Adrenal cortical cancer

This page tells you about cancer of the outer layer of the adrenal gland. There is information about

 
 

The adrenal glands

There are two adrenal glands, one above each kidney. Adrenal means next to the kidney. 

Diagram showing where the adrenal glands are in the body

The adrenal glands have an inner and outer layer. The outer layer is the cortex and the inner the medulla. Cancer can start in either of these areas of the adrenal gland. This page is about adrenal cortical tumours, including adrenal cortical carcinoma. Cortical means the the cells of the cortex. Carcinoma means cancer.

If you are looking for information about cancer that started in the inner part of the adrenal gland (the medulla), this is not the right page for you. Medullary adrenal cancer is called phaeochromocytoma and there is a separate page about this in the question and answer section of CancerHelp UK.

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Adrenal cortex tumours

The adrenal glands are small, but very important because they make several hormones that help the body to work properly and are vital to life. About 2 out of 100 people (2%) have non cancerous lumps (adenomas) in the adrenal cortex. These are completely harmless and are often found by chance in patients having scans for other reasons. When benign tumours are found by chance doctors call them incidentalomas. They do not need any treatment unless they are producing steroid hormones.

This page is about cancers that start in the adrenal gland. They are called primary adrenal gland carcinoma and are very rare. There are fewer than 30 diagnosed in the UK each year. Sometimes cancers that started in other parts of the body, such as the kidney, can spread to the adrenal glands. This is known as a secondary cancer and would be treated as a kidney cancer, not an adrenal gland cancer.

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Steroid hormones

The adrenal cortex makes steroid hormones. Benign or cancerous adrenal cortical tumours may make too much of any of these hormones. The hormones cause symptoms that affect your whole body and include

  • Cortisol – a natural steroid hormone that affects the level of sugar in the blood
  • Aldosterone, which helps to regulate the body’s water balance, salt balance and blood pressure
  • Male and female sex hormones (oestrogen and testosterone)
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Symptoms of adrenal cortical carcinoma

About two out of three adrenal cortical cancers make hormones. If you have one that doesn't, you may not have any symptoms until the cancer is quite far advanced. Then you may start to have pain, tiredness and weight loss.

If your tumour makes hormones, these will cause your symptoms. If your tumour makes too much cortisol or aldosterone, you may have

  • Raised blood pressure
  • Thirst
  • Passing urine frequently
  • Muscle cramps
  • Weight gain that is more noticeable in the trunk of the body
  • Muscle wasting in the legs or arms, making them look thinner
  • Fat accumulation in the base of the neck (known as a buffalo hump)
  • Swelling of the face giving a moon face appearance
  • Mild diabetes (less common)
  • Abnormal hair growth on the face, arms and upper back

Do bear in mind there are many other causes for raised blood pressure which are far more common than adrenal gland cancer.

If your tumour overproduces sex hormones

  • Women may have deepening of the voice, changes in periods, baldness or growth of facial hair
  • Men may have loss of sex drive (libido), impotence and sometimes swelling of the breasts
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Treating adrenal cortical carcinoma

Your doctor may suggest

Unfortunately, adrenal cortical tumours can be quite a fast growing type of cancer. They are often diagnosed in the later stages (when they are quite advanced) and this means it can be difficult to cure them.

Surgery

If your cancer is diagnosed early enough, surgery to remove the affected adrenal gland is usually the first choice of treatment and can cure the cancer. This operation is called an adrenalectomy. If your surgeon thinks the cancer may have spread locally, they will remove the tissues immediately surrounding the adrenal gland and nearby lymph nodes.

Hormones produced by the cancer can make your blood pressure unstable so it can change suddenly during and immediately after the operation. To make sure it is as stable as possible, your doctor may give you blood pressure medicines before the operation for up to 10 days. After surgery, your blood pressure should go back to normal.

If you need to have one of your adrenal glands removed, your other one will carry on making all the hormones you need. If you have both adrenal glands removed, you will have to take hormone replacement tablets every day for the rest of your life.

Radiotherapy

Radiotherapy is most often used for adrenal cancer that has spread. It can be very useful for shrinking cancer that has spread to the bones.

You may have radiotherapy for earlier stage adrenal cortical cancer, but this is still an experimental treatment and you are most likely to have this as part of a clinical trial.

Chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You may have just one drug or a combination of more than one drug. Chemotherapy is usually only used to treat adrenal cortical tumours that have spread to other parts of the body.

Some of the chemotherapy drugs used to treat adrenal cortical cancer are

You usually have two or more of these drugs together. Click on the links above to find out about the specific side effects of these drugs. There is more information about this treatment in the main chemotherapy section of CancerHelp UK.

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Research into adrenal cortical cancer

Researchers and doctors are continually trying to improve treatments for adrenal cancer. You can find information about clinical trials on our clinical trials database. Pick 'adrenal cancer' from the dropdown list of cancer types.

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