If You Have Adrenal Cancer

What is an adrenal tumor?

Tumors can start any place in the body. An adrenal tumor starts when cells in the adrenal glands grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Most tumors found in the adrenal glands are called adenomas. These are not cancer (benign) and don’t cause problems. Adenomas are sometimes found by accident when someone has tests for other reasons.

If an adrenal tumor is cancerous, the cancer cells can spread to other parts of the body. Cancer cells in the adrenal glands can sometimes travel to lymph nodes and other organs. When cancer cells do this, it’s called metastasis (pronounced meh-TAS-tuh-sis). To doctors, the cancer cells in the new place look just like the ones from the adrenal glands.

Cancer is always named for the place where it starts. Many cancers found in the adrenal glands did not start there. In these cases, the cancer has spread from other organs, so it is not considered or treated like adrenal cancer. For example, if lung cancer spreads to the adrenal gland, it is still called lung cancer.

The adrenal glands

The adrenals are small glands that are right above the kidneys. The kidneys are inside the upper part of the belly.

The adrenals have 2 parts called the cortex and medulla.  The main job of the adrenals is to make certain hormones. For example, some adrenal hormones help the body deal with stress and control blood pressure. Other adrenal hormones help develop sex organs and control puberty.

Different kinds of adrenal cancer

Cancer can start in either part of the adrenal gland (medulla or cortex). Tumors in the adrenal medulla are actually part of the nervous system and are not discussed here.  Cancers of the adrenal cortex may be called adrenal cortical carcinoma or adrenocortical cancer.

Questions to ask the doctor

• Why do you think I have cancer?
• Is there a chance I don’t have cancer?
• Would you please write down the kind of cancer you think I might have?
• What happens next?

How does the doctor know I have adrenal cancer?

Symptoms of adrenal cancer can happen because of changes in certain hormones. Or, symptoms can happen because the tumor is large and is pressing on nearby organs. These signs and symptoms might include:

• Weight gain
• Increased fat in the neck and shoulders
• Extra hair growing on the face, chest, and back in women
• Irregular periods in women
• Easy bruising
• Weak bones
• High blood sugar
• High blood pressure
• Low potassium in blood tests

If you have signs of adrenal cancer, your doctor will ask you questions about your health and physically examine you. If signs are still pointing to adrenal cancer, more tests will be done. Here are some of the tests you may need:

Blood and urine tests: Certain blood and urine tests can tell the doctor more about your overall health.

Biopsy (BY-op-see): For this test, the doctor takes out a small piece of tissue where the cancer seems to be. The tissue is checked for cancer cells. This is the best way to know for sure if you have cancer.

CT or CAT scan: Uses x-rays to make detailed pictures of your body. CT scans can be used to help do a biopsy and can show if the cancer has spread.

Ultrasound: For this test, a small wand is moved around on your skin. It gives off sound waves and picks up the echoes as they bounce off tissues. The echoes are made into a picture on a computer screen. It’s used to help find cancer and see if it has spread.

MRI scan: Uses radio waves and strong magnets instead of x-rays to make detailed pictures. MRI scans are helpful in looking at the liver and the brain and spinal cord.

Chest x-rays: X-rays may be done to see if the cancer has spread to your lungs.

PET scan: PET scans use a kind of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. This test looks at the whole body. It can help if the doctor thinks the cancer has spread, but doesn’t know where.

Questions to ask the doctor

• What tests will I need to have?
• Who will do these tests?
• Where will they be done?
• Who can explain them to me?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How serious is my cancer?

If you have adrenal cancer, the doctor will want to find out how far it has spread. This is called staging. You may have heard other people say that their cancer was “stage 1” or “stage 2.” Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.

The stage describes the growth or spread of the cancer in the adrenal glands. It also tells if the cancer has spread to the lymph nodes other organs of your body that are close by or farther away.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the adrenals. Be sure to ask the doctor about the cancer stage and what it means for you.

Questions to ask the doctor

• Do you know the stage of the cancer?
• If not, how and when will you find out the stage of the cancer?
• Would you explain to me what the stage means in my case?
• Based on the stage of the cancer, how long do you think I’ll live?
• What will happen next?

What kind of treatment will I need?

There are different ways to treat adrenal cancer, but the main types of treatment are surgery, radiation, and chemotherapy. A lot of times treatments are used together.

The treatment plan that’s best for you will depend on:

• The stage and grade of the cancer
• The chance that a type of treatment will cure the cancer or help in some way
• Your age
• Other health problems you have
• Your feelings about the treatment and the side effects that come with it

Surgery for adrenal cancer

Surgery that removes the adrenal gland is often part of the treatment for adrenal cancer if it can be done. There are different ways this surgery can be done. The way that’s best for you depends on the kind of adrenal cancer, how big it is, and where it is. Ask your doctor what kind of surgery you will have and what to expect.

Radiation treatments

Radiation uses high-energy rays (like x-rays) to kill cancer cells. One kind is aimed at the cancer from a machine outside the body. This is called external beam radiation. Another kind uses small seeds containing radiation next to or into the tumor. This is called brachytherapy and is not often used in adrenal cancer.

Chemo

Chemo is the short word for chemotherapy and means the use of drugs to fight cancer. Chemo does not work very well in adrenal cancer. If it is used, the drugs are given into a vein to go into the blood and spread through the body. Chemo is given in cycles or rounds. Each round of treatment is followed by a break. Treatment often lasts for many months. Chemo can be given before or after surgery. More than one chemo drug may be used. It can also be given together with radiation. Ask your doctor what to expect.

Hormones

Drugs that try to block hormone production by the cancer may be used to treat adrenal cancer. If these are given, they can affect different body systems and require extra testing and watching.

What about other treatments I hear about?

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.

Questions to ask the doctor

• What treatment do you think is best for me?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment, too?
• What’s the goal of these treatments?
• What side effects could I have from these treatments?
• What can I do about side effects that I might have?
• Is there a clinical trial that might be right for me?
• What about special vitamins or diets that friends tell me about? How will I know if they are safe?
• How soon do I need to start treatment?
• What should I do to be ready for treatment?
• Is there anything I can do to help the treatment work better?
• What’s the next step?

What will happen after treatment?

Your health care team will be your first source of information and support, but there are other resources for help when you need it. You might or might not need ongoing treatment and care for adrenal cancer. Tests and check-ups should be needed to follow-up even if more treatment is not needed. Ask your doctor what to expect.

Having adrenal cancer and dealing with surgery and treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your health care team to find out what you can do to feel better.

You can’t change the fact that you have or had adrenal cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.