About Adrenal Cancer

The adrenal glands are two in number, one above each kidney. When the cells in the adrenal gland start to grow out of control, they form a lump or mass called a tumour. When the cancer cells spread outside the adrenals to other parts of the body, it is called metastatic cancer.

 

Adrenal gland cancer is rare, and most tumours are not malignant. Adrenal gland tumours can be of different types, including:

• Adenoma
• Arenal cortex cancer
• Pheochromocytoma
• Neuroblastoma

 

While the exact cause of adrenal gland cancers is unknown, some factors that increase your risk of developing the condition are:

• Li-Fraumeni syndrome
• Beckwith-Wiedemann syndrome
• Familial adenomatous polyposis (FAP)
• Lynch syndrome
• Neurofibromatosis type 1

Symptoms of adrenal gland cancers occur when the tumour grows large and presses on nearby structures or organs. Some common symptoms are:

• Backache
• Abdominal pain
• Muscle cramps
• Increased heart rate
• Feeling of stomach fullness despite eating very less
• Weakness
• Excess facial hair in women, growth of breasts in men
• High blood pressure

When is Surgery Performed for Adrenal Cancer?

Surgery for adrenal gland cancers is a specialised procedure. It is essential to get access to the right specialised cancer care centres. Surgery is the primary treatment for adrenal gland cancers and is called adrenalectomy.

 

The surgeon aims to remove as much cancerous tissue as possible during this procedure. If the nearby lymph nodes appear affected, they may be checked for cancer and removed if affected.

 

Small adrenal gland cancers are removed through a small incision in the back. This technique may work for some large tumours as well. Advanced adrenal cancers that have spread to nearby organs like the kidneys may need to be removed surgically.

Surgery is recommended for the following clinical scenarios:

• Stage I and II: The entire adrenal gland may be removed in these stages. If the nearby lymph nodes are affected, they may be removed too. No further treatment is required if the entire tumour and gland are removed. Radiation treatment may be given if the tumour has not been removed entirely.
• Stage III: Surgery is often the primary treatment for stage III adrenal cancers, and its main goal is to remove all the cancerous tissue. The surgeon may also remove affected lymph nodes during the surgery.
• Stage IV: In the advanced stages of adrenal cancer, removing all of the cancerous tissue may not be possible. However, surgery is done to relieve the patient’s symptoms and prolong life. This procedure is called debulking, during which much of the cancer is removed. In stage IV adrenal cancer, chemotherapy may be used post-surgery.

Who is an Ideal Candidate for Adrenal Cancer Surgery?

Any individual having adrenal cancer is a candidate for surgery. Surgery is recommended for the following:

• A functional adrenal tumour that causes an imbalance of adrenal hormones
• Large adrenal tumours that are greater than 4 to 6 cm
• Metastasis or spread of adrenal cancer to other organs

 

The following adrenal cancers are treated by surgery:

• Adrenocortical carcinoma (ACC)
• Pheochromocytomas
• Paragangliomas
• Non-cancerous adrenal tumours that produce high levels of hormones
• Patients having a local recurrence of adrenal cancer

Adrenal Cancer Surgery Cost in the UK

Adrenal cancer surgery costs slightly higher than surgery for more common cancers. This can be attributed to the specialised procedure and skilled surgeons required. The cost of undergoing adrenal cancer surgery is also high for people who wish to undergo the procedure in a private healthcare facility and people who do not have insurance coverage. 

 

Your doctor and healthcare team will discuss the overall treatment cost for your adrenal cancer and the costs involved in your surgery. If you have any queries or concerns, seek a second opinion from another specialist in the field.

 

Other Treatments for Adrenal Cancer

While surgery remains the primary treatment for adrenal cancer, other standard options that are used include:

 

• Radiation therapy: This therapy uses high-energy radiation to damage or kills cancer cells. Radiation therapy is used as an adjuvant after surgery in adrenal gland cancer treatment to prevent cancer recurrence.

• Chemotherapy: This treatment uses strong anti-cancer drugs to kill cancer cells. The drugs are usually given as pills (to be taken by mouth) or injected into the vein. Chemotherapy is ineffective in treating adrenal cancer, so it is preferred in advanced cases after surgery. Mitotane is the most commonly used chemotherapy drug in people with adrenal cancer and blocks the production of hormones by the adrenal gland.

 

• Other drugs: Apart from mitotane which blocks adrenal gland cells from producing hormones and lowers their effects, a few other drugs like ketoconazole and metyrapone help reduce the production of steroid hormones.

 

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