Adrenal Gland Cancer

Adrenal glands produce hormones that help regulate many processes in the body such as, maintaining blood pressure, metabolism, immune system, stress levels, and other essential functions. Abnormal cell growth in the adrenal glands can cause high blood pressure, weakness, fatigue, psychiatric disturbances, diabetes, and other hormonal imbalance.

Adrenal glands may be affected by Benign/ cancerous tumour. While the vast majority of adrenal tumors are non-cancerous, some can be malignant. Benign adenoma started in the thin layer of adrenal glands. They do not invade nearby tissue or other organs. Most of the time benign tumors are non-functional but sometimes they could start affecting blood vessels and nerves and require serious attention.

Adrenal Cancer is rare cancer that occurs when abnormal cells grow in the triangle-shaped adrenal glands. The adrenal glands have two layers and it’s located above each kidney. The adrenal cortex is the outer layer that secretes steroid hormones. A cancerous tumor that occurs in the adrenal cortex is called an adrenocortical carcinoma.

Adrenal cortical carcinoma is a rare disease involving formation of malignant or cancerous cells that spread to nearby organs and damage them. There are two types of adrenal cortical carcinomas: Functioning (which increases production of adrenal hormones ) & non functioning (which do not increase the hormonal production of adrenal glands).

In most cases, symptoms do not occur till the tumour is big enough to press on other organs. Typically, symptoms of adrenal cancer are caused by excess production of hormones such as oestrogen, androgen, aldosterone & cortisol. Common symptoms include:

• Weight gain
• Unintentional weight loss
• Loss of appetite
• Nausea & vomiting
• Abdominal bloating
• Stretch marks on the skin
• Hair loss, excess facial hair & irregular periods in women
• Enlarged breast tissue & shrinking testicles in men
• Fat deposits on the neck
• Depressed mood & nervousness
• Heart Palpitations
• High Blood Glucose levels
• High Blood pressure levels

Cushing's syndrome:

In this condition, the tumour results in excessive cortisol secretion. While most cases of Cushing's syndrome are caused by tumours in the pituitary gland, some occur because of adrenal tumours.

Conn's Disease:

In this disease, adrenal glands produce too much of aldosterone, a hormone which controls potassium & salt levels in the body. Excessive secretion of aldosterone can lead to dangerously high blood pressure levels.

Pheochromocytoma:

In this condition, the body produces excessive adrenaline & noradrenaline. Increased production of these hormones puts body in a state of stress response, resulting in high blood pressure.

Diagnosis

Early detection of adrenal cancer offers a better chance of treatment & recovery. Blood and urine tests are the most common tests used to learn about the function of the tumor.

To further evaluate the growth of the cancerous cells CT, MRI, Imaging test, ultrasound may be recommended to get the 3-dimensional picture of the inside of the body.

A biopsy is done to detect the spread of cancer to another part of the body that helps doctors to plan a treatment.

Adrenal Vein Sampling (AVS) is a rare diagnostic procedure used to test the blood of each adrenal gland to detect the hormone-producing tumour.

The treatment depends on the type and stage of adrenal gland cancer. Some standard treatments of adrenal cancer are as follows:

Surgery: Normally, surgery is preferred to remove all of the affected adrenal gland tumors. If the tumor is small, a laparoscopic intervention may be recommended to avoid a large incision.

Radiation Therapy: Radiation therapy uses high-powered beams of X-rays and protons to kill cancer cells. It also helps to kill any cells that might still present after surgery.

Chemotherapy: It is a cancer drug treatment that helps to stop the new cancer cells from growing. For complex cancerous tumours that cannot be removed with surgery, chemotherapy is recommended to slow the progression of cancer.

Adrenal cancers tend to have a higher recurrence rate. As such, frequent follow-up appointments with your ur-oncologist is critical.