Adrenal gland cancer: Symptoms, diagnosis and prognosis

The body has many structures that often we do not know, so we just pay attention to them when a problem appears in them. The adrenal glands are a very clear example of this. These glands are located at the top of each kidney and are responsible for producing various hormones that are essential for life, for example, cortisol or sex hormones, while responding to daily stress and other functions that offer the same.

There are several alterations that can affect them and adrenal tumors are one of them, so it is essential to perform medical checks on a frequent basis. If you want to know more about this alteration, in the following article we offer you a lot of information about adrenal gland cancer: symptoms, diagnosis and prognosis.

Symptoms of adrenal gland cancer

The symptoms that appear in people suffering from a malignant adrenal tumor will depend on the area affected by it. If it is located in the adrenal cortex, the most characteristic symptomatology is the appearance of Cushing’s syndrome, related to an increase in the secretion of cortisol, so it may exist:

• An increase in the patient’s weight.
• High blood pressure.
• Decrease in muscle mass.
• Appearance of stretch marks in the abdominal area.

It is also possible that primary hyperaldosteronism occurs due to an increased secretion of the hormone aldosterone, whose accumulation in the body increases urinary excretion and causes much desire to drink water frequently, although it can also cause muscle changes such as cramping. To this, it is added that there could be an excess of androgens, which would cause excessive hair growth, so in the case of women can cause some masculinization.

In the situation where the malignant tumor affects the area of the adrenal medulla the most common symptoms are:

• Migraines.
• Hypertension.
• Palpitations.
• Excessive sweating.

As these signs can make reference to other alterations, it is important to go to a doctor for a review and corroborate if it is a malignancy in the adrenal glands to start treatment immediately.

Adrenal gland tumor: Diagnosis

While some of the most frequent signs of a cancer of the adrenal gland are present, it is important to perform a blood test indicated by the doctor with dosage of the various hormones, in this way, it would be evident that there is an excess in the secretion of these.

At the same time, it is likely that the specialist recommends that the patient undergo a CT scan or MRI of the abdomen, although the latter is usually less frequent, in order to visualize the adrenal tumor. On the other hand, you can also undergo a scintigraphy and, if you suspect a malignant tumor, it is likely that the doctor chooses to perform some type of study to find cancer cells that may be migrating to various organs, such as taking a sample of tissue, and if the result of this is a metastasis, the cancer is confirmed.

Prognosis of malignant tumors in the adrenal glands

As with most cancers, the prognosis or the possibility of recovery will depend on several factors, for example:

• The general health and age of the patient.
• The stage in which the adrenal tumor is located, that is, its size and whether it is only located at one point or disseminated to other areas, with lungs, liver and peritoneum being more frequent.
• If the tumor can be completely removed in a surgery.
• The degree of complexity of the case.

Therefore, if the cancer of the suprarenal glands is diagnosed early, the probability that the patient will be able to cure is very high; however, the risk still exists and health may decline due to the side effects of the treatment or due to the aggressiveness of the malignant tumor. For this reason, it is essential to perform medical checkup periodically and follow the specialist’s indications in an adequate way, achieving a superior survival at 5 years after diagnosis in 38% and 46% of the cases.

Treatment for adrenal gland cancer

The treatment for adrenal gland cancer is the same as that of most malignant tumors, so it will depend on the degree to which it is found, the results of the examinations and the general health of the patient.

The best option in the treatment of malignant neoplasms is still surgery to try to remove the entire tumor, the lymph nodes affected by the cancer and the surrounding tissues that may be affected in the same way. Also, chemotherapy and radiotherapy may be practiced accompanied with the administration of antihormonal drugs, although it is rarely used in this type of pathology because of the side effects and the low percentage of survival in aggressive cases.

Chemotherapy to treat adrenal cancer

Mitotane (Lysodren®) suppresses the function of the adrenal gland and is the drug of choice to treat adrenal gland cancer unusable. About 20 percent of adrenal cancer patients respond to treatment with mitotane. Side effects include gastrointestinal disorders (eg. loss of appetite, nausea, vomiting, diarrhea) and neurological disorders (eg. depression, lethargy, drowsiness).

When the mitotane treatment fails, cisplatin (Platinol®) may be tried alone or in combination with other agents. Combinations of drugs used are:

• Cyclophosphamide (Cytoxin®, Neosar®), doxorubicin (Adriamycin®), cisplatin
• Fluorouracil (Adrucil®, Efudex®), doxorubicin, cisplatin
• Cisplatin with VP-16

Neuroblastoma can be treated with chemotherapy in addition to surgery (adjuvant therapy) with carboplatin (Paraplatin®), cyclophosphamide, doxorubicin, etoposide and (Vepesid®).

The side effects of chemotherapy are often serious and include gastrointestinal disorders, low blood counts (anemia), skin disorders and neurological disorders.

Radiation therapy to treat adrenal cancer

Radiotherapy uses high-energy X-rays to destroy cancer cells. Radiation therapy decreases the size of the tumor and kills cancer cells. There are several forms of radiotherapy. External beam radiation therapy involves radiation that is administered by an external device. In radiofrequency ablation, doctors use electricity to attack the tumor with a needle. Internal radiotherapy is administered by means of implants. Like chemotherapy, radiotherapy can also be used with other treatments.

Radiation is not used as a primary treatment for adrenal gland cancer. It is sometimes used as a pain reliever (palliative) treatment for adrenal metastatic cancer.

Surgery to treat adrenal cancer

Surgery is sometimes an option for patients with adrenal tumors. When considering surgery, the size of the tumor is important. Doctors recommend laparoscopic surgery for tumors that measure less than 5 centimeters. Here surgeon using a small telescope and instruments to remove the tumor by a small incision. Doctors recommend thoracoabdominal surgery for larger tumors. This procedure involves a larger incision. It also allows surgeons to examine the tissues around the tumor.

Tumor debulking

When removing an entire tumor could cause excessive damage to the adrenal gland or surrounding tissues, surgeons can trim the tumor instead. During this procedure, surgeons remove as much of a tumor as possible safely. Although tumor reduction is not a cure, it can help relieve some of a patient’s symptoms, improve their quality of life and increase their chances of survival. After the procedure, doctors can continue to treat the remaining tumor using other methods.