What are the adrenal glands?

The adrenal glands are small glands that are situated on top of each kidney. They are responsible for producing important hormones, such as adrenaline, steroid hormones such as androgens, and corticosteroids.

These hormones help the body to control blood sugar, react to stress (e.g injury or illness), regulate blood pressure, and burn fat. The adrenal glands may make too much or too little of these hormones, which leads to health complications and in some cases, endocrine conditions.

What is adrenal gland cancer?

Adrenal gland cancer occurs when abnormal, malignant cells form in the glands. They are usually found in the outermost layer of the glands or the adrenal cortex.
 

What are the different types of adrenal gland tumours?

There are several different types of adrenal gland tumour: benign adenoma and adrenal cortical carcinoma.

Benign adenomas are non-cancerous and are small. This type of tumour does not have any symptoms and in most cases, occur on only one gland.

Adrenal cortical carcinomas are bigger in size than the benign adenomas (more than 2 inches in diameter) and are cancerous. They may produce hormones that cause other changes in the body.
 

What are the symptoms of adrenal gland cancer?

Tumours of the adrenal glands can occur at any age, although the disease is more common in children younger than five years old, and in adults between 40 and 50 years. Benign tumours do not usually show symptoms but they can secrete high levels of certain hormones, generating some complications. In contrast, with malignant tumour, the following symptoms can occur:

• Weight gain
• Increased fat in the neck and shoulders
• Additional hair growth on some parts of the body
• Weak bones
• Irregular menstrual periods in women
• High blood pressure 

Symptoms of adrenal cancer are easier to notice in children because the signs of physical changes related to puberty are more apparent. Signs of adrenal glands cancer in children may include:

• Excessive pubic, underarm and facial hair growth
• Early development of breast tissue
• Abdominal pain or fullness
• Weight changes
• Rapid pulse
• Excessive sweating
• Development of body odour or acne
   

How is adrenal glands cancer diagnosed?

Your doctor will take a blood and urine test to check if there are unusual levels of hormones, such as cortisol, aldosterone and androgens being produced by the adrenal glands. You may also have a CT or MRI scan to measure the growths of the adrenal glands.

The gland may also be removed and sent to the laboratory as a specialist (a cytologist) will study the tissues and confirm what types of cells are involved.

How is adrenal cancer treated?

The goal of treatment of adrenal glands cancer is surgery in order to remove the tumour. The doctor will remove all of the affected glands with a procedure called adrenalectomy. Following surgery, you may have radiation and/or chemotherapy to kill the cancer cells.

For those who are not able to have surgery, chemotherapy is an option to slow the progression of cancer. In cases where the cancer is recurrent, you may be treated with a medication called Mitotane, which is used to block hormone production by the adrenal glands and destroys both adrenal cancer cells and adrenal tissue.

Sometimes Mitotane is given for a period of time after surgery has removed all of cancer too. This is to prevent or delay the cancer’s return.