Adrenal Cancer: The Basics
The adrenal glands are two glands that sit on top of each of the kidneys. The adrenal glands are made up of two parts, the medulla, and the cortex. The adrenal glands make hormones that help the body work. Adrenal cancer is caused by adrenal cells growing out of control. As the number of cells grow, they form into a tumor. There are many types of adrenal cancers. They are described below.
- Adrenal Adenoma
- Not cancer and does not need treatment unless it is causing problems like high blood pressure.
- Adrenal Cortical Caricinoma
- Found in the cortex and can cause symptoms if they make too much of any hormone. Can cause weight gain, pain, fluid retention, extra hair on the face in women, and feeling full. Tumors that make too much steroid hormone are called functioning and the tumors that don’t are called non-functioning.
- Adrenal Medulla
- Cancer that is found in the medulla which is called pheochromocytoma in adults and neuroblastoma in kids.
- Melanoma, lung, and breast cancer can spread to the adrenal glands.
Adrenal cancer that has spread from the adrenal glands to another part of the body is called metastatic cancer.
- Genetic Syndromes: Li Fraumeni syndrome, Beckwith-Wiedmann syndrome, multiple endocrine neoplasia, hereditary nonpolyposis colorectal cancer, and familial adenomatous polyposis.
- Other general cancer risks: high-fat diet, smoking, lack of exercise.
Signs of Adrenal Cancer
Signs of adrenal cancer happen when the tumor is making too much of a hormone. The sign depends on which hormone is being made. Here are some examples:
- Aldosterone: high blood pressure, lack of strength, muscle cramps, feeling thirsty, needing to urinate often.
- Cortisol: weight gain, holding onto fluid in your body which makes the face round, fat on the back of the shoulders and neck, red or purple stretch marks, extra hair growth, infections, and mental changes like mood swings.
- Sex Hormones: Too much testosterone in a woman can cause a deeper voice, loss of hair, and a large clitoris. Too much estrogen in men can cause a lack of sex drive and growth of breasts.
An adrenal tumor that is big can also press against other organs causing a full feeling or pain.
Diagnosis of Adrenal Cancer
When your healthcare providers think you may have adrenal cancer, they will order tests. The tests ordered may depend on what signs you are having. Here are some of the tests:
Staging Adrenal Cancer
To guide treatment, adrenal cancer is "staged." This stage is based on
- Size and location of the tumor
- Whether cancer cells are in the lymph nodes
- Whether cancer cells are in other parts of the body
Stages range from stage I (smallest, most confined tumors) to stage IV (tumors that have spread to other parts of the body, also called metastatic cancer). The stage and type of adrenal cancer will guide your treatment plan.
Adrenal cancer is only treated if it is causing symptoms.
- Surgery: The only known way to cure adrenal cancer. The goal is to remove the whole tumor.
- Chemotherapy: Can be used before surgery to shrink a tumor or after surgery is done if the whole tumor couldn’t be taken out.
- Radiation: Can be used if the whole tumor is not removed during surgery or if the cancer comes back.
- Medication: Drugs can be used to treat the problems caused by the hormones being made by the tumor.
This article is a basic guide to adrenal cancer. You can learn more about your type of adrenal cancer and treatment by using the links below.
American Cancer Society. Adrenal Cancer. https://www.cancer.org/cancer/adrenal-cancer.html
Amin, M. B., & Edge, S. B. AJCC cancer staging manual. Eighth edition. 2017.
Bagi, RP et al. Adrenal carcinoma treatment and management. Medscape. 2014. Found at: http://emedicine.medscape.com/article/276264-treatment
Berruti A, et al. Adrenal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology (2013). 23(7):131-138.
National Comprehensive Cancer Network. NCCN Guidelines Version 4.2021 Neuroendocrine and Adrenal Tumors.
Terzolo M, et al. Management of adrenal cancer: a 2013 update. Journal of Endocrinological Investigation (2014). 37(3):207-217.