Adrenal glands, which are also called suprarenal glands, are small, triangular glands located on top of both kidneys. An adrenal gland is made of two parts: the outer region is called the adrenal cortex and the inner region is called the adrenal medulla.

The adrenal cortex, the outer portion of the adrenal gland, is essential to life by secreting hormones that have an effect on the body's metabolism, on chemicals in the blood, and on certain body characteristics. The adrenal cortex secretes corticosteroids and other hormones directly into the bloodstream.

The adrenal cortex, the outer portion of the adrenal gland, is essential to life by secreting hormones that have an effect on the body's metabolism, on chemicals in the blood, and on certain body characteristics. The adrenal cortex secretes corticosteroids and other hormones directly into the bloodstream.
 

The adrenal cortex, the outer portion of the adrenal gland, is essential to life by secreting hormones that have an effect on the body's metabolism, on chemicals in the blood, and on certain body characteristics. The adrenal cortex secretes corticosteroids and other hormones directly into the bloodstream.

 What is cancer of the adrenal cortex?

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. Cancer that starts in the adrenal medulla is called pheochromocytoma and is discussed in a separate PDQ patient information summary.

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.
 
 

Stage Explanation

Stages of cancer of the adrenal cortex

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.

Treatment Option Overview

How cancer of the adrenal cortex is treated

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 by stage

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. Clinical trials are ongoing in some parts of the country for patients with cancer of the adrenal cortex. For more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage I Adrenocortical Carcinoma
Treatment will probably be surgery to remove the cancer.

Stage II Adrenocortical Carcinoma
Treatment will probably be surgery to remove the cancer. Clinical trials are testing new treatments.

Stage III Adrenocortical Carcinoma
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.

Stage IV Adrenocortical Carcinoma
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.
Recurrent Adrenocortical Carcinoma
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.

To Learn More

Call

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Web sites and Organizations

The NCI's Cancer.gov  Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.

Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator 2. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

LiveHelp

The NCI's LiveHelp service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write

For more information from the NCI, please write to this address:

NCI Public Inquiries Office
Suite 3036A
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322
 

About PDQ

PDQ is a comprehensive cancer database available on Cancer.gov.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at Cancer.gov, the NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."

Listings of clinical trials are included in PDQ and are available online at Cancer.gov. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.