Adrenal glands are the small, triangular glands that sit above the kidneys and produce several different hormones. The hormones produced by the adrenal glands regulate kidney functions, metabolism, stress response, and certain body characteristics, like hair growth and body shape. Tumors can be malignant (cancerous) or benign (non-cancerous), and it is typically a very aggressive cancer.
Adrenal cancer is a very rare disease, and there are only about five hundred new cases each year. The cause of adrenal cancer is relatively unknown. Occasionally, it’s more common in those who have certain syndromes, which increase their chances of getting cancer. Risk factors for adrenal cancer include:
- Being between 30 and 50, or younger than five years old.
- Certain familial syndromes
In about 60 percent of the cases, adrenal cancer is found because excess hormone production causes symptoms which prompt the patient to seek medical care. These symptoms include:
- Abdominal pain, cramping, or fullness
- Changes in sexual desire or function
- Excess hair growth
- Easy bleeding or bruising
- Feeling very thirsty
- Frequent urination
- Irregular menstrual cycles
- Mood changes
- Voice deepening
- Weight gain, especially in the abdomen, chest, and face
While the above symptoms require medical attention, the following symptoms might indicate a life-threatening condition. If you experience any of the following symptoms or conditions, you should seek medical attention immediately by calling 911:
- A change in your level of alertness or consciousness
- Change in mental status or a sudden behavioral change, i.e. confusion, lethargy, delusions, delirium
- Chest pain, chest tightness, or palpitations
- Respiratory or breathing problems
- High fever (101 degrees or above)
- Severe abdominal pain or severe headache
Some cases of adrenal cancer produce no hormonal symptoms and may progress undetected until a point where cure is difficult or impossible.
Adrenal tumors are commonly detected on MRI, CT scans, or ultrasounds of the abdomen which are performed for other medical conditions or unrelated symptoms. In many cases these “incidentally” found tumors are benign and do not require treatment. Certain characteristics of the scan will indicate if the tumor is at high risk of being a cancer.
In order for a diagnosis to take place, your doctor will:
- Review your medical history
- Perform a physical exam
- Take blood and urine tests
- Take hormone level tests
- Perform CT scan, MRI, and PET scan
- Nuclear scintigraphy may be performed
- Biopsy may be performed
Treatment of adrenal cancer depends heavily on the size and type of the tumor.
If the tumor hasn’t spread past the adrenal glands, surgery may be recommended. Adrenal cancer surgeries include:
- Surgery through the chest and abdomen
- Posterior surgery
- Laparoscopic adrenalectomy, in which a tube with a camera is inserted into a tiny incision in your back or side, and the tumor is then removed.
Some tumors are too large for safe removal with this approach, so one of the other procedures may be used. If your cancer has spread, your doctor may perform tumor-reducing surgeries to improve your quality of life and survival. Other treatment options include:
- Radiation therapy