Adrenal Cancer: Overview

What is adrenal cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. They can spread to other parts of the body, too. This is called metastasis.

Adrenal cancer is a rare cancer. It starts in the adrenal glands. You have 2 adrenal glands. One sits on top of each kidney. The 2 kidneys are deep in the upper part of your belly (abdomen). The adrenal glands make hormones that balance salt in your body and help control blood pressure. They also make hormones that control how your body gets energy from food and reacts to stress. The adrenal glands make a small amount of sex hormones, too.

Each adrenal gland has 2 main parts. The outer part is called the adrenal cortex. Most adrenal cancers start in this area. The inner part is called the adrenal medulla.

Most tumors in the adrenal glands are not cancer. (These may be called benign tumors.) It's often hard to tell if an adrenal tumor is cancer (malignant) or benign. If the tumor grows and spreads to lymph nodes or other parts of the body, it's cancer. Benign tumors don’t spread.

 Types of tumors that start in the adrenal glands include:

• Adenoma. This is the most common kind of adrenal gland tumor. It's not cancer. (It's a benign tumor.)

• Adrenal cortex cancer (adrenal cortical carcinoma). This kind of tumor is rare. But it's the most common type of adrenal gland tumor that's cancer.

• Pheochromocytoma. This is a tumor that makes hormones inside the adrenal glands. It forms in the medulla. In most cases, it's not cancer.

• Neuroblastoma. This adrenal medulla tumor is cancer. It's most common in children. These tumors can also start in the neck, chest, or spinal cord.

Who is at risk for adrenal cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors cannot be controlled. But others may be things you can change.

Healthcare providers don’t know what causes most adrenal cancers. But some factors can increase your risk for it. These include having a family history of certain genetic syndromes such as:

• Li-Fraumeni syndrome

• Beckwith-Wiedemann syndrome

• Von Hippel-Lindau syndrome

• Multiple endocrine neoplasia (MEN) types 1 and 2

• Familial adenomatous polyposis (FAP)

• Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC)

• Neurofibromatosis type 1

• Carney complex

Talk with your healthcare provider about your risk factors for adrenal cancer and what you can do about them.

Can adrenal cancer be prevented?

Researchers don’t yet know how to prevent this type of cancer.

What are the symptoms of adrenal cancer?

Symptoms of adrenal cancer are usually caused by the hormones the tumor is making. Some symptoms are caused when the tumor is very large and presses on nearby organs. People with adrenal cancer may have any or all of these symptoms:

• Belly or back pain

• Belly stretch marks

• Muscle cramps

• Fast heartbeat or heart pounding

• Headache

• Full feeling in the belly or feeling full after eating only a small amount

• Sexual problems

• Enlarged breasts or sex organs

• Excess facial and body hair, often in women

• Fatty areas on the shoulders and the back of the neck

• Unexplained weight gain or weight loss

• Weakness

• Low potassium levels

• Anxiety or new panic attacks

• High blood pressure

• Diabetes

Many of these may be caused by other health problems. Still, it's important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is adrenal cancer diagnosed?

If your healthcare provider thinks you may have adrenal cancer, you will need certain exams and tests to be sure. Your provider will ask you about your health history, your symptoms, risk factors, and family history of disease. A physical exam will be done. You may also have some tests done, like blood and urine tests and imaging scans.

After a diagnosis of adrenal cancer, you’ll likely need more tests. These help your healthcare providers learn more about your overall health and the cancer. They can help find the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what this means for your treatment. Be sure to ask your provider to explain the details of your cancer to you in a way you can understand.

How is adrenal cancer treated?

Your treatment choices depend on the type of adrenal cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy and hormone therapy are systemic treatments.

You may have just one treatment or a combination of treatments. Tests will be done during treatment to see how well it's working.

Type of treatments for adrenal cancer include:

• Surgery

• Radiation therapy

• Chemotherapy

• Medicines to control hormone levels

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects?

Cancer treatments, like radiation and chemotherapy, can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects linked to your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

Coping with adrenal cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be tough on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group in person or online.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays. 

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.