What is Adrenal Cancer?

Adrenal cancer begins when cells in the adrenal glands start to grow out of control. This results in the formation of tumors, which may either be benign (mostly harmless) or malignant (cancerous).

The adrenal glands are small glands deep in the upper part of the abdomen that sit above each of your kidneys. They have two parts: the outer part, called the cortex, and the inner part, called the medulla.

The cortex is where most adrenal tumors develop. The cortex makes hormones for the body called ‘steroids’:

  • Cortisol - helps the body handle stress
  • Aldosterone - helps regulate blood pressure and helps the kidney regulate salt in the blood
  • Adrenal androgens - can be converted to either estrogen or testosterone

The medulla in the adrenal glands is an extension of the nervous system and produces nervous system hormones like epinephrine (adrenaline) and norepinephrine. Tumors that start in the medulla are often mostly benign pheochromocytomas and neuroblastomas.

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Adrenal Cortex Tumors

The two main types of adrenal tumors are adenomas and carcinomas. Adenomas are benign, while carcinomas are malignant or cancerous. These tumors are difficult to differentiate under the microscope. Often, the only way to be sure they are cancerous is if they have already spread outside the adrenal glands into the lymph nodes. This is why it is difficult to find adrenal cancers early, and when they are diagnosed, they are often already large.

Adrenal Cortex Adenomas

Most adrenal tumors are benign adenomas, usually less than 2 inches across, that often cause no symptoms and are discovered incidentally during imaging for other conditions. About 5% of abdominal CT scans reveal these nonfunctional tumors. Some adenomas produce excess adrenal hormones, causing symptoms similar to adrenal cancer. Adenomas are more likely than cancer to cause high aldosterone and hypertension.

Treatment of an adenoma depends on the chance it is cancerous and if it raises hormone levels. Incidentally, small tumors are observed for growth and excess hormones. If the tumor grows or produces hormones, surgery is often recommended to prevent hormone imbalances. Otherwise, small nonfunctional tumors may just be monitored long-term and not treated unless they enlarge or become functional. Removing the adrenal gland cures adenomas. Hormone blockers can also be used to treat some hormonal adenomas in patients unable to have surgery.

Adrenal Cortex Cancer

Adrenal cortex cancer, or simply adrenal cancer, is rare. According to the American Cancer Society, only around 200 cases are diagnosed in the US every year. But when it does occur, it is usually discovered when:

  • Imaging tests in the abdominal area are done, and the tumors are found incidentally
  • Hormonal imbalances cause severe weight fluctuation, excess facial hair in women, fluid retention, and early puberty in children.
  • Tumors are already larger than 6 cm and are causing pain and discomfort.

Adrenal cancer is the name given to the disease when the cancer originated in the adrenal glands. When tumors develop in the adrenal glands because of metastasis from cancers in the nearby organs like lung cancer or breast cancer, they are not considered adrenal cancer and are treated based on the origin of the cancer.

Signs and Symptoms of Adrenal Cancer

Adrenal cancer symptoms are either caused by abnormal hormone production or by the tumor pressing up against nearby organs when it has grown too large.

Androgens are male-type hormones produced by the adrenal glands. When adrenal cancer is present, androgen production may be increased. This can cause abnormal penis or clitoris enlargement in young children and early aggressive body hair growth, especially in the face and the underarms. Adrenal cancer may also increase female hormone production, such as estrogen, leading to early breast development in young girls. This is why it is easier to detect adrenal cancer earlier in children because adults who have already gone through puberty may not have noticeable physical changes due to their already fully-grown bodies. For adults, it is usually when the tumor is already large and causing pain that the adrenal cancer is detected.

Symptoms will be easier to notice if the tumor produces more hormones of the opposite sex. If the tumor produces estrogen in a male, it can lead to the development of gynecomastia or ‘man boobs’ and cause impotence. On the other hand, if women have adrenal tumors that produce excess androgens like testosterone, they can undergo virilization or development of male characteristics like receding hairlines, excess facial hair, and deepening of the voice, along with irregular menstrual periods.

Cushing Syndrome

Cortisol is a stress-regulatory hormone that is manufactured in the adrenal glands. If a tumor is causing excess cortisol release, it can lead to a condition known as 'Cushing Syndrome, ' which may result in some or all of the following symptoms:

  • Weight gain, usually above the collarbone, cheek area, and around the abdomen
  • Fat deposits behind the neck and shoulders
  • Purple stretch marks on the abdomen
  • Excessive hair growth on the face, chest, and back in women
  • Menstrual irregularities
  • Weakness and loss of muscle mass in the legs
  • Easy bruising
  • Depression
  • Osteoporosis
  • High blood sugar levels which may lead to diabetes
  • High blood pressure

Cushing syndrome may be caused by adrenal adenomas or adrenal cancer when they produce more cortisol in the body than needed. But this can also be caused by other conditions, such as benign pituitary gland tumors. If a patient has Cushing Syndrome, a doctor will conduct tests to figure out if the cause is adrenal cancer or some other disease.

If you or a loved one have suffered from a misdiagnosis or delayed diagnosis for your adrenal cancer, contact us at 833-PORTER9, or e-mail us at info@porterlawteam.com to discuss the details of our experience representing other clients and the results we were able to obtain in the past for clients who are suffering as you are. In many ways, our results speak for themselves, and we will stand ready to help you and your family in your time of greatest need.

Last Updated on March 1, 2024 by Michael S. Porter
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