What Is Adrenal Cancer? 

Adrenal cancer is cancer of the adrenal glands, which are two small, hormone-producing organs that sit atop the kidneys. It’s a rare form of cancer, affecting roughly five to six hundred persons a year in the U.S. Adrenal cancer can strike at any age but is most common in children under than the age of five and in adults ages 40 to 60. Like numerous other cancers, adrenal cancer can be successfully treated if caught early in development. If, however, it has spread to other locations in the body, adrenal cancer is more difficult to treat and a greater risk to health.

The adrenal glands are comprised of two main parts: the cortex and the medulla. Each produces hormones with a variety of functions and is susceptible to different kinds of tumors, some benign and some malignant. There tumors can be categorized thusly:

• Adrenal cortex adenomas: These are small, benign tumors that may or may not have an impact on hormone production. 
• Adrenal cortex carcinomas: These are larger, malignant tumors growing on the adrenal cortex. They’re involved in hormone production and may be indicated by other symptoms, as well. 
• Pheochromocytomas: A rare type of neuroendocrine tumor that forms on the adrenal medulla. These tumors are often benign. 
• Neuroblastomas: Neuroblastomas are malignant growths that develop in young nerve cells, called neuroblasts, including those found in the adrenal medulla. 

If you are concerned about the possibility of adrenal cancer, arrange to see your Baptist Health family physician or oncologist.

What Are the Symptoms of Adrenal Cancer?

Adrenal cancers can be difficult to detect, especially in adults. Possible symptoms include:

• Weakness and fatigue
• Fever
• Abdominal bloating
• Nausea and vomiting
• Loss of appetite or a sensation of always feeling full
• Persistent back pain
• Lumps in the abdomen
• Unexpected fluctuations in weight
• Purple or pink streaks on the skin.

Because of their impact on hormone production, adrenal cancers are sometimes easier to spot in children. An active tumor can lead to early-onset puberty, enlarged sex organs, excessive hair growth in girls, and breast development in boys.

What Causes Adrenal Cancer?

Like other cancers, adrenal cancers result from DNA mutations that drive changes in cell behavior. Cancer cells live longer and reproduce more rapidly than healthy cells, leading to the buildup of cancerous masses or tumors that interrupt normal bodily functions. Cancer cells also metastasize or spread, extending the range and degree of disease. Medical researchers have yet to determine the exact cause or causes of the mutations.

There is evidence that genes plays a role in some adrenal tumors. There are several heritable disorders that increase the likelihood of developing this type of cancer:

• Beckwith-Wiedemann syndrome
• Carney syndrome
• Cowden syndrome
• Gardner syndrome
• Li-Fraumeni syndrome
• Lynch syndrome
• Multiple endocrine neoplasia 1 (MEN1)
• Turcot syndrome

How Is Adrenal Cancer Diagnosed?

The diagnosis of adrenal cancers typically requires a number of tests and procedures:

• Physical exam: Your doctor will examine you for evidence of cancer. He or she will document your symptoms and ask questions about your medical history and possible risk factors.
• Urine test: A urine test will provide evidence of a cancer by identifying elevated levels of cortisol, aldosterone, and androgens, all produced by the adrenal glands.
• Blood test: If the bloodstream contains unusually high levels of certain hormones, they can be detected in blood-sample analyses. 
• Medical imaging: X-rays, CT scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans can help your physician locate a tumor or tumors, depending on whether the cancer has metastasized. 
• Biopsy: To confirm the presence of cancer, your physician will collect a tissue sample for analysis. This sample is called a biopsy. The sample will be removed either before or during surgery, and sent to a medical laboratory for analysis.

How Is Adrenal Cancer Treated?

How adrenal cancer is treated depends on a number of variables, including its size and location, whether it has spread to other parts of the body, and the role it’s playing in hormone production. The primary methods of treatment include:

• Surgery: The surgical removal of an adrenal tumor can be effective in the early stages of the disease. This typically requires the removal of an entire adrenal gland, in a procedure called an adrenalectomy. (You have two adrenal glands, so the removal of one does not eliminate your ability to produce adrenal hormones.) Surgery may be combined with other forms of cancer treatment, including radiation and chemotherapy.
• Post-surgical medications: A drug called mitotane has been effective in combatting the recurrence of adrenal cancers.

Success in treating adrenal cancers depends, in part, on how early it is discovered. The five-year survival rate for early-detected adrenal cancers is in the 50 to 60 percent range. When the cancer has spread, the survival rate drops to 10 to 20 percent at the five-year mark.