AUA Summit - What are Adrenal Gland Cancers?

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What are Adrenal Gland Cancers?

While benign (non-cancerous) tumors in the adrenal gland are very common, cancers in or around this gland are very rare. They are found in only 1 or 3 per 1 million people. These tumors can give off too much cortisol or other hormones.

What Happens Under Normal Conditions?

The adrenal glands are found above each kidney. They are triangle-shaped, and measure about half an inch in height and 3 inches in length. Each adrenal gland has 2 layers.

  • The adrenal medulla (inner part) makes epinephrine (also called adrenaline).
  • The adrenal cortex (outer part) makes steroid hormones (such as cortisone and aldosterone).

The adrenal glands control many processes in the body. Their job is to keep the body in balance by making various hormones that are critical for maintaining good health.

These hormones do many important things. For example, they help regulate fluid and salt levels in the body that affect blood volume and blood pressure. They also help the body react to stress and change. They cause a faster heart rate and boost other systems that help you to react quickly with a burst of energy when needed. Problems in the cortex or the medulla, then, can result in high blood pressure.

Symptoms

Adrenal cancer is very rare. A tumor can grow large without causing any symptoms at all. In about half of people with adrenal cancer, symptoms are based on the extra hormones released by the tumor. In the other half, symptoms such as pain can occur if the tumor presses on nearby organs. It’s important to get proper medical tests to learn if there is a mass or other problem.

Diagnosis

Adrenal cancer is often found by chance when a CT scan or an MRI are done for other reasons. Sometimes patients have the symptoms of Cushing disease and blood tests measure abnormal hormone levels.

Treatment

The treatment you receive depends on the type and stage of adrenal gland cancer found. Treatment could include surgery, radiation, cancer drugs (chemotherapy) or drugs to control the release of hormones.

Surgery for Adrenal Cancer

Benign or cancerous adrenal tumors are removed using adrenalectomy (surgery to remove the whole gland). It is controversial whether surgery should be done laparoscopically when an adrenal cancer is suspected. Laparoscopic surgery is when surgery is done with thin, tube like instruments that allow several small incisions to be made, rather than one large incision. Some experts recommend open surgery for adrenal cancers. Surgical approach is important to discuss with your physician. Follow-up chemotherapy may be needed if cancer cells are found.

It’s important to know that adrenal surgery is complex. It helps to choose a surgeon who has significant experience with surgery in the area around the kidneys and adrenal glands. Talk with a few surgeons before you choose one to work with.

After Treatment

Based on the type of tumor found, surgery may be the only treatment you need. If after surgery cancer cells are still present, other treatments are used. Often, patients will have to take hormonal supplements to replace the loss of the adrenal gland. Over time, if the cancer returns or spreads, more surgery or chemotherapy is again recommended.

Adrenal Cancer Outlook

Adrenal cancer is difficult to cure. The outlook for adrenal cancer depends on the cause, location and stage of cancer. The 5-year survival rate may be as low as 7 out of 100 people surviving or as high as 65 out of 100 people surviving. Survival depends on where the cancer is found.


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