Diagnosis and Causes of Adrenal Cancer | Endocrinology

Adrenal Cancer

Overview of adrenal cancer

Adrenal cancer, also known as cancer of the adrenal cortex, can occur at any age. But it does affect children under the age of 5 and adults between the ages of 40 and 50. When adrenal cancer is found early, prevention is possible. If cancer has spread to areas beyond the adrenal glands, prevention will be minimal. It can be used to delay the progression or recurrence of treatment.

Most growths that occur in the adrenal glands are not cancerous (benign). Benign adrenal tumors, such as adenoma or pheochromocytoma, can also develop in the adrenal glands. It is a condition that occurs when abnormal cells form or travel to the adrenal glands. Your body has two adrenal glands, one on top of every kidney. It usually occurs in the outer layer of the glands or in the adrenal cortex. Usually, it looks like a tumor.

A non-cancerous tumor of the adrenal is named a benign adenoma. If you have cancer of the adrenal glands, it does not start there, it is not considered adrenal cortical carcinoma. Cancers of the breast, stomach, kidneys, skin, and lymphoma spread to the adrenal glands.

Types of adrenal cancer

Under the microscope, distinguishing between benign and malignant adrenal tumors can be challenging.

There are three common types:

  • Carcinoma of the adrenal cortex: Also known as adrenal cortical carcinoma (ACC) or cancer of the adrenal cortex, it is the most common form of this disease. It usually occurs in the outer layer of the cortex and is usually not detected until the tumor is very large. This type of cancer is often found after the appearance of symptoms, especially pain or a feeling of fullness, weight loss. Adrenocortical carcinomas produce excess hormones that can lead to weight gain, excess facial hair, or puberty. If the adrenal tumor is larger than 5 to 6 centimetres, it is generally considered cancer.
  • Pheochromocytoma: This type of adrenal cancer occurs in the central part of the marrow and usually begins in the cells that produce adrenaline. Adrenaline helps regulate important body functions, including heart rate and blood pressure. Symptoms of this type of tumor include high blood pressure, excessive sweating, palpitations, and anxiety.
  • Neuroblastoma: This type of adrenal cancer, found in the developing nerve cells of the marrow, usually affects infants or children under 10 years of age. Due to the special nature of cells, it is possible to detect them in advance. However, in rare cases, the source can be difficult to identify because the cells spread rapidly. According to the American Cancer Society, one in three neuroblastomas begins in the adrenal glands.

Causes of adrenal cancer

The cause of adrenal cancer is unclear.

It occurs when something changes (mutations) in the DNA of the cells of the adrenal gland. Mutations can cause a cell to multiply uncontrollably and healthy cells to continue living when they die. When this happens, the abnormal cells build up and form a tumor. Tumor cells divide and spread to other parts of the body (metastasize).

Symptoms & signs of adrenal cancer

People with adrenal gland tumors may experience the following symptoms or signs. Sometimes people with adrenal gland tumors do not have any of these changes. Or, the symptom may be caused by another medical condition other than a tumor.

  • Hypertension
  • Low potassium level
  • Heart palpitations
  • Nervous
  • Feelings of anxiety or panic
  • Headache
  • Excessive sweating
  • Diabetes
  • Abdominal pain
  • Unexplained weight gain or loss
  • Weakness
  • Abdominal stretch marks
  • Excessive hair growth
  • Changes in the genitals
  • Abnormal pimples
  • Change in libido (sex drive)

In addition, pheochromocytoma can cause a dangerous increase in hormones that regulate blood pressure and the body’s response to stress. Hormone increases can cause blood pressure to rise too quickly, increasing the risk of heart attack, stroke, bleeding, or sudden death.

If you are concerned about any changes you may experience, speak with your doctor. Among other things, your doctor may ask you how often and how often you experience symptoms. It helps find the cause of the problem called the diagnosis.

If the tumor is diagnosed, the relief of symptoms is an important part of medical care and treatment. This is also known as symptom management, palliative care, or supportive care. Be sure to talk to your healthcare team about any symptoms you are experiencing, including new symptoms or changes in symptoms.

Risk factors for adrenal cancer

Any risk factor that changes your chance of getting a disease such as cancer. Different types of cancer have different risk factors. Some risk factors, like smoking, can change. Others cannot change a person’s age or family history.

Scientists have discovered some risk factors that increase a person’s chances of getting adrenal cancer. Although a patient has one or more risk factors for adrenal cancer, it is impossible to know exactly how much of a risk factor contributes to cancer.

But being a risk factor or being too high doesn’t mean you get the disease. Most people with risk factors never develop adrenal cancer, but others with the disease may have low or unknown risk factors.

  • Genetic syndromes: Most cancers of the adrenal cortex are not inherited (they are scattered), but some (up to 15%) are caused by a genetic defect. It is more common in adrenal cancers in children.
  • Li-Frameni syndrome: Li-Frameni syndrome is a rare condition caused by a defect in the TP53 gene. People with this syndrome are at increased risk for a variety of cancers, including breast cancer, bone cancer, brain cancer, and cancer of the adrenal cortex.
  • Beckwith-Wideman syndrome: People with this problem have larger tongues, which are larger, and are at higher risk of kidney, liver, and adrenal cortex cancer.
  • Multiple endocrine neoplasia (MEN1): People with MEN1 are at risk of developing 3 glandular tumors: pituitary, parathyroid, and pancreas. One-third to one-half of people with this condition will also develop adrenal adenomas (benign tumors) or enlarged adrenal glands. They usually do not cause any symptoms. The syndrome is caused by a defect in a gene called MEN1. People with a family history of MEN1 or cancers of the pituitary, parathyroid, pancreas, or adrenal should ask their doctor if they can benefit from genetic counselling.
  • Familial adenomatous polyposis (FAP): These polyps can lead to colon cancer if the colon is not removed. FAP also increases the risk of other cancers and increases the risk of adrenal cancer.  The syndrome is caused by a genetic defect called APC.
  • Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC): Lynch syndrome (formerly known as HNPCC) is an inherited genetic disorder that increases the risk of some other cancers, such as colorectal cancer, stomach cancer, and cancer of the adrenal cortex. In most cases, the disorder is caused by a defect in the MLH1 or MSH2 gene, while other genes, including MLH3, MSH6, TGFBR2, PMS1, and PMS2, can cause Lynch syndrome. Lynch syndrome in colorectal cancer is discussed in more detail.
  • Lifestyle and environmental factors: Although none of these factors has been found to increase the risk of adrenal cancer, some researchers have suggested that smoking is a risk factor.

Diagnosis of adrenal cancer

Tests and procedures used to diagnose adrenal cancer:

  • Blood and urine tests.including cortisol, aldosterone, and androgens.
  • Imaging tests: Your doctor may recommend CT scans, MRIs, or positron emission tomography (PET) scans to better understand any growth in the adrenal glands and to see if cancer has spread to other parts of your body, such as your lungs or liver.
  • Lab tests of your adrenal gland: If your doctor suspects you have adrenal cancer, he or she may recommend removing the affected adrenal gland. A doctor who studies body tissues (pathologist) analyzes the gland in a laboratory. This test can determine if you have cancer and what type of cells you have.

Adrenal cancer treatment

Treatment As your CTCA® doctors develop your treatment plan, they evaluate several factors, including the dimensions and site of the adrenal tumor. This information will help your care team develop a comprehensive care plan that’s tailored to your specific needs and tumor treatment, while at an equivalent time helping you manage related side effects. Common treatments for adrenal cancer:

  • Surgery: Surgery is employed to treat all stages of adrenal cancer.
  • Chemotherapy: In some cases of advanced adrenal cancer, chemotherapy is often utilized in combination with surgery to kill cancer cells or to stay them from growing and spreading.
  • Radiotherapy: Radiation, which shrinks or kills cancer cells that can’t be removed during surgery, is usually recommended after surgery in patients with advanced adrenal cancer.
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