What Is Adenocarcinoma?
If your doctor tells you that you have adenocarcinoma, it means you have a type of cancer that starts in the glands that line the inside of one of your organs. Sometimes it's called the "cancer of the cavities."
Adenocarcinoma is very common for some kinds of cancers. For instance, 99% of prostate cancers, 85% of pancreatic cancers, and 40% of lung cancers are adenocaricnomas.
It's natural to feel worried when you find out you have cancer, but remember that treatments can slow or stop the disease. You might need chemotherapy, radiation, targeted therapy, or surgery. You and your doctor will decide on the best approach, based on where your tumors are growing and how long you've had them.
Adenocarcinoma vs. carcinoma
Cancers are classified either by the type of tissues where the cancer comes from or by the part of the body where the cancer first shows up. A carcinoma is a type of cancer that starts in the epithelial tissue. These are tissues that form the covering of all body surfaces as well as the lining of body cavities and hollow organs, and are the main tissue in glands. Most cancer cases (80-90%) are carcinomas.
Adenocarcinoma is one of the two main types of carcinoma, one where the cancer develops in an organ or gland. (The other main type, squamous cell carcinoma, occurs mostly occurs in the skin).
Types of Adenocarcinoma
Your glands make fluids that your body needs to stay moist and work well. You get adenocarcinoma when cells in the glands that line your organs grow out of control. They may spread to other places and harm healthy tissue.
Adenocarcinoma can start in your:
- Colon and rectum. The colon, which is also called your large intestine, is part of your digestive system. It's a long tube that removes water and nutrients from the food you eat. Adenocarcinoma is the most common type of colon cancer. It starts out as a small polyp, or growth, that's usually harmless at first but can turn into cancer. The disease can also start in your rectum, the part of your large intestine where stool gets pushed out of your body.
- Breasts. Most breast cancers are adenocarcinomas. They start in the glands of the breast where milk is made.
- Stomach. This starts in the cells that create mucus. This cancer, also known as gastric cancer, can start either in the stomach or where the stomach meets the esophagus.
- Esophagus. This is the tube that carries food from your mouth to your stomach. Adenocarcinoma usually starts in mucus glands that line the lower part of your esophagus.
- Lungs. Adenocarcinoma is most often found in the outer part of the lungs and grows more slowly than other types of lung cancer. You usually get it if you're a smoker or used to be one.
- Pancreas. This is an organ in the back of your belly, behind your stomach. It makes hormones and enzymes that digest food. These tumors start in the ducts of this organ.
- Prostate. This is a gland in men that's just below the bladder. It helps make some of the fluid that protects sperm cells. Adenocarcinoma starts in the cells that make this fluid.
If your cancer cells spread from where they originated to nearby lymph nodes (glands that are part of the immune system) or tissues, or to another part of your body, this is known as invasive adenocarcinoma.
Metastatic adenocarcinoma is a later stage of invasive adenocarcinoma. If your cancer cells have spread to distant body parts, then you are considered to have metastatic adenocarcinoma. For instance, breast cancer could have spread (metastasized) to the brain or lungs.
Causes of Adenocarcinoma
Since adenocarcinoma can affect so many parts of the body, the causes can vary a lot. But here are some common risk factors:
- Smoking. Smoking is the biggest cause of lung adenocarcinoma. Exposure to secondhand smoke also plays a role.
- Genes. Having a family history of a certain kind of cancer can make it more likely you develop it.
- Lifestyle. What we eat or whether we exercise or drink alcohol (and how often) can all play a part in whether we're more likely to get some kinds of cancers, especially if we already have the genes for them.
- Obesity. Carrying a lot of extra weight can be a risk factor for some cancers.
- Environment. Exposure to harmful toxins in our food, water, air, or products we use can cause adenocarcinoma.
- Radiation exposure. Previous radiation therapy can put you at a higher risk of getting adenocarcinoma. So can too much UV radiation from sunlight.
The symptoms of adenocarcinoma you experience will depend on the type of cancer you have. Here are some of the main cancer symptoms:
A test called low-dose CT (LDCT) scan is available for people who are smokers or otherwise at higher risk for lung cancer. Symptoms include:
- Persistent cough
- Coughing up blood, even a small amount
- Shortness of breath or wheezing
- Loss of appetite
- Weight loss
- Chest pain
- Repeated infections (such as bronchitis and pneumonia)
If you're having regular prostate exams, this may be caught in the early stages. Otherwise, there may not be any symptoms. In later stages you may experience:
- Frequent peeing (especially at night)
- Trouble fully emptying your bladder
- Weak urine flow
- Blood in the urine
- Pain when sitting down
- Pain or burning when urinating
If you're having regular mammograms, your doctor may catch this in the early stages. Some warning signs include:
- Lump in the breast or under the armpit
- Thickening or swelling of the breast
- Irritation or dimpling of the breast skin
- Red or flaky skin around the nipple
- Nipple discharge other than milk (like blood)
- Breast pain
There’s no screening test for this and no symptoms in the early stages. In the later stages you might experience:
- Back or belly pain
- Jaundice (yellowing of the skin and whites of eyes)
- Dark or brown urine
- Light or gray stools
- Weight loss and loss of appetite
Screening tests are available but not given routinely in the U.S., as stomach cancer is not that common. In other parts of the world, stomach cancer screening is routine. If you have a family history of stomach cancer, ask your doctor about a screening test called an upper endoscopy (a tube with a tiny camera is put down your throat). There may be no symptoms of stomach adenocarcinoma in the early stages. In the later stages you may experience:
- Stomach pain
- Loss of appetite
- Weight loss
- Feeling full after eating small amounts of food
- Heartburn or indigestion
- Nausea or vomiting
Colorectal (colon) cancer
If you have a regular colonoscopy, where a doctor puts a tube into your colon to check for polyps, this may be caught in the early stages. The symptoms you experience will depend on the size of the tumor in the colon but could include:
- Changes to your bowel habits, such as more diarrhea or constipation
- Persistent need to have a bowel movement
- Rectal bleeding or bloody stool
- Stomach pain, gas, or cramping
- Fatigue and weakness
Screening tests are available but not given routinely in the U.S. as this cancer is not that common. An upper endoscopy is the normal screening test. In the early stages, there may be no symptoms. In later stages, symptoms may include:
- Difficulty swallowing some foods
- Pain or choking with swallowing
- Chest pain or pressure
- Worsening heartburn or indigestion
- Coughing or hoarseness
- Weight loss
Your doctor will give you a physical exam. They may feel your organs to see if there is any swelling or a growth.
You may also get tests to see if you have adenocarcinoma in any of your organs:
- Blood tests. Your blood may show signs of cancer. For example, your doctor may check it to see if you have anemia from a bleeding tumor. Also, high levels of some enzymes or other things made by cancer cells might mean cancer is likely.
- Imaging tests. They can help see if any of the tissues in your organs don't look normal. You may get a CT scan, which is a powerful X-ray that makes detailed pictures inside your body. Or you might need an MRI, which uses powerful magnets and radio waves to make pictures of organs and tissues. If you do have cancer and start treatment, imaging tests can also help your doctor learn how well your treatment is working.
- Biopsy. Your doctor takes a small sample of tissue from the organ where they think you may have cancer. For example, they may remove a polyp or growth from your colon, or use a small needle to remove tissue from your breast. A doctor called a pathologist will look at it under a microscope to see if there are cancer cells. A biopsy can also show if they are just in that one organ, have spread from another place in your body, or how much they've grown.
This refers to the grade given to your cancer cells based on what they look like under a microscope, compared with normal cells. If the tumor cells look like normal cells (well-differentiated), they are given a low grade. If they don't look very much like normal cells (poorly differentiated), they are given a high grade. The higher the grade, the faster the cancer is likely to spread. Grades are usually from 1 to 4, though some may only go from 1 to 3. The grades might also be written in Roman numerals.
Grade 1. Well-differentiated; cancer cells not growing very fast
Grade 2. Moderately differentiated; cancer cells growing faster than normal cells
Grade 3. Poorly differentiated; cancer cells growing and spreading fast
Grade 4. Undifferentiated; cancer cells growing and spreading fast
Grade X. Grade is unknown.
This shouldn't be confused with grading. Grading has to do with the appearance of the cancerous cells, while staging describes the size of the cancer tumor and how far it has spread. There are four stages usually designated as numbers 1 to 4, or as Roman numerals I to IV. The higher the number, the more advanced the cancer is. Each type of cancer has its own staging system, but here is the general rule:
Stage I. The cancer is small and hasn't spread beyond the cells where it started.
Stage II. The cancer is a bit larger than at stage I but hasn't spread beyond the organ where it started.
Stage III. The cancer is larger than stage II and may have spread to nearby lymph nodes or other tissues.
Stage IV. The cancer has spread to at least one other organ (metastasized).
You might see a stage 0 as well. This means there is no cancer but abnormal cells have been found with the potential to become cancerous. These should be treated as well.
The staging number helps the doctor decide how to treat the cancer. Higher-stage cancers are harder to treat than lower-stage cancers.
TNM Staging System
This system uses letters to describe the kind of cancer you have:
T (tumor) describes the size of your tumor, using numbers 1-4 (1 is small; 4 is very large).
N (nodes) describes how many of your lymph nodes have cancer, using numbers 1-3. (1 means no lymph nodes have cancer; 3 means many do).
M (metastases) describes whether your cancer has spread to other parts of your body (0 means it has not spread; 1 means it has spread).
You might see your cancer described as (for instance) T2N1M0 in a lab report. If you see an X included (for example T2N1MX), that means that something cannot be measured. In this example, the metastases cannot be measured.
Your treatment depends on the type of adenocarcinoma you have and the stage of your cancer.
- Surgery. Your first treatment will probably be to remove the tumor and tissue around it. Your doctor can then look at the tissue to see if you're cured or if there still may be cancer cells in your body. You may need to combine other treatments with surgery to make sure your cancer is gone.
- Chemotherapy. Drugs can kill adenocarcinoma cells, slow their growth, or even cure your disease. These drugs may kill healthy cells as well.
- Radiation. Doctors use high-energy X-rays or other types of rays to kill your cancer cells.
- Immunotherapy. This could refer to drugs that block your immune checkpoints (allowing immune cells to respond more strongly to the cancer cells) or to immune cells taken from your tumor, changed in the lab to better fight the cancer cells and reinjected into your body) or other procedures that use your immune system to better fight the cancer.
- Targeted therapy. This uses drugs that target just your cancer cells rather than all your cells. Not all cancers can be treated with targeted therapy.
You may need chemo along with surgery and radiation to treat your cancer.
Your cancer treatment can have side effects. You might get very tired or feel like you need to throw up. Your doctor can suggest ways to manage these problems. They may prescribe drugs that fight nausea.
Talk to your family and friends about how you're feeling, and don't hesitate to ask them for help while you're getting treatment. Also tell them about your worries and fears. They can be a huge source of support.
Check the web site of the American Cancer Society. You can find out about local support groups, where you'll meet people who have the same type of cancer as you and can share their experience.
Adenocarcinoma is a very common type of cancer that starts either in the skin or in one of the body cavities. It can affect many parts of your body like your colon, breasts, lungs, pancreas, or prostate. Treatments like surgery, radiation, and chemotherapy can stop or slow down the disease.
Is adenocarcinoma cancer curable?
Yes, in many cases. The survival rate for adenocarcinoma depends on the type of cancer, stage, and where it is located. The relative survival rate tells you what percentage of people who have the same type and stage of cancer are still alive 5 years after diagnosis. The figures below are based on research in the U.S.
- About 67% of cancer survivors have survived 5 or more years after diagnosis.
- About 18% of cancer survivors have survived 20 or more years after diagnosis.
However, a lot depends on the type of cancer. More than 99% of people with prostate cancer were alive 5 years later. Some 90% of people with breast cancer or colorectal cancer were alive 5 years later. On the other hand, only 32% of people with stomach cancer and only 7% of those with pancreatic cancer were alive 5 years later. Early detection (thanks to routine screening tests) has a lot to do with high survival numbers.
How serious is adenocarcinoma?
It depends on the type of cancer you've been diagnosed with and how far along it was when diagnosed. Some adenocarcinomas are more serious than others.