Adrenocortical carcinoma

Definition

Adrenal gland cancers are rare cancers occuring in the endocrine tissue of the adrenals. They are characterized by overproduction of adrenal gland hormones.

Description

Cancers of the adrenal gland are very rare. The adrenal gland is a hormone producing endocrine gland with two main parts, the cortex and the medulla. The main hormone of the adrenal cortex is cortisol and the main hormone of the adrenal medulla is epinephrine. When tumors develop in the adrenal gland, they secrete excess amounts of these hormones. A cancer that arises in the adrenal cortex is called an adrenocortical carcinoma and can produce high blood pressure, weight gain, excess body hair, weakening of the bones and diabetes. A cancer in the adrenal medulla is called a pheochromocytoma and can cause high blood pressure, headache, palpitations, and excessive perspiration. Although these cancers can happen at any age, most occur in young adults.

Causes & symptoms

It is not known what causes adrenal gland cancer, but some cases are associated with hereditary diseases. Symptoms of adrenal cancer are related to the specific hormones produced by that tumor. An adrenocortical carcinoma typically secretes high amounts of cortisol, producing Cushing's Syndrome. This syndrome produces progressive weight gain, rounding of the face, and increased blood pressure. Women can experience menstrual cycle alterations and men can experience feminization. The symptoms for pheochromocytoma include hypertension, acidosis, unexplained fever and weight loss. Because of the hormones produced by this type of tumor, anxiety is often a feature also.

Diagnosis

Diagnosis for adrenal cancer usually begins with blood tests to evaluate the hormone levels. These hormones include epinephrine, cortisol, and testosterone. It also includes magnetic resonance imaging, and computed tomography scans to determine the extent of the disease. Urine and blood tests can be done to detect the high levels of hormone secreted by the tumor.

Treatment

Treatment is aimed at removing the tumor by surgery. In some cases, this can be done by laparoscopy. Surgery is sometimes followed by chemotherapy and/or radiation therapy. Because the surgery removes the source of many important hormones, hormones must be supplemented following surgery. If adrenocortical cancer recurs or has spread to other parts of the body (metastasized), additional surgery may be done followed by chemotherapy using the drug mitotane.

Alternative treatment

As with any form of cancer, all conventional treatment options should be considered and applied as appropriate. Nutritional support, as well as supporting the functioning of the entire person diagnosed with adrenal gland cancer through homeopathic medicine, acupuncture, vitamin and mineral supplementation, and herbal medicine, can benefit recovery and enhance quality of life.

Prognosis

The prognosis for adrenal gland cancer is variable. For localized pheochromocytomas the 5-year survival rate is 95%. This rate decreases with aggressive tumors that have metastasized. The prognosis for adrenal cortical cancer is not as good with a 5-year survival rate of 10-35%.

Prevention

Since so little is known about the cause of adrenal gland cancer, it is not known if it can be prevented.

Key Terms

Cortisol

A hormone produced by the adrenal cortex. It is partially responsible for regulating blood sugar levels.

Diabetes

A disease characterized by low blood sugar.

Epinephrine

A hormone produced by the adrenal medulla. It is important in the response to stress and partially regulates heart rate and metabolism. It is also called adrenaline.

Laparoscopy

The insertion of a tube through the abdominal wall. It can be used to visualize the inside of the abdomen and for surgical procedures.

Further Reading

For Your Information

Books

• Norton, J.A. "Adrenal Tumors." In Cancer, Principles and Practice of Oncology, edited by V.T. DeVita, S. Hellman, and S.A. Rosenberg. Philadelphia: Lippincott-Raven, 1997.

  Other

• Endocrine Web, Inc. http://www.endocrineweb.com.

Gale Encyclopedia of Medicine. Gale Research, 1999.