Adrenal Cancer Causes and Risk Factors

It’s not clear why some people get these tumors. But they may be more common if you have one of these diseases that’s tied to your genes:

• Li-Fraumeni syndrome
• Beckwith-Wiedemann syndrome
• Carney complex
• Multiple endocrine neoplasia
• Familial adenomatous polyposis
• Lynch syndrome

Adrenal Cancer Types

Adrenal tumors that are cancerous are called malignant. Those that aren’t cancer are benign. Their names are based on where they start. Malignant tumors include:

• Adrenocortical carcinoma begins in the outer layer, or cortex, of your adrenal gland. Most of these tumors are functioning, which means they make hormones. The rest are called nonfunctioning.
• Malignant adrenal pheochromocytoma starts in the middle or medulla. It’s very rare.
• Neuroblastoma also begins in the medulla, usually in children.
• Malignant paraganglioma grows inside or outside your adrenal gland.

Benign tumors include:

• Adenoma. These may make extra cortisol, leading to a condition called Cushing’s syndrome.
• Benign pheochromocytoma
• Benign paraganglioma

Adrenal Cancer Diagnosis

If you have symptoms or if you have a disease that puts you at risk for adrenal cancer, your doctor may order tests to check for a tumor. These exams can also show the stage of your cancer and whether it’s spread to other organs.

• Physical exam and medical history. Your doctor will ask about your health habits and any past problems.
• Blood and urine tests. They check for signs that you make too many sex hormones or steroids, such as low levels of potassium or high levels of cortisol or estrogen.
• Imaging tests. Scans look for a tumor or cancer cells. These include X-rays, ultrasounds, CT scans, MRIs, and positron emission tomography (PET) scans, which can also tell whether your disease has spread.
• Laparoscopy. Your doctor inserts a very thin tube into your body. It has a tiny video camera attached to the end. This shows places where your cancer may be growing.
• Biopsy. With a needle, your doctor takes a tiny sample of tissue to look at under a microscope for signs of cancer.
• Adrenal angiography or venography. Your doctor injects dye into your bloodstream and then takes X-rays to look for blocked arteries or veins.

Adrenal Cancer Treatments

Your doctor will recommend a treatment plan based on your case and your overall health.

Surgery. This is the only treatment that may be able to cure you. Your doctor may take out one or both of your adrenal glands. If the disease has spread, they may also need to take out nearby lymph nodes — small glands that are part of your immune system, your body’s defense against germs.

Radiation. This treatment can kill cancer cells or keep a tumor from growing. You might have it after surgery. Your doctor may beam radiation into your body through an outside machine, put radioactive seeds near the tumor, or insert a sealed radioactive capsule or wire into it.

Medications. Doctors most often prescribe a drug called mitotane (Lysodren), which blocks your adrenal gland from making hormones. It also destroys cancer cells. Your doctor may recommend this after surgery if there’s a risk that the tumor may return.

Meds called biologics can help your immune system fight cancer.

Hormone drugs can balance, lower, or replace hormone levels that were affected by your tumor.

Chemotherapy. You might get drugs that go through your whole body to kill cancer cells. They can also harm healthy cells. Targeted therapy drugs look for and kill cancer cells without harming good ones.

Tumor ablation. This uses heat or cold to kill cancer cells if your tumor has spread or returned, or if you’re too sick for surgery. It can ease your symptoms and give you a better quality of life.

Whatever treatment you choose, make sure you tend to your emotions as well as your body. Your doctor may be able to suggest support groups that can give you a chance to talk with others who are going through the same things. They can give you tips and advice on how to keep positive while you get the care you need.

Adrenal Cancer Outlook

Your outlook depends on several things, including your age, how big the tumor was when it was diagnosed, and whether the tumor makes hormones.

Of people whose cancer is treated before it spreads beyond their adrenal glands, about 74% live at least 5 more years. That 5-year survival rate is 56% If it’s spread to nearby tissues or organs. It’s about 37% if cancer has spread to farther parts of your body.