Adrenal Cancer

What Is Adrenal Cancer?

Adrenal cancer is part of a group of tumors called neuroendocrine tumors (NETs). These can start in hormone-producing glands all over your body. Adrenal cancer starts in small glands called adrenal glands. You have two of them, one on top of each kidney. Cancer can happen in one or both.

Your adrenal glands make hormones, chemicals that help control how your body works. They affect things like hair growth, blood pressure, sex drive, and even how you handle stress. Many adrenal tumors make hormones of their own.

A tumor might begin in the outer layer of your adrenal glands, which your doctor may call the cortex. The disease can also start with a tumor that grows in the middle part, called the medulla.

A tumor may be large by the time you notice symptoms. But your doctor can choose from many treatments to push back against this cancer.

Talk with your doctor about your treatment options. And don't hesitate to reach out to 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.

Symptoms of Adrenal Cancer

If you have a small tumor, you might not notice any signs. As they grow, tumors can cause symptoms such as:

  • Pain or a lump in your belly
  • A feeling of pressure or fullness soon after you eat

A tumor can affect the levels of certain hormones in your body. Symptoms caused by extra androgens include:

  • Extra face or body hair
  • A larger penis in young boys or clitoris in girls

A tumor that makes estrogen may cause:

  • Periods or breast growth at an early age in girls
  • Uneven periods or a deeper voice in women
  • Spotting in women past menopause
  • Breast growth in males
  • Impotence or loss of sex drive in men

Too much of the hormone cortisol can cause:

  • Weight gain
  • A puffy face
  • Fine hair on your face, upper back, or arms
  • Stretch marks
  • Weaker bones and muscles
  • Easy bruising
  • Mood swings
  • Depression
  • High blood pressure
  • High blood sugar

Signs of extra aldosterone include:

  • Weakness
  • Muscle cramps
  • High blood pressure
  • Low potassium levels
  • Severe thirst
  • Peeing more than usual

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Adrenal Cancer Causes and Risk Factors

It's not clear why some people get these tumors. But they may be more common if you have one of these diseases that’s tied to your genes:

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

Adrenal Cancer Types

Adrenal tumors that are cancerous are called malignant. Those that aren’t cancer are benign. Their names are based on where they start. Malignant tumors include:

  • Adrenocortical carcinoma begins in the outer layer, or cortex, of your adrenal gland. Most of these tumors are functioning, which means they make hormones. The rest are called nonfunctioning.
  • Malignant adrenal pheochromocytoma starts in the middle or medulla. It’s very rare.
  • Neuroblastoma also begins in the medulla, usually in children.
  • Malignant paraganglioma grows inside or outside your adrenal gland.

Benign tumors include:

  • Adenoma. These may make extra cortisol, leading to a condition called Cushing’s syndrome.
  • Benign pheochromocytoma
  • Benign paraganglioma

Adrenal Cancer Diagnosis

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

  • Physical exam and medical history. Your doctor will ask 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. 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. Your doctor inserts a very thin tube into your body. It has a tiny video camera attached to the end. This shows places where your cancer may be growing.
  • Biopsy. With a needle, your doctor takes a tiny sample of tissue to look at under a microscope for signs of cancer.
  • Adrenal angiography or venography. Your doctor injects dye into your bloodstream and then takes X-rays to look for blocked arteries or veins.

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Adrenal Cancer Treatments

Your doctor will recommend a treatment plan based on your case and your overall health.

Surgery. This is the only treatment that may be able to cure you. Your doctor may take out one or both of your adrenal glands. If the disease has spread, they 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 a tumor from growing. You might have it after surgery. Your doctor may beam radiation into your body through an outside machine, put radioactive seeds near the tumor, or insert a sealed radioactive capsule or wire into it.

Medications. Doctors most 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 after surgery if there's a risk that the tumor may return.

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.

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

Tumor ablation. This uses heat or cold to kill cancer cells if your tumor has spread or returned, or if you're too sick for surgery. It can ease 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 that can give you a chance to talk with others who are going through the same things. They can give you tips and advice on how to keep positive while you get the care you need.

Adrenal Cancer Outlook

Your outlook depends on several things, including your age, how big the tumor was when it was diagnosed, and whether the tumor makes hormones.

Of people whose cancer is treated before it spreads beyond their adrenal glands, about 74% live at least 5 more years. That 5-year survival rate is 56% If it’s spread to nearby tissues or organs. It’s about 37% if cancer has spread to farther parts of your body.

WebMD Medical Reference Reviewed by Gabriela Pichardo on May 17, 2020

Sources

SOURCES:

National Cancer Institute: "Adrenocortical Carcinoma."

Memorial Sloan Kettering Cancer Center: "Adrenal Tumors."

M.D. Anderson Cancer Center: "Adrenal Tumors."

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

UptoDate: "Adrenal Cancer."

American Cancer Society: “Signs and Symptoms of Adrenal Cancers,” “What Is Neuroblastoma?” "What is adrenal cancer?"

American Society of Clinical Oncology: “Adrenal Gland Tumor.”

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