Adrenal Cortical Cancer

Adrenal Cortical Cancer Definition

The body’s two adrenal glands are small and sit just above the kidneys, respectively. The adrenal glands are made up of an outer part, called the cortex, and an inner part called the medulla. Most tumors develop in the outer part (cortex), but one rather rare variety is referred to as adrenal cortex cancer, adrenal cortical cancer, adrenal cortical carcinoma, or simply adrenal cancer.

Adrenal cortical cancer actually develops in the cortex of the body’s adrenal gland. This distinction is important because most cancers found in the adrenal glands originated in other tissues and organs within the body and then metastasized to the glands via the bloodstream.

How adrenal cortical cancer is found
Adrenal cortical cancer is often found accidentally when looking for something else. Sometimes patients become concerned because of changes that the malfunctioning adrenal glands cause to their body. These symptoms may include weight gain, fluid retention, excess body or facial hair in women, or early puberty in children.

The tumor may also grow quite large, which can cause pain when it presses on other organs in the body or create a sense of fullness. Adrenal cortical cancers can be quite large when compared to adrenal adenomas, which is a benign tumor that usually occur in one gland, but may also occur in both adrenals.

Adrenal Cortical Cancer Stages

Staging is the process of figuring out the extent of the cancer, whether it has metastasized (spread) to other parts of the body, and if so, how far it’s spread. Staging is important because it helps doctors determine treatment protocols and offer patients a prognosis.

Staging seeks to answer a few important questions. How large is the cancer? Has it grown into any nearby organs or tissues? Has the cancer metastasized to any distant organs or lymph nodes? Adrenal cortical cancer staging is determined through a series of tests, biopsies, and physical exams.

The staging system can be quite confusing for patients to understand, so it’s important to ask questions of your doctor to fully understand the situation. Every patient’s cancer is unique to their body, so staging has inherent limitations. However, the goal is to use historical data to determine how best to treat the cancer.

Staging data appears as a series of letters followed by numbers. The higher the number, the more the adrenal cancer has spread. Stage IV is the highest number possible, and this means that the cancer is in an advanced stage. Doctors often treat cancers with similar stages in the same way, which is why treatment may work for one patient but not for another. This is why it’s important to understand your staging and then seek treatment that you believe has the best chance of success.

Understanding the staging system for adrenal cortical cancer
Adrenal cancers are staged according to the TNM staging system, which breaks down the cancer into three important categories. These letters stand for the following pieces of information:

• T – Tumor – This letter describes the size of the adrenal tumor with information regarding whether its grown into nearby areas within the body.

• N- Nodes – This letter describes whether the adrenal cancer has spread to any lymph nodes within the region of the adrenal glands.

• M – Metastasized – This letter describes whether the adrenal cancer has spread to distant areas (organs and lymph nodes) within the patient’s body.

Numbers will appear directly after these letters. Lower numbers mean the cancer is in its earlier stages, while higher numbers mean the cancer is more advanced. These numbers are usually determined after adrenal surgery. The individual values are then combined in a process called grouping, and then an overall stage is assigned to the cancer which may be I, II, III, or IV.

You may also notice coding that isn’t mentioned above. These are what these values represent:

• TX – This means that the tumor can’t be accessed because there isn’t enough information
• T0 – This means that evidence of a primary tumor doesn’t exist
• NX – This means that information concerning lymph nodes is not available

Obviously, staging is a complex process that will lead to many questions. Doctors will offer patient’s a prognosis for recovery based on the information in the staging report. They will also recommend treatment based on the same data. Their recommendations and opinions are based on historical data, but every cancer is unique, so it’s important to be fully educated on treatment options.

Adrenal Cortical Cancer Symptoms (signs of Adrenal Cortical cancer)

There are two reasons why symptoms appear in patients with adrenal cortical cancer. About half of patients suffer symptoms because of hormones manufactured by the damaged adrenal gland. The other half suffer symptoms because the tumor has grown to the point where it’s impacting surrounding tissue or organs.

If you or your child have any symptoms mentioned here, it’s vital that you seek a proper diagnosis from a qualified physician. The earlier adrenal cortical cancer is detected, the better the chance of recovery. What follows is a breakdown of symptoms for each of the situations described above.How adrenal cortical cancer is found

Adrenal Cortical Cancer Definition

The body’s two adrenal glands are small and sit just above the kidneys, respectively. The adrenal glands are made up of an outer part, called the cortex, and an inner part called the medulla. Most tumors develop in the outer part (cortex), but one rather rare variety is referred to as adrenal cortex cancer, adrenal cortical cancer, adrenal cortical carcinoma, or simply adrenal cancer.

Adrenal cortical cancer actually develops in the cortex of the body’s adrenal gland. This distinction is important because most cancers found in the adrenal glands originated in other tissues and organs within the body and then metastasized to the glands via the bloodstream.

How adrenal cortical cancer is found
Adrenal cortical cancer is often found accidentally when looking for something else. Sometimes patients become concerned because of changes that the malfunctioning adrenal glands cause to their body. These symptoms may include weight gain, fluid retention, excess body or facial hair in women, or early puberty in children.

The tumor may also grow quite large, which can cause pain when it presses on other organs in the body or create a sense of fullness. Adrenal cortical cancers can be quite large when compared to adrenal adenomas, which is a benign tumor that usually occur in one gland, but may also occur in both adrenals.

Adrenal Cortical Cancer Stages

Staging is the process of figuring out the extent of the cancer, whether it has metastasized (spread) to other parts of the body, and if so, how far it’s spread. Staging is important because it helps doctors determine treatment protocols and offer patients a prognosis.

Staging seeks to answer a few important questions. How large is the cancer? Has it grown into any nearby organs or tissues? Has the cancer metastasized to any distant organs or lymph nodes? Adrenal cortical cancer staging is determined through a series of tests, biopsies, and physical exams.

The staging system can be quite confusing for patients to understand, so it’s important to ask questions of your doctor to fully understand the situation. Every patient’s cancer is unique to their body, so staging has inherent limitations. However, the goal is to use historical data to determine how best to treat the cancer.

Staging data appears as a series of letters followed by numbers. The higher the number, the more the adrenal cancer has spread. Stage IV is the highest number possible, and this means that the cancer is in an advanced stage. Doctors often treat cancers with similar stages in the same way, which is why treatment may work for one patient but not for another. This is why it’s important to understand your staging and then seek treatment that you believe has the best chance of success.

Understanding the staging system for adrenal cortical cancer
Adrenal cancers are staged according to the TNM staging system, which breaks down the cancer into three important categories. These letters stand for the following pieces of information:

• T – Tumor – This letter describes the size of the adrenal tumor with information regarding whether its grown into nearby areas within the body.

• N- Nodes – This letter describes whether the adrenal cancer has spread to any lymph nodes within the region of the adrenal glands.

• M – Metastasized – This letter describes whether the adrenal cancer has spread to distant areas (organs and lymph nodes) within the patient’s body.

Numbers will appear directly after these letters. Lower numbers mean the cancer is in its earlier stages, while higher numbers mean the cancer is more advanced. These numbers are usually determined after adrenal surgery. The individual values are then combined in a process called grouping, and then an overall stage is assigned to the cancer which may be I, II, III, or IV.

You may also notice coding that isn’t mentioned above. These are what these values represent:

• TX – This means that the tumor can’t be accessed because there isn’t enough information
• T0 – This means that evidence of a primary tumor doesn’t exist
• NX – This means that information concerning lymph nodes is not available

Obviously, staging is a complex process that will lead to many questions. Doctors will offer patient’s a prognosis for recovery based on the information in the staging report. They will also recommend treatment based on the same data. Their recommendations and opinions are based on historical data, but every cancer is unique, so it’s important to be fully educated on treatment options.

Adrenal Cortical Cancer Symptoms (signs of Adrenal Cortical cancer)

There are two reasons why symptoms appear in patients with adrenal cortical cancer. About half of patients suffer symptoms because of hormones manufactured by the damaged adrenal gland. The other half suffer symptoms because the tumor has grown to the point where it’s impacting surrounding tissue or organs.

If you or your child have any symptoms mentioned here, it’s vital that you seek a proper diagnosis from a qualified physician. The earlier adrenal cortical cancer is detected, the better the chance of recovery. What follows is a breakdown of symptoms for each of the situations described above.

Adrenal cortical cancer symptoms caused by abnormal hormone production
Androgen and estrogen are the hormones secreted by the adrenal gland, and these are the hormones that cause symptoms associated with the disease. Symptoms associated with abnormal androgen production include excessive growth of body hair, especially under the arms and in the pubic region. These hormones may also enlarge the cliroris in girls and the penis in boys.

Symptoms associated with estrogen include the early onset of puberty in girls, which means that breasts and menstruation may start early. For boys, this hormone may cause breasts to develop. In adults, high levels of sex hormones suddenly being manufactured will not be as noticeable because they are already fully developed. This means that symptoms of adrenal cortical cancer may be more difficult to ascertain. This means the cancer may go undiagnosed until it starts to effect nearby body tissue or organs.

However, if the hormone being produced is usually found in the opposite sex, symptoms may be more noticeable. For men, this may mean enlarged breasts start to appear, sudden erectile dysfunction, nad loss of their sex drive. Women producing male sex hormones may suddenly produce excess facial or body hair, irregular menstrual cycles, a deeper voice, or even a receding hairline.

If you or a child experience any of these symptoms, seek a medical opinion right away. This is especially important for children.

Excessive production of cortisol, which is a stress hormone produced by the adrenal glands, can cause a wide variety of symptoms that may indicate adrenal cortical cancer. When all or most of the symtoms are suffered in unison, it’s called Cushing syndrome. The symptoms of Cushing syndrome include:

• Weight gain around the abdomen, the cheeks, and above the collarbone
• Stretch marks around the abdomen that are purple in color
• A fatty hump or “buffalo hump” behind the shoulders and neck
• Excessive hair growth on the chest, back, and face (affecting women)
• Irregular menstrual cycles
• Unusually easy bruising
• Weakness in the legs or loss of muscle mass
• Feeling of moodiness or depression
• Weakened bones, often noticed when fractures occur
• High blood pressure or blood sugar
• Diabetes

There are other reasons why Cushing syndrome may develop in patients, so it’s important to understand why the symptoms are occurring so it can be treated most effectively.

Adrenal cortical cancer symptoms caused by lateral pain
As a tumor grows, it will press against nearby tissues and organs, causing certain symptoms in people suffering from adrenal cortical cancer. Symptoms are usually straightforward, as the feeling of pain near the tumor will likely be acute. Other symptoms include a feeling of fullness in the abdomen, or difficulty eating because of feeling full after only eating a few bites.

Adrenal Cortical Cancer Statistics

To get a better idea of the risks associated with adrenal cortical cancer, statistics provide a frame of reference that many find useful. What are your chances of getting adrenal cancer, and if you develop the disease, what is your overall prognosis?

Adrenal cortical cancer is relatively rare. About 200 to 500 people are diagnosed with this disease every year. Keep in mind that this is a rough estimate. This is because adrenal cortical cancer is so rare, there are no firm statistics regarding its frequency. Adrenal adenoma is far more common, but this is a benign tumor unrelated to adrenal cortical cancer.

The average for an adrenal cancer diagnosis is 46, but the disease can appear in young children and older adults. Women are slightly more likely to develop adrenal cancers than men, although these numbers are very close statistically.

When determining the survival rates for various cancers, a 5-year survival rate is most often used. This statistic reveals how many people live for at least 5 years after the adrenal cancer is initially diagnosed. The 5-year survival rate for adrenal cortical cancer depends on the stage of the cancer when it’s first diagnosed. The patient’s age will also determine their survival rate.

If the cancer is diagnosed before it spreads to other parts of the body, the 5-year survival rate is around 65%. If the cancer has spread to nearby lymph nodes, organs, or tissues, the 5-year survival rate drops to 45%. If the cancer has spread to distant areas of the body, the 5-year survival rate drops to a mere 10% or less.

These statistics are only an estimate, and improvements in treatment can lead to better survival rates well before the statistical data is compiled. Remember too that statistics are impersonal and cannot reveal the overall health of each patient at the time of diagnosis. Persons that are healthier overall and maintain a proper diet while getting plenty of exercise will be better prepared for treatment than those who are obese or inactive. You should also never let statistical evidence allow you to give up hope or fail to seek treatment.

Causes of Adrenal Cortical Cancer

The cause of adrenal cortical cancer is unknown at this time. It is estimated that genetic disorders cause about 15% of adrenal cancer cases, and certain conditions may increase the risk of developing the disease. Some of these conditions are as follows:

• Li-Fraumeni Syndrome is an inherited disorder that can increase the risk of developing adrenal cancer and many other forms of cancer.

• Familial Adenomatous Polyposis (FAP) is another inherited disorder where the large intestine is infested with large numbers of polyps. Sufferers of this disorder also run a high risk of developing colon cancer.

• Beckwith-Wiedemann Syndrome is a disorder where marked by abnormal growth in the body’s organs. This may lead to abnormal growth in the body as well. Sufferers of this disease also are at risk of developing other cancers in their liver and kidneys.

Multiple Endocrine Neoplasia Type 1 (MEN!) is an inherited condition that can cause many different malignant and benign tumors to develop. This usually takes place in tissues that produce hormones, including the pancreas, pituitary gland, and parathyroid.

It is also believed that smoking increases the risk of developing adrenal cortical cancer, but at this time there is no direct evidence to confirm this hypothesis. However, the link between smoking and many other cancers is well documented, so it makes sense to avoid smoking if you have any family history of cancer.

Adrenal Cortical Cancer Screening and Prevention

Unfortunately, the risk factors for adrenal cortical cancer are unknown, which makes prevention virtually impossible. That being said, a healthy lifestyle promotes overall good health and helps maintain a strong immune system. Not only can this prevent the onset of diseases like cancer, but it can help fight the disease once it develops in a patient.

Screening is the process of testing to see whether cancer exists. With some cancers (like colon cancer) regular screenings are designed to diagnose the disease at an early stage to increase the chance of successful treatment. However, finding adrenal cancers at an early stage is difficult, because symptoms don’t manifest until the tumor has grown quite large.

It is easier to diagnose adrenal cancers in children because they are more likely to exhibit symptoms when hormones are secreted that prompt signs of puberty at a young age. Still, there are no routine adrenal cancer screenings recommended by the American Cancer Society because of the disease’s rarity. In fact, most adrenal cancers are found by accident when conducting tests for other health problems.

Diagnosing adrenal cortical cancer
While there are no screening procedures for adrenal cortical cancer, certain tests are capable of diagnosing the disease. Usually, these tests are being conducted for some other health problem, or if a doctor suspects that a patient’s symptoms may be the result of adrenal cancer.

Adrenal Cortical Cancer

Before conducting any tests your doctor will request your medical history and conduct a physical exam. This is intended to ascertain the nature of your symptoms and whether or not you have a family history of cancer or other relative problems. Following this, your doctor may do any or all of the following tests:

• Urine or Blood Tests – These are used to assess the levels of adrenal hormones in the body. High hormone levels do not mean that a patient has adrenal cortical cancer, but it may provide a doctor with enough information to recommend further testing.

• CT Scans – CT is short for Computed Tomography. These scans not only show any sized tumor growing in the adrenal glands, they also show if it’s growing into or around any nearby tissue. CT scans are also capable of looking into nearby organs to ascertain whether the cancer has metastasized. For CT scans to work it’s often necessary to drink a solution before the exam and receive a dye injection that helps outline the intestine so doctors don’t mistake it for a tumor.

• MRI – This is an acronym for Magnetic Resonance Imaging, which is basically a bunch of magnets that take a detailed picture of the body’s interior. MRIs are capable of identifying whether a mass is an adenoma or cancer.

• Ultrasound – This is the same technology used to take pictures of fetuses inside a mother’s belly. Sound waves are used to take the image, but it’s not as accurate as other tests. Ultrasounds are sometimes used to guide a biopsy procedure.

• PET Scans – This test is conducted by injecting radioactive sugar into the patient’s vein followed by a scan that reveals areas that absorb the sugar. Because cancer cells absorb sugar faster than healthy cells, cancer can readily be identified using this test. While PET scans are useful for identifying adrenal cortical cancer, studies are being done to make this technology more useful by distinguishing between adenomas and adrenal cancer.

• Aniography– These studies seek to determine whether blood vessels surrounding the adrenal glands are being blocked or compressed by a tumor.

Your doctor may use a single test or a combination of tests to determine the size of the tumor, whether it’s malignant, and whether it’s spread to other parts of the body. Be sure that you fully understand any medical procedure so that you know what to expect ahead of time.

Adrenal Cortical Cancer Treatments

Mainstream medicine has reached an international consensus for a standardized approach to adrenal cortical cancer treatment. If the cancer is confined to the adrenal gland, surgical removal of the gland is recommended. If the cancer has spread, surgery will likely be accompanied by other therapies. Sometimes it’s impossible to surgically remove the cancer, but it’s best to remove it when possible because it is usually a very aggressive form of cancer.

When you first discover that you have adrenal cancer, you feel overwhelmed and have a lot of very important questions running through your mind. The stress and shock can make it hard to determine how best to proceed, especially when you’re faced with a variety of medical options and opinions. Treatment is a personal choice, but most doctors recommend that you take the time to make decisions with loved ones and other people you trust to offer support.

Few doctors have experience treating this rare cancer, so it’s important to take a multidisciplinary approach to treatment and explore all of your options. After speaking with oncologists, radiologists, endocrine specialists, and other experts in the various fields of cancer treatment, you will have a better idea of what may work best for you. It’s likely you will be ready to start treatment a few weeks after your initial diagnosis.

Surgery is often the first step
The only known cure for adrenal cortical cancer is to completely remove the cancerous adrenal gland. However, since this aggressive cancer has often spread to other parts of the body before a diagnosis can be made, other treatment may be required. In certain situations the cancer may be inoperable.

Surgery should be performed by a surgeon with experience removing cancerous tumors and adrenal glands. Because the cancer is so rare, you will likely have to seek out such a physician. Successful removal of the adrenal gland takes careful planning and patient evaluation.

The goal of surgery is the complete removal of the tumor without allowing cancer cells to spread to other parts of the body. Oftentimes, non-cancerous tissue surrounding the adrenal gland is also removed, acting as a margin of sorts to prevent the cancer from recurring. The removal of the entire adrenal gland is called an adrenalectomy.

Radiation therapy for adrenal cortical cancer
Radiation therapy uses a beam of radiation to kill cancer cells. Radiation damages both cancerous and non-cancerous cells, but normal cells are generally able to recover after a period of time. While radiation therapy is not used as standard treatment for adrenal cortical cancer, it is used to decrease the risk of local recurrence or manage areas where the tumor has spread.

Chemotherapy for adrenal cortical cancer
Chemotherapy uses drugs to destroy cancer cells. Normal cells are also killed during chemotherapy, which is usually the cause of side effects associated with the treatment. Chemotherapy is used in situations where removal of the adrenal gland via surgery is not possible. In these situations, the cancer has usually spread to other parts of the body, so the goal is to prevent further growth and spreading, or reduce the patient’s symptoms.

Alternative Treatments Used for Adrenal Cortical Cancer

If a cancer treatment falls outside of the mainstream medical treatments outlined above, it is considered “alternative.” With so little data relative to the rare disease, patients sometimes seek ways to maximize their chances of survival, especially if they have Stage IV adrenal cortical cancer.

The goal with many alternative adrenal cancer treatments is to encourage the body to maximize its self healing potential by boosting the immune system. Every person has cancer cells in their body that the immune system keeps in check, so the idea behind these concepts is to reinforce the body’s natural healing systems in an effort to get the cancer under control.

Sometimes patients seek alternative treatments to support a more traditional treatment protocol. Others may use alternative remedies to help alleviate the side effects of treatments like radiation therapy and chemotherapy. Still others may seek an entirely naturopathic approach to treatment.

Some alternative approaches to treatment are focused around understating the nature of the cancer in each patient, and then developing a specific treatment protocol based on that information. Every patient’s cancer is unique to their body, which explains why mainstream treatments work for some patients and not for others, even though they have the same stage of adrenal cancer.

Doctors using this methodology will do in-depth testing on their patient’s cancer in an effort to understand how best to control and kill it. In the meantime, the patient’s immune system is enhanced through diet, exercise, and other holistic methods. Treatment for one patient may be vastly different than another because their cancers respond differently to similar treatment protocols.

Many alternative treatment methods view chemotherapy and radiation therapy as detrimental to the patient, because if they fail to kill the cancer, the patient is left in weakened state. This may make it difficult to pursue other forms of treatment.

As with any treatment for any cancer, you should be fully aware of your options before deciding on any treatment protocol. Talk to your doctor about your options. Talk to other specialists about alternative treatments. Talk to your family members for emotional support and loving advice. Ultimately, the choice for treatment is yours alone, so explore every option before you take the first step toward recovery.

Vitamins and Supplements Used in the Treatment of Adrenal Cortical Cancer

In an effort to prevent and treat cancer, vitamins and supplements often play a key role. Vitamin deficiencies have been linked to certain varieties of cancer, yet there is still a great deal of controversy surrounding the role vitamins play in regards to cancer treatment.

Alternative treatments that focus on enhancing the immune system often utilize vitamin and supplement therapies. Some of the more common varieties used are as follows.

• Vitamin B6 – This vitamin supports the normal function of the adrenal glands, and also makes antibodies that help the immune system fight disease.

• Vitamin C – Another immune system booster, this natural vitamin also helps repair and regenerate tissue in the body, an essential process for many on cancer treatment protocols.

• Vitamin D – There are studies that prove a link between vitamin D deficiencies and higher risk of cancer. While usually absorbed through the skin by exposure to natural sunlight, some people require supplements to maintain proper levels of vitamin D. If you live in a northern latitude, you should have your vitamin D levels routinely checked to be sure you’re getting the proper dosage.

• Vitamin E – This vitamin helps the body fight infection, which is a powerful tool during cancer treatment.

• Vitamin A – This is yet another vitamin that boosts the immune system while creating a barrier against infection.

• Selenium – Aggressive forms of cancer like adrenal cortical cancer can overwhelm the body, but selenium has been shown to slow down this reaction.

There are many other supplements and vitamins commonly used during cancer treatment. Be sure to talk to your doctor before using any supplement or vitamin to be sure it fits into your treatment protocols.

Natural Remedies that May Help Adrenal Cortical Cancer

There are a number of natural remedies that adrenal cancer patients use either to treat the disease, symptoms associated with the disease, or side effects caused by treatment. What follows is a breakdown of some of the more common natural remedies used by patients suffering from adrenal cortical cancer.

• Massage – Not only can massage help with pain, it’s also a powerful tool to help cancer patients relax and relieve stress.
• Herbal Preparations – These often take the form of extracts, teas, and tinctures that can be taken orally to relieve pain or boost the body’s metabolism.
• Dietary supplements – As mentioned above, there are many vitamins and supplements thought to help prevent cancer and boost the body’s natural ability to combat cancer.
• Physical therapy – Join and muscle pain are common during cancer treatment, and physical therapy often helps relieve this pain while building overall strength.
• Hydrotherapy – Large water basins, spas, swimming pools, and even hot and cold body wraps are capable of offering real relief from stress and pain often associated with cancer and its treatments.
• Acupuncture – Many people swear by the healing and pain relieving abilities of acupuncture. It can be especially helpful for patients suffering from insomnia, nausea, and hot flashes.
• Counseling – There are many forms of counseling that can help with emotional stress or assist patients to adopt healthier lifestyles.
• Diet and Exercise – Eating healthy and remaining active are two of the best ways to maintain a healthy body and strong immune system. Nutrition plays a proven role in cancer prevention, so it’s important to eat plant-based foods with the nutrients that body needs to operate at its best

As with any form of cancer treatment, be sure to talk to your doctor before pursuing any natural remedy.

For more information about adrenal cortical cancer, contact a helpful member of the Causenta team.