Adrenocortical Carcinoma
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Cancer of the adrenal cortex, a rare cancer, is a
disease in which cancer (malignant) cells are found in the adrenal cortex,
which is the outside layer of the adrenal gland. Cancer of the adrenal cortex
is also called adrenocortical carcinoma. There are two adrenal glands, one
above each kidney in the back of the upper abdomen. The adrenal glands are
also called the suprarenal glands. The inside layer of the adrenal gland is
called the adrenal medulla.
The cells in the adrenal cortex make important hormones
that help the body work properly. When cells in the adrenal cortex become cancerous,
they may make too much of one or more hormones, which can cause symptoms such
as high blood pressure, weakening of the bones, or diabetes. If male or female
hormones are affected, the body may go through changes such as a deepening
of the voice, growing hair on the face, swelling of the sex organs, or swelling
of the breasts. Cancers that make hormones are called functioning tumors. Many
cancers of the adrenal cortex do not make extra hormones and are called nonfunctioning
tumors.
A doctor should be seen if the following
symptoms appear and won’t go away:
- pain in the abdomen,
- loss of weight without dieting, or
- weakness.
If there is a functioning tumor, there may be symptoms
or signs caused by too many hormones.
If there are symptoms, a doctor will order blood and
urine tests to see whether the amounts of hormones in the body are normal.
A doctor may also order a computed tomography scan of your abdomen, a special
x-ray that uses a computer to make a picture of the inside of the abdomen.
Other special x-rays may also be done to tell what kind of tumor is present.
The chance of recovery (prognosis) depends on how
far the cancer has spread (stage) and on whether a doctor was able to surgically
remove all of the cancer.
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Once cancer of the adrenal cortex has been found,
more tests will be done to see how far the cancer has spread. This is called
staging. A doctor needs to know the stage of of the cancer to plan treatment.
The following stages are used for cancer of the adrenal cortex:
Stage I
The cancer is less than 5 centimeters (less than
2 inches) and has not spread into tissues around the adrenal gland.
Stage II
The cancer is more than 5 centimeters (greater than
2 inches) and has not spread into tissues around the adrenal gland.
Stage III
The cancer has spread into tissues around the adrenal
gland or has spread to the lymph nodes around the adrenal gland. Lymph nodes
are part of the lymph system and are small, bean shaped organs that make and
store infection-fighting cells.
Stage IV
The cancer has spread to tissues or organs in the
area and to lymph nodes around the adrenal cortex, or the cancer has spread
to other parts of the body.
Recurrent
The cancer has come back (recurred) after it has
been treated. It may come back in the adrenal cortex or in another part of
the body.
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There are treatments for all patients with cancer
of the adrenal cortex. Three kinds of treatment are used:
- Surgery (taking out the cancer).
- Chemotherapy (using drugs to kill cancer cells).
- Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer
cells).
A doctor may take out the adrenal gland in an operation
called an adrenalectomy. Tissues around the adrenal glands that contain cancer
may be removed. Lymph nodes in the area may also be removed (lymph node dissection).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy
may be taken by pill, or it may be put into the body by a needle in a vein
or muscle. Chemotherapy is called a systemic treatment because the drug enters
the bloodstream, travels through the body, and kills cancer cells throughout
the body.
Radiation therapy uses high-energy x-rays to kill
cancer cells and shrink tumors. Radiation for cancer of the adrenal cortex
usually comes from a machine outside the body (external radiation therapy).
Besides treatment for cancer (chemotherapy, radiation
therapy, and/or surgery), a patient may also receive therapy to prevent or
treat symptoms caused by the extra hormones that are made by the cancer.
Treatment depends on how far the cancer has spread,
and a patient’s age and overall health.
Standard treatment may be considered because of
its effectiveness in past studies, or participation in a clinical trial may
be considered. Not all patients are cured with standard therapy, and some standard
treatments may have more side effects than are desired. For these reasons,
clinical trials are designed to find better ways to treat cancer patients and
are based on the most up-to-date information.
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Treatment will probably be surgery to remove the
cancer.
Treatment will probably be surgery to remove the
cancer. Clinical trials are testing new treatments.
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Treatment may be one of the following:
- Surgery to remove the cancer. Lymph nodes in the area may also be
removed (lymph node dissection).
- A clinical trial of radiation therapy.
- A clinical trial of chemotherapy if the size of the tumor can be measured with
x-rays and/or if the tumor is making hormones.
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Treatment may be one of the following:
- Chemotherapy. Clinical trials are testing new drugs.
- Radiation therapy to bones where the cancer has spread.
- Surgery to remove the cancer in places where it has spread.
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Treatment depends on many factors, including where
the cancer came back and what treatment has already been received. In some
cases, surgery can be effective in decreasing the symptoms of the disease by
removing some of the tumor. Clinical trials are testing new treatments.
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