Adrenal Gland Cancer

Adrenal gland cancer is an extremely rare disease affecting 1 or 2 persons in a population of a million. Adrenal glands are triangular in shape and are located on top of each kidney. They can be divided into two parts, the outer region known as adrenal cortex, and the inner region called adrenal medulla. Both the regions are centers of production of some very important hormones, that play a vital role in many metabolic activities as well as physical and mental responses to stress. When cells in these glands proliferate uncontrollably to form a mass, it results in the development of a tumor in the glands. These tumors can be divided into two types, benign tumors and malignant tumors . Benign tumors are non-cancerous as they do not spread to the other parts, while malignant tumors are cancerous and affect other parts of the body. The causes of adrenal gland cancer are still unknown, though heredity is suspected to play an important role in triggering it.

Types of Adrenal Cancer

Adrenocortical carcinoma: This is the most common type of adrenal cancer that develops in the cortex region of the adrenal glands. It is mainly found in adults, mostly among people in their 40s.

Pheochromocytoma: This is quite a rare disease that begins in the adrenal medulla, especially in the cells that produce epinephrine and norepinephrine. This type is also found to affect mainly adults in their 30s or 40s.

Neuroblastoma: This is another type of adrenal cancer which develops in the medulla region of the adrenal glands, mainly in the undeveloped nerve cells. Neuroblastoma is prevalent among children and infants with symptoms of abdominal and bone pain.

Symptoms of Adrenal Cancer
The symptoms of this disease depend on the type of tumor, i.e whether it is a functional or non-functional tumor. A functional tumor causes excessive production of adrenal hormones, while a non-functional tumor does not produce hormones. So, the symptoms produced by the functional cancerous tumors are associated with abnormalities caused by the overproduction of hormones. If excess cortisol is produced for example, it can develop into Cushing's syndrome, which is characterized by intolerance to glucose, central body obesity, high blood pressure, excessive growth of hair, osteoporosis, kidney stones, and menstrual irregularities in women.

Overproduction of female hormones may cause early puberty, and return of vaginal bleeding in women who have attained menopause. On the other hand if the tumor causes excessive secretion of male hormones or androgens in women, then it may lead to development of male traits like excess growth of body hair and deepening of voice. Similarly, excess production of estrogens in males result in the development of female traits such as enlargement of breasts in men.

Non-functional tumors does not produce these symptoms. They may instead cause pain in the abdomen and flank. Some other symptoms of adrenal cancer include fever, abdominal mass, unexplained weight gain and weight loss, appearance of excessive acne, high blood pressure, etc. However, sometimes symptoms may not be present in individuals suffering from adrenal cancer.

Diagnosis and Treatment
Since in many instances, cancerous tumor in the adrenal glands induces excess hormone production, so the diagnosis usually starts with blood test to determine the level of adrenal hormone in the blood. However, sometimes non cancerous benign tumors can also cause excess production of adrenal hormones. The next step for detecting the disease is X-ray and CT (computed tomography) scan, which can give a detailed image of the adrenal glands. Sometimes magnetic resonance imaging is also used for diagnosis, which gives detailed image with the help of magnetic field. Usually these tests are sufficient for diagnosing the cancer in adrenal glands, however, in some instances biopsy may also be required.

Treatment of adrenal gland cancer usually depend on the size as well as the location of the cancerous tumors. If the tumor is small in size, less than 5cm and non cancerous, then it can be removed with the help of laparoscopic surgery, which involves insertion of fiber optic scopes through tiny incisions made in the abdomen or back. If the tumor is larger and there is ground to believe that it is cancerous, then a large incision is made either in the abdomen or back for carrying out surgery. Chemotherapy and radiation therapy are also a part of cancer treatment. Chemotherapy involves the use of certain drugs to destroy the cancerous cells, while in radiation therapy, X-ray or other particles are used to kill the cancerous cells.

Adrenal cancer is hardly diagnosed at the early stages. By the time the patients are diagnosed the cancer spread to the nearby regions and affects different organs like liver, bone and abdominal cavity. Since, heredity is supposed to be an important factor for adrenal gland cancer, therefore people having relatives who have suffered from adrenal cancer should go for regular medical examination to prevent the occurrence of the disease.