The adrenal glands are two glands located just above each kidney. The glands produce important hormones. These hormones regulate heart rate, blood pressure, and many other vital functions. The adrenal cortex is the outside layer of the two adrenal glands.
Cancers of the adrenal cortex are very rare. They make up 0.5-2 cases per million. The majority of these tumors produce excess hormones. The excess can alter hormonal balance.
There are few known risk factors for cancers of the adrenal cortex but, the following factors may contribute:
Approximately 40% of adrenocortical carcinoma do not secrete any hormone. These do not have any specific symptoms. They are discovered either by accident or as part of an evaluation of abdominal pain.
Other tumors are functional. This means are hormonally active. Excess hormones may produce symptoms such as:
These symptoms may be caused by other health conditions. Anyone experiencing these symptoms should see a doctor.
Your doctor will ask about your symptoms, and medical and family history. A physical exam will be done.
Tests may include the following:
Once cancer of the adrenal cortex is confirmed, you will be referred to an oncologist. This type of doctor focuses on cancer.
Further testing to determine what stage (1-4) the cancer has reached. The stage of a tumor is determined by its size and how far it has spread from its point of origin. At the time of diagnosis, 30%-85% of patients are found to have cancer that has spread. The higher the stage, the more dangerous and difficult it is to treat.
Treatment depends on the stage of the tumor and your overall health. Talk with your doctor about the best plan for you.
The following methods are used to treat cancer of the adrenal cortex:
Surgery to remove the adrenal tumor. This is the first treatment approach for about 75 % of all cases. The doctor will also need to remove any surrounding tissues or lymph nodes that contains cancer cells.
These treatments tend to be less effective in treating this type of cancer. They are most often used if the cancer has spread. Chemotherapy may also be used if there is a high chance the cancer will come back.
If treatment is successful you will still need to be screened for reoccurrence of the cancer on a periodic basis.
RESOURCES:
American Cancer Society
http://www.cancer.org/
National Cancer Institute
http://www.cancer.gov/
CANADIAN RESOURCES:
BC Cancer Agency
http://www.bccancer.bc.ca/
Canadian Cancer Society
http://www.cancer.ca/
References:
Abiven G, Coste J, Groussin L, et al. Clinical and biological features in the prognosis of adrenocortical cancer: poor outcome of cortisol-secreting tumors in a series of 202 consecutive patients. J Clin Endo & Metab . 2006;91:2650-55.
Adrenal cortical carcinoma. DynaMed website. Available at: http://dynamed102.epnet.com/Detail.aspx?id=116754. Accessed November 30, 2006.
Adrenocortical carcinoma. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/adrenocortical . Accessed November 30, 2006.
Adrenocortical carcinoma: treatment statement for health professionals. National Cancer Institute website. Available at: http://www.meb.uni-bonn.de/cancer.gov/CDR0000062907.html . Accessed Nov. 30, 2006.
Allolio B, Fassnacht M. Adrencortical carcinoma: clinical update. J Clin Endocrinol Metab .2006;91:2027-37.
Detailed guide: adrenal cortical cancer. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=71 . Accessed November 29, 2006.
Kirschner LS. Review: emerging treatment strategies for adrnocortical carcinoma: a new hope. J Clin Endocinol Metab .2006;91:14-21.
Van Ditzhuijsen cI, van de Weijer R, Haak HR: Adrenocortical carcinoma. Neth J Med. 2007;65:55-60.
Last reviewed January 2009 by Rosalyn Carson-DeW¹itt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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