Adrenal carcinoma is a rare form of cancer that occurs when healthy cells in the adrenal glands mutate and grow out of control.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295b65f32e-d519-49aa-a8a2-c9c388fa730c The adrenal glands are two small organs located above each of the kidneys in the upper part of the abdomen. They are responsible for producing various hormones, such as adrenaline and cortisol, that help regulate body functions.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a8783ef-64d9-4480-be44-95315bf1850c Adrenal carcinomas are often called adrenocortical carcinomas, a reference to where the tumors develop: in the outer part of the adrenal gland called the cortex.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a8783ef-64d9-4480-be44-95315bf1850c Individual survival rates vary greatly and depend on many factors, including the size and extent of the cancer and your overall health.e60dc2a1-f33c-4a05-9b50-8e3e8e59762945c5efff-45eb-468f-8e94-855aaf0dca0f Most cancers of the adrenal glands spread from other locations, when other forms of cancer have metastasized and spread.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc9e38d7-0094-4d52-a5dc-dcbdbdfca12b This guide is specifically about cancers that originate in the adrenal gland, which is less common.
Types of Adrenal Carcinoma Types Adrenal carcinomas are considered “functioning” or “non-functioning,” depending on whether or not they produce excess hormones. An estimated 70 percent of adrenal carcinomas are functioning, producing hormones such as cortisol, androgens (like testosterone), estrogen, or aldosterone.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f05674c4-3c6f-41db-8afd-d7dc787e71dce60dc2a1-f33c-4a05-9b50-8e3e8e597629e23aecc8-af32-4853-b4e0-9d86f205fb98 Though very rare, other types of adrenal tumors include: Neuroblastoma, which starts in neuroblasts (early nerve cells) in the adrenal gland and usually affects infants or children under 10.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290f02c6a1-b391-4fd9-990c-49d3ba2c7421e60dc2a1-f33c-4a05-9b50-8e3e8e5976296787e09e-846b-481a-bc66-d93d3cca3f96 Pheochromocytoma, which begins in the medulla, the inner part of the adrenal gland, usually in adrenaline-producing cells.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290f02c6a1-b391-4fd9-990c-49d3ba2c7421 Paraganglioma, which develops near certain blood vessels and nerves outside the adrenal glands.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b372662f-9e40-4952-904c-c8e96aea6481 Most adrenal gland tumors or lesions are benign or noncancerous and do not spread beyond the organ. Benign tumors are called adrenal adenomas.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d8ada3ab-42ba-4b86-b3eb-4157d95026ca
Signs and Symptoms of Adrenal Carcinoma Symptoms Adrenal carcinomas can cause a range of symptoms — either from the hormones they overproduce or the tumor itself pressing on other nearby structures. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f930552d-eda2-46bb-853e-0c16929984e3e60dc2a1-f33c-4a05-9b50-8e3e8e597629e67c698b-3436-41b6-9247-c69dbef8e3d2 High blood pressure Weight gain, particularly in the cheek area (moon face), around the midsection, and above the collarbone Fatigue Depression and anxiety Insomnia Tremor Lightheadedness when standing up from sitting or lying down Headache Rapid or irregular heartbeat Sweating Paleness Elevated blood sugar levels, which can lead to diabetes Acne e60dc2a1-f33c-4a05-9b50-8e3e8e5976291a20344f-529a-4dcc-895b-da914ddc6497 Excessive hair growth on the face and body Weakness and loss of muscle, especially in the legs Weakened bones ( osteoporosis ) Bruising easily Purple-red stretch marks on the abdomen, thighs, or breasts Low blood potassium levels Muscle cramps Abdominal pain or fullness Back pain or discomforte60dc2a1-f33c-4a05-9b50-8e3e8e5976291a20344f-529a-4dcc-895b-da914ddc6497 Enlarged penis or breasts in boys Enlarged clitoris or early puberty in girls Deepening voice or menstruation abnormalities in women Breast tenderness or enlargement, lowered sex drive, or erectile dysfunction in men
Causes and Risk Factors of Adrenal Carcinoma Causes While the exact cause of adrenal cancer remains unclear, several factors may contribute to its development. Adrenal carcinoma runs in families 50 percent of the time,e60dc2a1-f33c-4a05-9b50-8e3e8e597629fec4ec2f-c168-402b-bf85-145911436827 and certain inherited conditions can increase your risk of the disease, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629c854f139-7c17-4efa-8fdd-8718b374a437e60dc2a1-f33c-4a05-9b50-8e3e8e597629132bf5e2-193e-47f0-9d58-fbfe13ea51c1 Li-Fraumeni syndrome Beckwith-Wiedemann syndrome Carney complexe60dc2a1-f33c-4a05-9b50-8e3e8e597629c12f734e-d437-4a80-8c78-0c6f764f2e77 Multiple endocrine neoplasia type 1 (MEN1) Multiple endocrine neoplasia type 2 (MEN2) Familial adenomatous polyposis Lynch syndrome Von Hippel-Lindau disease Von Recklinghausen’s disease (neurofibromatosis type 1) Paraganglioma syndrome Other risk factors include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976298e09ef8e-6372-4477-a8d1-ae9679a605a2 Overweight or obesity e60dc2a1-f33c-4a05-9b50-8e3e8e59762990d9c4ac-8ba9-47c8-9269-eb4cb92898bb A sedentary lifestylee60dc2a1-f33c-4a05-9b50-8e3e8e59762990d9c4ac-8ba9-47c8-9269-eb4cb92898bb Smoking Exposure to chemicals like asbestos and radon Radiation therapy to your abdomen
How Is Adrenal Carcinoma Diagnosed? Diagnosis To diagnose adrenal carcinoma, your doctor will likely perform the following tests:e60dc2a1-f33c-4a05-9b50-8e3e8e597629421e4f26-f444-4246-9779-7a23f14895c1e60dc2a1-f33c-4a05-9b50-8e3e8e5976295ab315eb-55f3-4ae9-9f13-5a31a882f580 Physical examination, including reviewing your medical history, evaluating your symptoms, reviewing your risk factors, and examining your abdomen for any masses Blood and urine tests to measure the amount of adrenal hormones in your body Dexamethasone suppression tests , which determine if your adrenal gland is producing too much of the hormone cortisol Adrenal angiography and venography , which determine if the blood flow in your adrenal arteries and veins are blocked, respectively Imaging tests to visualize the size and spread of the tumor, such as ultrasound , CT, MRI , PET , and X-ray scans MIGB (meta-iodobenzylguanidine) scans , which use a radioactive tracer to identify pheochromocytomas (a type of tumor) in the inner layer of the adrenal glande60dc2a1-f33c-4a05-9b50-8e3e8e597629402857f6-2a37-43ed-aa46-3d618c04d42e If you have cancer that has spread to other parts of your body (metastasized), your healthcare provider may perform a biopsy — they’ll collect a tissue sample from the tumor and examine it under a microscope — to determine if it is from an adrenal cancer or another type of cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e59762975a6c3f9-6812-4f45-8fdd-d5fe7e63f5a5
Treatment and Medication Options for Adrenal Carcinoma Treatment Treatment for adrenal carcinoma depends largely on how large it is, how far it has spread, and your general health and fitness. Surgery Surgery to remove the tumor is the primary treatment for adrenal carcinoma. During this procedure, called an adrenalectomy, your surgeon may also remove nearby lymph nodes if they are affected.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297f6bf06c-177d-4cc5-8c36-9025a10185a0 In some cases, only a portion of an adrenal gland may need to be removed, while others may require both glands to be fully removed, depending on the location of the cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297f6bf06c-177d-4cc5-8c36-9025a10185a0 Your surgeon may use one of two methods to perform an adrenalectomy:e60dc2a1-f33c-4a05-9b50-8e3e8e5976297f6bf06c-177d-4cc5-8c36-9025a10185a0 Open adrenalectomy is an operation through one large incision or cut in the abdomen. Laparoscopic adrenalectomy is an operation through several smaller incisions using a laparoscope (a long, thin tube with a light and camera at the end). People who undergo laparoscopic surgery typically report less post-operative pain and faster recovery times, though the procedure requires more skill to complete successfully.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299aa2beb5-4b3e-4c9e-893d-9b3d33187f01 Some research suggests laparoscopic adrenalectomy carries a higher risk of peritoneal carcinomatosis (cancer of the thin membrane lining the abdominal cavity) than open surgery.e60dc2a1-f33c-4a05-9b50-8e3e8e597629745101ca-4a6b-45bb-89b3-6042611473db Adrenal cancer returns or recurs after surgery in 19 to 34 percent of cases, so additional treatments (called adjuvant therapies) often follow an adrenalectomy — usually radiation therapy or chemotherapy.e60dc2a1-f33c-4a05-9b50-8e3e8e597629745101ca-4a6b-45bb-89b3-6042611473db If only one of your adrenal glands is removed, your remaining gland will produce the hormones your body needs. If you have both removed, however, you will require lifetime hormone replacement therapy.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299aa2beb5-4b3e-4c9e-893d-9b3d33187f01 Radiation Therapy Radiation therapy kills cancer cells using high-energy rays like X-rays.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b7cf92a5-7cef-4297-9710-d172d87d2d59 Aside from being an adjuvant therapy to adrenalectomy, radiation therapy is also used to reduce symptoms in cases of advanced adrenal carcinoma.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b54624b3-5a51-4ee0-836d-d6ec8f49f781e60dc2a1-f33c-4a05-9b50-8e3e8e597629b7cf92a5-7cef-4297-9710-d172d87d2d59 There are a couple types of radiation therapy that may be used to treat adrenal cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b54624b3-5a51-4ee0-836d-d6ec8f49f781 External-beam radiation therapy , which uses radiation produced from a machine outside the body to kill the cancer cells, usually with imagery and computer guidance systems to target tumor cells accurately with precise dosages. Radiofrequency ablation , which uses a thin, needle-like probe to deliver high-energy radio waves to destroy tumor cells with heat. It’s typically only used if you’re not able to have surgery or the tumor cannot be surgically removed. Common side effects of radiation therapy include gastrointestinal issues, skin changes like redness and blistering, and fatigue.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b7cf92a5-7cef-4297-9710-d172d87d2d59 Chemotherapy Chemotherapy, the use of powerful drugs to kill cancer cells, does not work well as a primary treatment for adrenal cancer, but it is useful as an adjuvant therapy or to help manage symptoms of advanced adrenal carcinoma.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e775632d-7eb1-472a-bc97-fd0572b0d68a The chemo drug usually used for adrenal carcinoma is mitotane, which can both destroy cancer cells in the adrenal gland and block adrenal hormone production.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e775632d-7eb1-472a-bc97-fd0572b0d68a But mitotane also destroys healthy cells and blocks hormone production in a healthy adrenal gland.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e775632d-7eb1-472a-bc97-fd0572b0d68a This may result in various symptoms, such as weakness, depression, and high cholesterol.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e775632d-7eb1-472a-bc97-fd0572b0d68a Hormone Therapy While mitotane reduces adrenal hormone production, in general, some drugs can help manage elevated levels of specific hormones.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a4713f6f-0f5c-44a9-8894-c49a13f70c89 For too much cortisol, metyrapone, ketoconazole, mifepristone, and etomidate For too much aldosterone, spironolactone, eplerenone, and amiloride For too much testosterone, bicalutamide, finasteride, and spironolactone For too much estrogen, tamoxifen Immunotherapy Immunotherapy drugs help the body’s immune system more effectively find and destroy cancer cells. Immune checkpoint inhibitors are drugs that target specific proteins that cancer cells use to evade the immune system.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a07f660-fa3a-4e7b-9d76-c474aa1ed67e Sometimes used with or without mitotane to treat advanced adrenal cancer, pembrolizumab (Keytruda) is an immune checkpoint inhibitor that targets the protein PD-1.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a07f660-fa3a-4e7b-9d76-c474aa1ed67e It can cause side effects like cough, gastrointestinal issues, poor appetite, nausea, and skin rash.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a07f660-fa3a-4e7b-9d76-c474aa1ed67e It can also cause the immune system to attack other parts of the body, leading to potentially life-threatening issues affecting other organs.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a07f660-fa3a-4e7b-9d76-c474aa1ed67e
Prevention of Adrenal Carcinoma Prevention While not all cases of adrenal carcinoma can be prevented, you can lower your risk with the following measures.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fb0c7cc2-a62d-4c88-87c1-3d94554271d6e60dc2a1-f33c-4a05-9b50-8e3e8e597629608bd4f1-735f-48ae-b41b-15cb2d40a0bc Avoid tobacco products, alcohol, and cancer-causing chemical s. The Centers for Disease Control and Prevention recommends that you restrict alcohol consumption to no more than two drinks a day for men and one drink a day for women.e60dc2a1-f33c-4a05-9b50-8e3e8e59762964c85c10-15f4-4892-abc2-19da11cd5de9 There is no safe amount of alcohol consumption when it comes to affecting cancer risk — even small amounts could increase risk of health complications or cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b55f1b2c-65e0-4ad0-a1e4-a11f9e39aac5 Maintain a healthy body weight for you. A BMI of 18.5 to 29.4 is generally considered healthy for most adults, but can vary based on body composition.e60dc2a1-f33c-4a05-9b50-8e3e8e597629325fffc7-3556-493c-ae9f-369f85a3f9da Be physically active. The American Heart Association recommends 150 minutes of moderate to intense physical activity per week for adults.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294323a9c4-c3a4-482b-89dd-32fb30511536 Eat a healthy diet. Stick to meals rich in fruits and vegetables and low in processed meats. Get genetic tests. You may want to consider genetic screening if you have a family history of adrenal cancer or other cancers.
Lifestyle Changes for Adrenal Carcinoma Lifestyle Changes Certain lifestyle changes can improve your overall well-being after having adrenal cancer, such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629764a1e31-0d3e-4f81-b023-eddf5bc42971 Regular checkups and follow-up care. This may include blood and urine hormone tests to check your hormone levels. A healthy, nutritious diet Meditation, yoga , psychotherapy , and other stress-reduction practices to help regulate your cortisol (stress hormone) levelse60dc2a1-f33c-4a05-9b50-8e3e8e5976295a3dfe78-ee95-4963-a26c-95794c5bbb6e
Adrenal Carcinoma Prognosis Prognosis and Outlook While the overall five-year survival rate for adrenal carcinoma cancer is 50 percent, five-year survival rates can be further broken down by cancer stage or how far it has spread.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e12ab27e-db66-430e-8d11-e276e41762b7 73 percent for localized cancer that’s only growing in the adrenal gland 53 percent for regional cancer that’s spread beyond the gland to nearby lymph nodes or tissues 38 percent for distance cancer that’s spread to the liver, lungs, or other distant parts of the body Various factors can affect your specific survival rate, such as your overall health, how early the cancer was detected, and lifestyle factors, such as if you smoke.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e12ab27e-db66-430e-8d11-e276e41762b7
Complications of Adrenal Carcinoma Complications Adrenal carcinoma may cause complications related to excess hormone production. The most common of these is hypercortisolism, or excessive cortisol levels, which occurs in 50 to 80 percent of functioning adrenocortical carcinomas.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294d3cea82-4768-44f1-99e3-0a137214e016 This can cause symptoms such as:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294d3cea82-4768-44f1-99e3-0a137214e016 Diabetes mellitus Fatigue High blood pressure Obesity Muscle weakness and atrophy Osteoporosis
Research and Statistics: How Many People Have Adrenal Carcinoma? Research and Statistics While adrenal tumors are relatively common, showing up in about 10 percent of people who have an imaging test of the adrenal gland, the vast majority are benign tumors called adenomas.e60dc2a1-f33c-4a05-9b50-8e3e8e597629785b51fb-963e-4ac5-acd0-aca311b72e7f The American Cancer Society estimates that there are only about 200 new cases of adrenocortical carcinomas diagnosed each year in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e597629785b51fb-963e-4ac5-acd0-aca311b72e7f Adrenocortical carcinomas tend to affect more women than men, and it is most often found in young children under 5 years old and adults in their forties to fifties.e60dc2a1-f33c-4a05-9b50-8e3e8e597629785b51fb-963e-4ac5-acd0-aca311b72e7f
Related Conditions Related Conditions There are many conditions that affect the adrenal glands, causing them to produce too little or too much of one or more hormones, such as:e60dc2a1-f33c-4a05-9b50-8e3e8e59762978895535-9b64-4f86-a29e-aca8a4b068c3 Cushing’s syndrome (excess cortisol) Addison’s disease (cortisol or aldosterone deficiency) Conn’s syndrome (excess aldosterone)
The Takeaway Adrenal carcinoma is a rare, aggressive condition that can wreak havoc on your hormones, causing a wide range of issues. Understanding the disease’s risk factors, recognizing its many symptoms, and maintaining a proactive approach to your health can make a significant difference in treatment outcomes. If caught early enough, the cancer can be surgically removed before it has spread beyond your adrenal glands.
Resources We Trust Mayo Clinic: Science Saturday: All Adrenal Tumors Should Be InvestigatedCleveland Clinic: Time to Rethink Cancer Risk With Adrenal IncidentalomaAmerican Cancer Society: Questions to Ask About Adrenal CancerNational Cancer Institute: Adrenocortical CarcinomaEndocrine Society: Navigating an Adrenocortical Carcinoma Diagnosis
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