Where It All Starts

Adrenal cancer is part of a group of diseases called neuroendocrine tumors, or NETs. These can form in different glands all over your body.

If you have adrenal cancer, sometimes your tumor begins in the outer layer of your adrenal glands, which your doctor may refer to as the cortex. The disease can also start with a tumor that grows in the middle part, called the medulla. It can happen in one or both of your adrenal glands.

These glands make hormones, chemicals that help control how your body works. They affect things like hair growth, blood pressure, your sex drive, and even how you handle stress. When you have adrenal cancer, you might notice changes in these areas.

Many adrenal tumors actually make hormones of their own. This is called a "functioning tumor." You may notice symptoms like sudden weight gain or a flushed face.

Causes

It's not clear why some people get these tumors. But you may be at a higher risk if you have one of these genetic diseases:

  • Li-Fraumeni syndrome
  • Beckwith-Wiedemann syndrome
  • Carney complex
  • Multiple endocrine neoplasia
  • Familial adenomatous polyposis
  • Lynch syndrome

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Common Symptoms

If your adrenal tumor grows large, it can press against other organs. You may feel a pain in your stomach or back. Or you could feel pressure or fullness soon after you eat. You may even notice a lump. On the other hand, if your tumor is small, you might not feel like anything's wrong.

Your tumor can change your levels of some hormones, which sets off a variety of symptoms. For instance, high levels of male hormones, called androgens, can cause too much face or body hair to grow. They can also enlarge the penis in young boys or the clitoris in girls.

Girls with too much estrogen can start their periods or start growing breasts at a very young age. Boys can make too much of that hormone also, and grow breasts.

Men with too much estrogen may notice breast growth, impotence, or loss of sex drive. Women who make too many androgens may have excess body hair or a receding hairline, irregular periods, or a deeper voice. Women past menopause may have spotting.

If your tumor makes too much of the stress hormone cortisol, you may pick up some extra pounds or get a puffy face. You may also notice stretch marks around your middle. Both men and women might notice they have weaker bones and muscles, and get bruised easily. You may also have swings in your mood or depression. High blood pressure or high blood sugar is also a possibility.

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Diagnosis

If you have any symptoms -- or have a genetic disease that puts you at risk for adrenal cancer -- your doctor can order tests to check for a tumor. These exams can also show the stage of your cancer, and if it's spread to other organs.

Physical exam and medical history. Your doctor will ask you about your health habits and any past problems.

Blood and urine tests. They check for signs that you make too many sex hormones or steroids, such as low levels of potassium or high levels of cortisol or estrogen.

Imaging tests. Your doctor can give you scans to see if you have a tumor or cancer cells. These include X-rays, ultrasound, computed tomography (CT) scan, MRI, and positron emission tomography (PET) scan, which can also tell if your disease has spread.

Laparoscopy. Your doctor can insert a very thin tube into your body with a tiny video camera attached to the end. This shows places where your cancer may be growing.

Biopsy. With a needle, your doctor can take a tiny sample of tissue to test under a microscope to see if you have cancer.

Treatments

Your doctor will come up with a treatment plan based on your cancer and your overall health.

Surgery. This is theonly option that may be able to cure you. Yourdoctor mayremove one or both of your adrenal glands. If your disease has spread, he may also need to take out nearby lymph nodes -- small glands that are part of your immune system, your body's defense against germs.

Radiation. This treatment can kill cancer cells or keep your tumor from growing. It's sometimes done after you've had surgery. Your doctor may beam radiation into your body through an outside machine, place radioactive seeds near the tumor, or insert a sealed radioactive capsule or wire into it.

Medications. Doctorsmost often prescribe a drug called mitotane (Lysodren), which blocks your adrenal gland from making hormones. It also destroys cancer cells. Your doctor may recommend this drug after your surgery if there's a risk that your disease may return.

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You might also get chemotherapy drugs that go through your whole body to kill cancer cells, but they can also harm healthy cells, too. Targeted therapy drugs look for and kill cancer cells without harming good ones.

Also, meds called biologics can help your immune system fight cancer.

Hormone drugs can balance, lower, or replace hormone levels that were affected by your tumor.

Tumor ablation. It's a method that uses heat or cold to kill cancer cells if your tumor has spread or returned, or if you're too sick for surgery. This can relieve your symptoms and give you a better quality of life.

Whatever treatment you choose, make sure you tend to your emotions as well as your body. Your doctor may be able to suggest support groups near you that can give you a chance to talk with others who are going through the same things you are. They can give you practical tips and advice on how to keep positive while you get the care you need.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on August 03, 2016

Sources

SOURCES:

American Cancer Society: "What is adrenal cancer?"

National Cancer Institute: "Adrenocortical Carcinoma."

Memorial Sloan Kettering Cancer Center: "Adrenal Tumors."

MD Anderson Cancer Center: "Adrenal Tumors."

Diane Reidy-Lagunes, MD, Memorial Sloan Kettering Cancer Center.

UptoDate: "Adrenal Cancer."

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