Adrenal Cancer

Adrenal cancer, also known as adrenocortical carcinoma, is a rare but aggressive cancer that begins in the adrenal glands—two small, triangular glands located above the kidneys. These glands produce hormones that regulate essential body functions such as metabolism, blood pressure, stress response, and sexual development.

While most adrenal tumors are benign, malignant adrenal tumors can cause serious health problems due to their rapid growth and hormone overproduction.

Adrenal Cancer

Causes and Risk Factors

The exact cause of adrenal cancer remains unclear. However, certain factors may increase risk:

  • Genetic syndromes such as Li-Fraumeni syndrome, Beckwith–Wiedemann syndrome, and familial adenomatous polyposis (FAP)
  • Inherited gene mutations affecting tumor suppression
  • Previous radiation therapy to the abdomen, especially during childhood Most cases occur without a known cause.

Symptoms

Symptoms vary depending on whether the tumor produces excess hormones. Because the signs are often vague, early detection can be challenging.

Common symptoms include:

  • Abdominal pain or a noticeable mass
  • Unexplained weight loss
  • Fatigue
  • High blood pressure
  • Hormonal changes, such as:
    • Irregular menstrual periods
    • Excessive hair growth in women
    • Deepening voice
    • Changes in blood sugar levels
  • Weakness or swelling due to abnormal steroid production

These symptoms can overlap with other conditions, so evaluation by a specialist is essential.

Diagnosis

Diagnosis typically involves:

  • Blood and urine tests to measure hormone levels
  • CT scan or MRI to visualize the adrenal glands and detect tumors
  • PET scan in selected cases to check for cancer spread
  • Biopsy, when needed, to confirm malignancy Accurate staging helps guide treatment decisions.

Treatment Options

Treatment depends on the tumor size, stage, and whether the cancer has spread.

  1. Surgery (Adrenalectomy)

Removal of the affected adrenal gland is the primary and most effective treatment for localized adrenal cancer. Complete surgical excision offers the best chance for cure.

  1. Mitotane (Adrenal-targeting medication)

Often used after surgery or for advanced disease, mitotane helps suppress adrenal hormone production and slow cancer growth.

  1. Chemotherapy

Recommended when cancer has spread or does not respond to surgery alone. Combination regimens may be used depending on the case.

  1. Radiation Therapy

Used to control local tumor growth, treat metastases, or relieve symptoms.

  1. Targeted Therapy & Clinical Trials

Patients with advanced disease may benefit from newer targeted treatments or participation in clinical trials exploring innovative therapies.

Prognosis

Prognosis depends heavily on the stage at diagnosis:

  • Localized adrenal cancer: 5-year survival 60–80%
  • Advanced or metastatic disease: Less than 20%

Early detection and complete surgical removal significantly improve outcomes. Regular follow-up with imaging and hormone monitoring is essential to detect recurrence early.