Adrenal Cancer Symptoms

Adrenal cancer is a rare cancer that begins in the adrenal glands, which are small glands located above your kidneys. Its symptoms often arise from the tumor producing too many hormones, such as cortisol or aldosterone, or from the tumor growing large enough to press on nearby organs, causing various physical changes.

What is Adrenal Cancer Symptoms?

Adrenal cancer, specifically adrenocortical carcinoma, is a rare type of cancer that starts in the outer layer (cortex) of the adrenal glands. These small glands, located above each kidney, produce vital hormones. Symptoms typically appear when the cancerous tumor either overproduces these hormones or grows large enough to cause pressure on surrounding tissues.

The adrenal glands are crucial endocrine glands responsible for making hormones that regulate many bodily functions. These hormones include cortisol, which manages stress and metabolism; aldosterone, which controls blood pressure; and sex hormones like androgens and estrogens. When adrenal cancer develops, the tumor cells can produce an excess of these hormones, leading to a range of symptoms related to hormone imbalance. For example, too much cortisol can cause weight gain and high blood pressure. Alternatively, if the tumor does not produce excess hormones, its growth can still cause symptoms by pressing on nearby organs in the abdomen. Because adrenal cancer is rare and its symptoms can be vague or mimic other conditions, it is often diagnosed at a later stage. Understanding the potential symptoms is important for early detection and treatment.

Symptoms

Adrenal cancer symptoms vary widely depending on which hormones the tumor produces in excess or if the tumor grows large enough to press on nearby organs. Common symptoms can include unexplained weight gain, muscle weakness, new or worsening high blood pressure, and noticeable changes in body hair or sex characteristics.

Many symptoms of adrenal cancer are caused by the overproduction of hormones by the tumor. For instance, an excess of cortisol can lead to symptoms similar to Cushing's syndrome, such as weight gain, especially around the face and trunk, easy bruising, thin skin, and muscle weakness. You might also experience high blood pressure (hypertension), high blood sugar, and mood changes. If the tumor produces too much aldosterone, you may develop symptoms of Conn's syndrome, including high blood pressure, low potassium levels (hypokalemia), muscle weakness, and frequent urination. Tumors that produce excess male hormones (androgens) can cause symptoms like increased facial and body hair (hirsutism), deepening of the voice, and male-pattern baldness in women, or early puberty in boys. Conversely, excess female hormones (estrogens) can lead to breast enlargement (gynecomastia) in men and irregular periods or vaginal bleeding in women. Beyond hormone-related effects, a growing tumor can cause symptoms by its sheer size. These non-hormonal symptoms often appear later and can include abdominal pain, a feeling of fullness in the abdomen, a noticeable lump in the abdomen, or unexplained weight loss. Back pain can also occur if the tumor is large or pressing on nerves.

Causes & risk factors

The exact causes of adrenal cancer are largely unknown, and most cases occur without a clear reason. It is a very rare disease. While certain rare inherited genetic conditions can increase your risk, these account for only a small percentage of all adrenal cancer diagnoses.

Most cases of adrenal cancer, also known as adrenocortical carcinoma, are sporadic, meaning they occur randomly without any identifiable cause or family history. Researchers have not identified specific lifestyle or environmental factors that clearly increase the risk of developing this rare cancer. However, a small number of adrenal cancer cases are linked to inherited genetic syndromes. These include Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, Multiple Endocrine Neoplasia type 1 (MEN1), and Familial Adenomatous Polyposis (FAP). If you have one of these rare syndromes, your risk of developing adrenal cancer, along with other types of cancer, may be higher. It is important to remember that even with these genetic links, adrenal cancer remains exceptionally rare. For the vast majority of people, there are no known preventable causes or clear risk factors that can be modified.

How it's diagnosed

Diagnosing adrenal cancer typically involves a combination of tests to assess hormone levels and locate the tumor. This often includes blood and urine tests to check for excess hormones, followed by imaging scans like CT or MRI to visualize the adrenal glands. A biopsy may sometimes be performed to confirm the cancer diagnosis.

The diagnostic process usually begins with blood and urine tests. These tests measure the levels of various hormones, such as cortisol, aldosterone, androgens, and estrogens, as well as their breakdown products. High levels of these hormones can indicate an overactive adrenal tumor. If hormone levels are abnormal, or if symptoms suggest an adrenal problem, imaging tests are performed. Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are commonly used to create detailed images of the adrenal glands and surrounding areas. These scans help doctors find the tumor, determine its size, and check if it has spread to other parts of the body. Positron emission tomography (PET) scans may also be used to detect cancer cells throughout the body. In some cases, a biopsy may be necessary. This procedure involves taking a small tissue sample from the adrenal tumor, which is then examined under a microscope by a pathologist to confirm if the cells are cancerous (malignant). However, biopsies of adrenal masses are not always performed due to potential risks and because imaging and hormone tests can often provide strong indications of cancer.

Treatment options

Treatment for adrenal cancer primarily involves surgery to remove the tumor, especially when the cancer is localized. Depending on the stage of the cancer and whether it has spread, additional treatments such as chemotherapy, radiation therapy, or targeted therapy may also be used to help manage the disease and improve outcomes.

For adrenal cancer that is confined to the adrenal gland, surgery is the main treatment. The goal of surgery is to remove the entire tumor, along with the affected adrenal gland, to achieve a cure. If the cancer has spread, surgery may still be performed to remove as much of the tumor as possible or to relieve symptoms. Chemotherapy uses powerful drugs to kill cancer cells. Mitotane is a specific chemotherapy drug often used for adrenal cancer, which can help reduce hormone production and slow tumor growth, particularly in advanced or recurrent cases. Other chemotherapy regimens may also be used. Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or shrink tumors. It may be used after surgery to destroy any remaining cancer cells, or to manage symptoms like pain if the cancer has spread to bones. Targeted therapy is a newer approach that uses drugs designed to attack specific vulnerabilities in cancer cells, with research ongoing to identify effective options for adrenal cancer. Your treatment plan will be highly individualized, based on factors such as the cancer's stage, the tumor's characteristics, your overall health, and whether the tumor is producing hormones. A team of specialists will work together to determine the best course of action.

Recovery & outlook

The recovery and outlook for adrenal cancer vary significantly, largely depending on the cancer's stage at diagnosis, the tumor's size, and whether it has spread. Early detection and complete surgical removal offer the best chance for a positive outcome. Regular follow-up care is essential to monitor for any recurrence of the disease.

Adrenal cancer can be an aggressive disease, and its prognosis is highly dependent on how early it is diagnosed and treated. If the cancer is found when it is small and confined to the adrenal gland, and can be completely removed with surgery, the chances of a successful recovery are significantly better. However, if the cancer has spread (metastasized) to other organs, treatment becomes more challenging. After treatment, regular follow-up appointments are crucial. These typically involve physical exams, blood tests to check hormone levels, and imaging scans (like CT or MRI) to monitor for any signs of the cancer returning. This ongoing surveillance helps detect any recurrence early, allowing for prompt intervention. Patients who have had an adrenal gland removed may need lifelong hormone replacement therapy to compensate for the lost hormone production. Managing treatment side effects and maintaining a good quality of life are important aspects of long-term recovery. While adrenal cancer can be difficult to treat, ongoing research continues to improve understanding and develop new therapeutic strategies.

When to see a doctor

You should see a doctor if you experience new, persistent, or concerning symptoms that could suggest adrenal cancer, such as unexplained weight gain or loss, new high blood pressure, significant muscle weakness, or changes in body hair or sex characteristics. Prompt medical evaluation is important for any unusual or worsening symptoms.

It is important to consult a healthcare professional if you notice any of the following symptoms, especially if they are new, worsening, or unexplained: * **Unexplained weight gain or loss:** Particularly if it's rapid or accompanied by other symptoms. * **New or worsening high blood pressure (hypertension):** Especially if it's difficult to control with medication. * **Significant muscle weakness or fatigue:** Feeling unusually tired or weak without a clear reason. * **Changes in body hair or sex characteristics:** For women, this might include new facial hair growth, deepening of the voice, or male-pattern baldness. For men, it could be breast enlargement (gynecomastia). * **Persistent abdominal pain or a noticeable lump:** A feeling of fullness or discomfort in your abdomen, or if you can feel a mass. While these symptoms can be caused by many less serious conditions, it is always best to have them evaluated by a doctor. Early detection of adrenal cancer can significantly improve treatment outcomes. Do not delay seeking medical advice for any concerning health changes.

Frequently asked questions

Is adrenal cancer common?

Adrenal cancer (adrenocortical carcinoma) is a very rare type of cancer. It affects only about 1 to 2 people per million each year, making it one of the less common cancers.

Can adrenal cancer symptoms appear suddenly?

Symptoms of adrenal cancer can sometimes appear suddenly, especially if the tumor rapidly produces a large amount of hormones. However, they can also develop slowly over time, making them harder to notice initially.

Are all adrenal tumors cancerous?

No, most tumors or masses found in the adrenal glands are benign (non-cancerous). These benign tumors, such as adenomas, are much more common than cancerous adrenal tumors and often do not require treatment unless they cause symptoms.

Can adrenal cancer spread to other parts of the body?

Yes, adrenal cancer can spread (metastasize) to other parts of the body, most commonly to the liver, lungs, and bones. This spread often makes the cancer more difficult to treat and can affect the overall outlook.

Do adrenal cancer symptoms differ in men and women?

Symptoms can differ based on the type of sex hormones the tumor produces. For example, women might experience male-pattern hair growth or a deepening voice if the tumor produces excess male hormones, while men might develop breast enlargement if the tumor produces excess female hormones.

What is the main difference between adrenal cancer and a pheochromocytoma?

Adrenal cancer (adrenocortical carcinoma) develops in the outer layer (cortex) of the adrenal gland and often produces steroid hormones like cortisol or aldosterone. A pheochromocytoma is a tumor that develops in the inner part (medulla) of the adrenal gland and produces different hormones called catecholamines, leading to symptoms like sudden high blood pressure, sweating, and rapid heart rate.

Sources

• MedlinePlus — Adrenal Cancer Symptoms
• Mayo Clinic — Adrenal Cancer Symptoms
• Cochrane Library — Adrenal Cancer Symptoms