Treatment of Adrenal Cancer

Introduction

Adrenal cancer also known as adrenocortical carcinoma (ACC) is a rare but serious condition that develops in the adrenal glands located above the kidneys. These glands produce essential hormones that regulate metabolism, blood pressure, immune response, and stress. When cancer forms in this region, it can disrupt hormone production and spread to nearby organs. Early detection and timely treatment significantly improve outcomes. This comprehensive guide explains the latest treatment options for adrenal cancer, how doctors diagnose the disease, and what patients can expect during recovery.

Understanding Adrenal Cancer

Adrenal cancer occurs when abnormal cells grow uncontrollably in the cortex of the adrenal gland. It can be hormone-producing or non-functioning, meaning some tumors release excessive hormones like cortisol, aldosterone, or androgens, leading to noticeable symptoms. Because symptoms often mimic common health issues such as weight gain, fatigue, high blood pressure, and hair growth diagnosis can sometimes be delayed.

Common Symptoms of Adrenal Cancer

1. Rapid weight gain or unexplained weight loss
2. High blood pressure
3. Muscle weakness
4. Facial rounding or abdominal obesity
5. Excessive hair growth
6. Mood swings or anxiety
7. Abdominal pain or a palpable mass

Not everyone experiences all symptoms, which is why medical evaluation is crucial when abnormalities persist.

How Adrenal Cancer Is Diagnosed

An accurate diagnosis forms the foundation for an effective treatment plan. Doctors use several tests to identify the tumor, determine its size, and evaluate if it is producing hormones.

1. Blood and Urine Tests :- These tests check hormone levels such as cortisol, aldosterone, and androgens. Elevated values can confirm that a tumor is producing excess hormones.
2. Imaging Tests :- CT scans, MRI scans, and PET scans help detect the tumor’s location, size, and spread. Imaging is also essential for pre-surgical planning.
3. Biopsy (Rarely Used) :- Because biopsies can sometimes cause cancer cells to spread, they are only done when imaging is inconclusive or when the tumor appears to be metastatic from another organ.

Once diagnosis is complete, doctors classify the cancer into stages (I to IV), which guide the treatment approach.

Treatment of Adrenal Cancer

Treating adrenal cancer requires a specialized, multidisciplinary approach, often involving endocrine surgeons, oncologists, and radiation specialists. The most effective treatment depends on the size, stage, and behavior of the tumor.

1. Surgery (Adrenalectomy): The Primary Treatment :- Surgery is the mainstay treatment for adrenal cancer and offers the highest chance of cure, especially when the cancer is detected early.

• Open Adrenalectomy :- For larger or invasive tumors, surgeons typically choose an open procedure. It allows for complete removal of the tumor along with surrounding tissues, reducing the risk of cancer spread.
• Laparoscopic Adrenalectomy :- This minimally invasive approach is used for smaller, localized tumors. It offers benefits like faster recovery, smaller incisions, and less postoperative pain.
• Lymph Node Removal :- If cancer has spread to nearby lymph nodes, they may also be removed to prevent future recurrence.

2. Medications: Targeted & Hormone-Blocking Treatments :- Several medications help control adrenal cancer growth or manage excess hormone levels.

• Mitotane :- Mitotane is the most commonly used drug for adrenal cancer. It destroys adrenal tissue and helps reduce hormone production. It is especially helpful after surgery to eliminate microscopic cancer cells and prevent recurrence.
• Hormone-Blocking Medications :- If the tumor causes hormonal imbalance, drugs such as spironolactone, ketoconazole, or metyrapone may be prescribed to control symptoms like high blood pressure and cortisol excess.
• Chemotherapy :- Advanced or metastatic adrenal cancer may require chemotherapy combinations such as etoposide, doxorubicin, and cisplatin (EDP) along with mitotane. These drugs help slow tumor progression and relieve symptoms.

3. Radiation Therapy :- Radiation therapy is not the first line of treatment but is useful in certain situations, especially when

• Cancer cannot be completely removed surgically
• There is a high risk of recurrence
• The patient experiences pain due to tumor spread

External beam radiation targets cancer cells precisely, minimizing injury to nearby organs.

4. Immunotherapy & Targeted Therapies :- Emerging treatments like immunotherapy are being explored for adrenal cancer, especially in advanced stages. Drugs such as checkpoint inhibitors help the immune system identify and attack cancer cells more effectively.

Although still under research, targeted therapies may also benefit select patients by blocking specific genes or proteins responsible for tumor growth.

Recovery After Adrenal Cancer Treatment

Recovery depends on the treatment type, stage, and the patient’s overall health. Most patients require regular monitoring to assess hormone levels and ensure the cancer has not returned.

• Post-Surgery Recovery :- Patients usually stay in the hospital for a few days. Temporary weakness, fatigue, and hormonal fluctuations are common. Doctors may prescribe hormone replacement therapy if the remaining adrenal gland does not produce enough hormones.
• Long-Term Follow-Up :- Follow-up appointments often include imaging scans and hormone tests every few months, especially in the first two years when the risk of recurrence is highest.
• Lifestyle Support

1. Eat a balanced diet rich in vitamins and protein
2. Engage in moderate physical activity
3. Manage stress through yoga or meditation
4. Avoid smoking and excessive alcohol
5. Maintain a healthy sleep routine

These habits support healing and overall well-being.

Prognosis & Importance of Early Treatment

Prognosis varies widely based on the stage at diagnosis. Early-stage adrenal cancer has a much better outlook because surgery can often remove the tumor completely. For advanced cases, a combination of treatments helps control disease progression and improve quality of life.

Timely medical attention plays a critical role in achieving the best outcomes. If symptoms like unexplained weight changes, excessive hair growth, or persistent high blood pressure appear, consulting a specialist early is essential.

Conclusion

Adrenal cancer treatment has advanced significantly, offering patients options like minimally invasive surgery, hormonal therapies, chemotherapy, and emerging immunotherapies. Early diagnosis and a personalized treatment plan can dramatically improve success rates. If you or a loved one is experiencing symptoms or has been diagnosed with adrenal cancer, seeking expert care promptly is the key to better recovery and long-term health.