Adrenal Cancer Early Detection, Diagnosis, and Staging

Learn about the signs and symptoms of adrenal cancer, how it is diagnosed and staged, and what to expect after a diagnosis.

For information on neuroblastoma, a cancer that often begins in the inner part of adrenal glands, see Early Detection, Diagnosis and Staging of Neuroblastoma.

Can adrenal cancer be found early?

Adrenal cancers in adults can often grow without causing symptoms for some time. Because of this, tumors can be quite large by the time they are diagnosed. In adults, adrenal tumors can be found before symptoms when imaging tests are done for some other reason. These tumors are often not cancers, but more testing is needed to know for sure.

In children, adrenal cancers such as adrenocortical carcinoma, are more likely to make hormones. These can cause early signs of puberty which might lead to an earlier diagnosis.

Screening tests for adrenal cancer

Because adrenal cancers are rare, no screening tests are recommended for people at average risk of adrenal cancer.

People with certain family cancer syndromes have a higher risk of adrenal tumors, including adrenal cancers in some cases. People with a family cancer syndrome may have cancer screening recommendations that include adrenal cancer.

If you have a family cancer syndrome, talk to your doctor about whether adrenal cancer screening is recommended for you.

What are the signs and symptoms of adrenal cancer?

Adrenal cancers can cause symptoms because of their size or hormones they make. The symptoms of adrenal cancer depend on which extra hormones are made by the tumor. For example, in young children, adrenocortical carcinoma can make sex hormones, causing early puberty changes such as pubic hair growth. Other hormones cause other signs and symptoms.

About 1 in 5 adrenal cancers are found before any signs or symptoms. They’re usually found during an imaging test done for another reason.

How is adrenal cancer diagnosed?

Adrenal cancer is often first suspected when imaging tests show a tumor on the adrenal gland. Your healthcare team then uses other tests to learn more about the tumor and determine if it is cancerous. This might include other imaging tests, blood or urine tests, or surgery to remove all or part of the adrenal gland to check for cancer cells.

Not all adrenal tumors are cancerous. Tumors that have not grown beyond the adrenal gland may be benign (not cancer).

Staging and outlook for adrenal cancer

After a cancer diagnosis, staging gives your healthcare team important information about the extent of cancer in your body and your expected response to treatment.

The cancer stage describes how far cancer has spread in the body. It helps determine how serious the cancer is, what treatment options are available, and what to expect going forward. Your healthcare team will determine the stage of your cancer and use that to help guide your treatment plan.

Your cancer care team also uses a cancer’s stage when talking about survival statistics.

Adrenal cancer staging

Two major staging systems are used for adrenal cancer. They are the American Joint Committee on Cancer (AJCC) TNM staging system and the ENSAT (European Network for the Study of Adrenal Tumors) staging system. Both are based on the same TNM categories, which include 3 key pieces of information:

• T (tumor) describes the size of the main tumor and whether it has grown into nearby areas.
• N (nodes) describes the extent of spread to nearby (regional) lymph nodes).
• M (metastasis) indicates if the cancer has spread to distant parts of the body, such as other organs or lymph nodes that are not near the adrenal gland.

Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced.

Once a person’s T, N, and M categories have been determined this information is combined in a process called stage grouping. This is usually done after surgery. This assigns an overall stage.

Adrenal cancer stages range from stages I through IV. The lower the number, the less the cancer has spread. A higher number, such as stage IV, means a more advanced cancer. Cancers with similar stages tend to have a similar outlook and are often treated in similar ways.

Adrenal cancer staging can be complex. If you have any questions about your stage, talk with your doctor or care team.

The following additional categories are not listed on the table above:

• TX: Main tumor cannot be assessed due to lack of information.
• T0: No evidence of a primary tumor.
• NX: Regional lymph nodes cannot be assessed due to lack of information.

Staging for children with adrenocortical carcinoma (ACC)

In children, the International Pediatric Adrenocortical Tumor Registry (IPACTR) System may be used for staging. In this system, stage is based on the size of the tumor, surgery outcome, hormone levels after surgery, and whether the cancer has spread to distant sites.

Outlook and survival rates for adrenal cancer

Cancer professionals use a cancer’s stage when talking about survival statistics. Survival rates are a way to measure how many people survive a certain type and certain stage of cancer over time. Some people find this information helpful, while others prefer to focus more on treatment plans and next steps.