Adrenal cancer – or adrenal gland cancer – develops when abnormal cells in the adrenal gland start to mutate and grow uncontrollably and more rapidly than normal cells. Adrenal cancer usually appears as a tumour on the outermost layer of the adrenal gland, the adrenal cortex.
A cancerous tumour on the adrenal gland is called an adrenal cortical carcinoma, whereas a noncancerous tumour is called a benign adenoma. The latter tend to be smaller and cause no symptoms unless they grow. Tumours larger than 4 cm in diameter are more likely to be cancerous.
The adrenal glands are small organs that secrete hormones such as adrenaline, noradrenaline, androgens, estrogens, aldosterone, and cortisol, regulating a range of bodily functions like your immune system, blood sugar levels, blood pressure control, and metabolism.
As the name implies, they are located near the renal area, just above the two kidneys. Although small, they are complex glands. Cells in the inner area of the adrenal glands – known as the adrenal medulla – secrete hormones called catecholamines, which include adrenaline and noradrenaline.
Tumours that form in these cells are known as pheochromocytomas and are usually benign. Adrenal cancer usually appears on the outermost layer of the adrenal gland, the adrenal cortex.
Symptoms of adrenal cancer usually appear due to excess hormones produced by the adrenal gland. Larger tumours will generally present more symptoms and can even cause symptoms by pressing against neighbouring organs.
Because of the range of functions, the hormones produced by the adrenal glands, adrenal cancer symptoms can vary greatly.
In children and young adults, excess production of androgen or estrogen can accelerate accelerated physical changes associated with puberty, such as excess facial or pubic hair or large breasts. In adults, excess cortisol and aldosterone can result in high blood pressure, weight gain, irregular periods, depression, and muscles cramps.
Like other forms of the disease, we don’t know exactly what causes adrenal cancer. However, there are several conditions associated with its occurrence and development:
• Li-Fraumeni syndrome: This is an inherited disorder that poses a risk for developing many types of cancers, including breast cancer, bone cancer, brain cancer.
• Beckwith-Wiedemann syndrome: This disorder causes abnormal growth of organs and body parts and increases the risk of different cancers.
• Multiple endocrine neoplasias (MEN1): This is an inherited condition that greatly increases the risk of developing tumours in the pituitary gland, parathyroid, and pancreas, as well as the adrenal glands.
• Familial adenomatous polyposis (FAP): This is a syndrome characterised by the development of hundreds of polyps in the large intestine and may increase the risk of adrenal cancer.
The treatment of adrenal cancer depends on its growth and the extent of the tumour. Surgery is the most common treatment:
Surgery – Adrenalectomies are commonly used to treat benign or cancerous tumours in the adrenal gland. An adrenalectomy can be performed in two ways:
Open: An open adrenalectomy is often required when either the adrenal glands or the tumours are abnormally large. A single incision is made either in the abdominal wall just under the ribcage or the back or sides in this procedure. The surgeon then disconnects the adrenal gland from the blood vessels and surrounding tissue, removes it via the incision and closes the wounds.
Laparoscopic or robotic: Laparoscopic or robotic adrenalectomies are less invasive than open surgery, and as such, the recovery time is much quicker. This is where the adrenal glands are removed via several small incisions using fibre-optic technology.
Chemotherapy – The use of drugs to destroy tumour cells to help stop cancer from spreading. This can be administered intravenously or orally.
Radiotherapy – The use of high energy rays or other particles to destroy tumour cells. Radiotherapy can be used to help manage painful tumours.
Radiofrequency ablation – This is where a needle is inserted into cancer under local anaesthetic, and it is destroyed from the inside by high energy waves.
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