What is Adrenal Cancer?

From roller coasters to horror movies, everyone knows the heart-pounding feeling of an adrenaline rush. It happens when a scary or stressful event triggers your body’s fight-or-flight response. That feeling, in part, is because your adrenal glands release hormones into your blood, including adrenaline (also called epinephrine). 

Your adrenal glands sit on top of your kidneys. They make hormones that control everything from blood pressure to how you break down food. And, like any other part of your body, they can develop tumors.

There are different kinds of adrenal gland tumors, and it can be hard to tell that ones that are cancerous from the ones that aren’t. Most of them are benign, which means they’re not cancer.

Adrenal cancer is rare, but it’s aggressive and can spread quickly. If they find it early, doctors may be able to cure it. But if it moves outside the adrenal gland, it’s very hard to treat.

What Are the Adrenal Glands?

You have two adrenal glands, one on each kidney. They’re small, shaped like triangles, and they’re part of your body’s endocrine system. Those are the parts of your body that make hormones. Hormones are chemical messengers. They move throughout your body and tell different organs what they need to do to keep you healthy and balanced.

The outer part of the adrenal gland (the cortex) makes these hormones:

  • Aldosterone helps control your blood pressure.
  • Cortisol helps you handle stress, break down foods, and make substances your body needs.
  • Sex hormones have many different roles. For example, they affect menstrual cycles in women, sex drive, and physical features, such as facial hair.

The inside part (the medulla) makes hormones for the nervous system:

  • Epinephrine, also called adrenaline, triggers your short-term response to stress.
  • Norepinephrine affects mood and attention, as well as your stress response.

What Types of Tumors Affect the Adrenal Glands?

Usually, cells grow and divide in a very orderly way. But sometimes, a change in certain cells means they start to grow out of control. That’s when you get a tumor. It’s another name for a mass of cells that normally wouldn’t be there. You can get tumors in both the adrenal cortex and the medulla.

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Adrenal cortex tumors come in two types:

  • Adrenal carcinoma is adrenal cancer, also called adrenocortical cancer.
  • Adrenal adenoma is a benign tumor, meaning it’s not cancer.

Both of these tumors are usually found by accident when you get an imaging test to look at some other problem. These tumors often don’t cause symptoms early on unless they’re “functioning,” which means that the tumor makes the same hormones as the adrenal gland. In that case, higher-than-normal hormone levels can cause a range of symptoms like weight gain, acne, and muscle cramps.

Most cancers found in the adrenal gland didn’t start there. They began somewhere else in the body -- often in the lungs, breast, or skin -- and spread to the adrenal glands. These cancers are named after the place in the body they started. So if you have breast cancer that’s spread to your adrenal gland, it’s still breast cancer.

Benign adenomas tend to be small, round, and smooth. Carcinomas (cancers) are more likely to have an irregular shape and to be larger than 4 centimeters (about an inch and a half).

Medulla tumors. These tumors show up on the inner part of the adrenal gland:

  • Pheochromocytoma is a rare tumor that’s usually benign, but not always.
  • Neuroblastoma is a type of cancer mostly found in children under 5 years old.

What Causes Adrenal Cancer?

Doctors aren’t sure. It starts with a change in the genes of some adrenal cells, but that change seems to happen at random.

It can run in families, so if anyone in your family has cancer in their adrenal glands or other parts of the endocrine system, tell your doctor. If you do get it, regular checkups can help you catch it early.

When you have a genetic condition, you have a defect in one or more genes. Certain genetic conditions may give you higher odds of getting adrenal cancer:

  • Beckwith-Wiedemann syndrome leads to a larger body and tongue than normal. It also can raise your chances of kidney, liver, and adrenal cancer.
  • Familial adenomatous polyposis (FAP) causes hundreds of small growths in your large intestine that can lead to colon cancer. It can raise your risk for adrenal cancer, but more often leads to adrenal adenomas.
  • Hereditary nonpolyposis colorectal cancer (HNPC), also called Lynch syndrome, can increase your risk of colorectal cancer, endometrial cancer in women, and adrenal cancer.
  • Li-Fraumeni syndrome increases your odds of getting many cancers, such as breast, brain, and adrenal cancer.
  • Multiple endocrine neoplasia (MEN1) makes you more likely to get tumors in your pituitary gland, parathyroid, pancreas, and adrenal gland.

Other things that make you more likely to get adrenal cancer:

  • Too much fat in your diet
  • Being exposed to substances that cause cancer
  • Smoking
  • Getting very little exercise
WebMD Medical Reference Reviewed by Sabrina Felson, MD on November 03, 2019

Sources

SOURCES:

Harvard Health Publications, Harvard Medical School: “Understanding the Stress Response.”

American Cancer Society: “Adrenal Cancer.”

The University of Texas MD Anderson Cancer Center: “Adrenal Tumors.”

Memorial Sloan Kettering Cancer Center: “Adrenal Tumors.”

Mayo Clinic: “Adrenal Cancer.”

KidsHealth: “Hormones.”

National Institutes of Health, National Cancer Institute: “Adrenocortical Carcinoma Treatment (PDQ) -- Patient Version.”

The Abramson Cancer Center at the University of Pennsylvania, OncoLink: “All About Adrenal Cancer,” “All About Neuroblastoma.”

Comprehensive Medicine Center, Michigan Medicine: “Adrenal Tumors and Cancer.”

Medscape: “Pheochromocytoma.”

Stanford Health Care: “Adrenal Cancer.”

Northwell Health: “Adrenal Cancer.”

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