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Adrenal Gland Tumor - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Adrenal Gland Tumor. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

About the adrenal glands

Each person has two adrenal glands; one located on top of each of the body’s two kidneys. These glands are important to the body’s endocrine (hormonal) system. Each adrenal gland has two main parts that function separately:

Adrenal cortex. The outer part of the adrenal gland is called the cortex. The adrenal cortex makes three main hormones: cortisol, aldosterone, and dehydroepiandrosterone (DHEA). These hormones carefully control metabolism and body characteristics, such as hair growth and body shape.

Adrenal medulla. The gland’s inner part is called the medulla. The adrenal medulla makes three other hormones: epinephrine, norepinephrine, and dopamine. These hormones control the body’s responses to stress, including the “fight or flight” adrenaline surge.

Types of adrenal gland tumors

A tumor begins when normal cells change and grow uncontrollably, forming a mass. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread.

A tumor can start in an adrenal gland, called a primary adrenal tumor, or it can begin in another organ, such as the lungs, and then spread to the adrenal glands. An adrenal gland tumor can sometimes overproduce hormones. When it does, the tumor is called a functioning tumor. An adrenal gland tumor that does not produce hormones is called a nonfunctioning tumor. The symptoms and treatment of an adrenal gland tumor depend on whether the tumor is functioning or nonfunctioning, what hormone(s) is overproduced, and whether the tumor is a primary adrenal gland tumor or if the cancer has spread from another organ.

This section focuses on primary adrenal gland tumors, which include the following:

Adenoma. Also called an adrenocortical adenoma, this is the most common type of adrenal gland tumor. It is a noncancerous, nonfunctioning tumor of the adrenal cortex. An adenoma usually does not cause symptoms and, if it is small, often does not need treatment.

Adrenocortical carcinoma. Although rare, adrenocortical carcinoma is the most common type of cancerous adrenal gland tumor. It is also known as adrenal cortical carcinoma. Approximately four to 12 out of one million people develop this type of tumor, which begins in the adrenal cortex. Adrenocortical carcinoma can be a functioning or nonfunctioning tumor. If the tumor is functioning, it may produce more than one hormone.

Neuroblastoma. This is a type of childhood cancer that can begin in the adrenal medulla. Learn more about childhood neuroblastoma.

Pheochromocytoma. This type of neuroendocrine tumor most often begins in the adrenal medulla. Learn more about pheochromocytoma.

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Adrenal Gland Tumor - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find information about how many people learn they have this type of tumor each year and some general survival information. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

A primary adrenal gland tumor is very uncommon, and exact statistics are not available for this type of tumor in the United States. It is estimated that approximately 300 adults in the United States are diagnosed each year with adrenal cortical cancer. This type of cancer is much less common than an adrenal adenoma, a benign tumor that is more common for middle-age and older adults. The average age of a person diagnosed with an adrenal gland tumor is between 45 and 50; however, these tumors can occur at any age. More women than men tend to be diagnosed with adrenal gland tumors.

The five-year survival rate is the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases. The five-year survival rate of people with an adrenal cortical cancer depends on different factors, including the extent (or stage) of cancer at the time it is diagnosed. In general, for people with a Stage I or II adrenal cortical cancerous tumor, meaning the cancer has not spread and it can be removed by surgery, the five-year survival rate is about 40% to 60%. Stage III cancer has an overall survival rate of 20%, and Stage IV cancer has an overall rate of 10%. Other factors that affect survival include the age of the patient and whether the tumor produces hormones.

Statistics should be interpreted with caution. These estimates are based on data from thousands of people with this type of tumor in the United States, but the actual risk for a particular individual may differ. Because the survival statistics are measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. It is not possible to tell a person how long he or she will live with an adrenal gland tumor. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society and the University of Michigan.

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Adrenal Gland Tumor - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing a tumor. Although risk factors often influence the development of a tumor, most do not directly cause the tumor. Some people with several risk factors never develop a tumor, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The cause of most cancerous adrenal cortical carcinomas is not known. However, people with certain hereditary conditions, such as Multiple Endocrine Neoplasia Type 2, Li-Fraumeni syndrome, Von Hippel-Lindau syndrome, Neurofibromatosis Type 1, and Carney Complex, have a higher risk of developing an adrenal gland tumor. People who have a high risk of developing an adrenal gland tumor because of family history should be examined and evaluated by their doctor every year.

Research continues to look into what factors cause this type of tumor and what people can do to lower their personal risk. There is no proven way to completely prevent this disease, but there may be steps you can take to lower your cancer risk. Talk with your doctor if you have concerns about your personal risk of developing this type of tumor.

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Adrenal Gland Tumor - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

People with an adrenal gland tumor may experience the following symptoms or signs. Sometimes, people with an adrenal gland tumor do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not a tumor.

  • High blood pressure
  • Low potassium level
  • Heart palpitations
  • Nervousness
  • Feelings of anxiety or panic attacks
  • Headache
  • Excessive perspiration
  • Diabetes
  • Abdominal pain
  • Unexplained weight gain or weight loss
  • Weakness
  • Abdominal stretch marks
  • Excessive hair growth
  • Unusual acne
  • Change in libido (sex drive)

In addition, pheochromocytoma may cause dangerous surges of the adrenal gland hormones that regulate blood pressure and response to stress. A hormonal surge can cause blood pressure to increase very quickly, increasing the risk of heart attack, stroke, hemorrhage, or sudden death.

If you are concerned about one or more of the symptoms or signs on this list, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If a tumor is diagnosed, relieving symptoms remains an important part of medical care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose a tumor, find out if it is cancerous, and if so, whether it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. To diagnose an adrenal gland tumor, blood and urine tests (see below) are done to look for certain substances that help determine if the tumor is functional or non-functional. A computed tomography (CT or CAT) scan or a magnetic resonance imaging (MRI) scan (see below) may also be useful in making a diagnosis and evaluating whether an adrenal gland tumor may be cancerous. Imaging tests may also be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition
  • Type of tumor suspected
  • Severity of symptoms
  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose an adrenal gland tumor:

Blood and urine tests. Blood tests can measure the amounts of natural hormones, such as catecholamines and metanephrines, produced during stress, which can detect a functional tumor. A patient may be asked to take a pill on the evening before the blood and urine tests to help detect the normal suppression of production of the hormone cortisol. A 24-hour urine sample, which requires the collection of all urine during that timeframe for laboratory testing, may also be needed. This helps the doctor track how quickly various hormones are produced. Tell your doctor about any medications that you take, even over-the-counter drugs, because this information is needed to correctly interpret the results.

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. For an adrenal tumor, a narrow, hollow needle is used to collect the tissue. This is called a fine needle biopsy or fine needle aspiration. The biopsy is performed by a radiologist who uses specialized imaging procedures, such as CT or MRI scans (see below) to direct the needle into the tumor. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

If the doctor suspects that cancer has spread to the adrenal gland from another area of the body where the cancer started, a biopsy may be done to determine the type of cancer, which can help the doctor plan treatment.

CT scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein.

MRI. An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein.

Metaiodobenzylguanidine (MIBG) scan. MIBG is a chemical similar to adrenaline that will collect in a neuroendocrine tumor. A MIBG scan can show a tumor of the adrenal medulla that may not appear on an x-ray. The scan takes place over two consecutive days. On the first day, an injection of MIBG is given in the arm. Several hours later, pictures are taken with a special camera that can detect if or where in the body the MIBG has collected. The following morning, more pictures are taken, and the process may be repeated if needed.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is a tumor, these results also help the doctor describe it; this is called staging

The next section helps explain the different stages for this type of tumor. Use the menu on the side of your screen to select Stages, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will learn about how doctors describe a tumor’s growth or spread. This is called the stage. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where the tumor is located, if it is cancerous, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the tumor’s stage, so staging may not be complete until all of the tests, or even the surgical removal of the tumor or adrenal gland, are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

  • How large is the primary tumor and where is it located? (Tumor, T)
  • Has the tumor spread to the lymph nodes? (Node, N)
  • Has the cancer metastasized to other parts of the body? (Metastasis, M)

The results are combined to determine the stage of cancer for each person. This section covers the standard staging system for adrenocortical carcinoma, which includes four stages: stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for adrenocortical carcinoma:

Tumor. Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information is listed below.

TX: The primary tumor cannot be evaluated.

T0: There is no primary tumor.

T1: The tumor is 5 centimeters (cm) or less and has not grown outside the adrenal gland.

T2: The tumor is larger than 5 cm and has not grown outside the adrenal gland.

T3: The tumor is any size, and it has grown into the area around the adrenal gland but not to nearby organs.

T4: The tumor is any size and has grown into nearby organs, such as the kidney; diaphragm (the
thin muscle under the lungs and heart that separates the chest from the abdomen); larger blood vessels, called the aorta and the vena cava; pancreas; spleen; and liver.

Node. The “N” in the TNM staging system stands for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes near where the tumor started are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

NX: The regional lymph nodes cannot be evaluated.

N0 (N plus zero): The cancer has not spread to the regional lymph nodes.

N1: The cancer has spread to the regional lymph nodes.

Distant metastasis. The “M” in the TNM system indicates whether the cancer has spread to other parts of the body.

M0 (M plus zero): The cancer has not spread to other parts of the body.

M1: The cancer has spread to other parts of the body beyond the nearby organs.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications.

Stage I: The tumor is 5 cm or less and has not grown beyond the adrenal gland. It has not spread to the regional lymph nodes or to other parts of the body (T1, N0, M0).

Stage II: The tumor is larger than 5 cm. It has not grown beyond the adrenal gland or spread to regional lymph nodes or other parts of the body (T2, N0, M0).

Stage III: The tumor is described by the following:

  • It is 5 cm or smaller and has spread to the regional lymph nodes but not to other parts of the body (T1, N1, M0).
  • It is larger than 5 cm and has spread to the regional lymph nodes but not to other parts of the body (T2, N1, M0).
  • It is any size and has grown beyond the adrenal gland but not to nearby organs (T3, N0, M0).

Stage IV: The tumor is described by the following:

  • It is any size and has grown into the area around the adrenal gland but not to nearby organs. The tumor has spread to regional lymph nodes but not to other parts of the body (T3, N1, M0).
  • It is any size and has spread to nearby organs but not to the lymph nodes or other parts of the body beyond the nearby organs (T4, N0, M0).
  • It is any size and has spread to nearby organs. The tumor has spread to the regional lymph nodes but not to other parts of the body beyond the nearby organs (T4, N1, M0).
  • The tumor has spread to other parts of the body (any T, any N, M1).

Recurrent: Recurrent cancer is cancer that has come back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010), published by Springer-Verlag New York, www.cancerstaging.net.

Information about the tumor’s stage will help the doctor recommend a treatment plan. The next section helps explain the treatment options for this type of tumor. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will learn about the different ways doctors use to treat people with this type of tumor. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best proven treatments available) for this specific type of tumor. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study to test a new approach to treatment to evaluate whether it is safe, effective, and possibly better than standard treatment. Clinical trials may test such approaches as a new drug, a new combination of standard treatments, or new doses of current therapies. Your doctor can help you review all treatment options. For more information, visit the Clinical Trials and Latest Research sections.

Treatment overview

For an adrenal gland tumor, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team.

Descriptions of the most common treatment options for an adrenal gland tumor are listed below. Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Up to 25% of adrenal tumors may be linked to a genetic syndrome (see the Risk Factors section). When planning treatment, it may be helpful to talk with a genetic counselor to learn whether the tumor is associated with a specific syndrome. In addition, your family may learn whether other family members should undergo specific genetic tests. Learn more about genetic testing.

Surgery

Surgery is the removal of the tumor and surrounding tissue during an operation. Adrenalectomy, which is the surgical removal of the adrenal gland with the tumor, may be needed to treat an adrenal gland tumor. A surgical endocrinologist is a surgeon who specializes in treating an endocrine tumor using surgery.

If the tumor is smaller than 5 cm and, based on its size or the way it looks on imaging scans, shows no evidence that it is cancerous, then laparoscopic surgery may be possible. Laparoscopic surgery is a minimally invasive technique in which a surgeon uses a lighted, flexible, tube instrument and makes small incisions in the skin. This technique minimizes pain and post-operative recovery time compared with traditional incisions. Laparoscopic surgery may be performed from the abdomen or back, depending on the location of the tumor and the experience of the surgeon.

If the tumor is possibly cancerous or larger than 5 cm to 6 cm, surgery using one large incision in the abdomen or back is recommended. If the patient has previously had abdominal surgery, an incision in the back may be easier.

If the surgery is performed laparoscopically, the person can usually leave the hospital in one to three days and resume daily activities within a week. If a larger incision is needed, then the person is usually hospitalized for up to five to seven days and should not lift heavy objects for six weeks after surgery.

Surgery is the main treatment for a pheochromocytoma. Learn more about treatment options for a neuroendocrine tumor.

Adrenal surgery can cause bleeding. The tumor can also make excess stress hormones, called catecholamines, and the patient will need to be monitored and receive medication to treat high blood pressure during surgery. Talk with your surgeon before the operation about the possible side effects you may experience and how they will be managed. Learn more about surgery.

Hormone therapy

Because adrenal gland tumors may produce excess hormones, the doctor may prescribe various medications to control the levels of these hormones before, during, or after other treatments. For example, if the tumor is producing excess catecholamines, the patient may need a drug to lower the levels of these body chemicals before additional treatment can be given. Or, after surgery, a patient may need medication to block the effects of excess cortisol, a natural steroid that may be produced by the tumor. These drugs include metyrapone (Metopirone), metyrosine (Demser), spironolactone (Aldactone), and streptozin (Zanosar).

Chemotherapy

Chemotherapy is the use of drugs to destroy tumor cells, usually by stopping the cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating a tumor with medication.

Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally). A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.

Mitotane (Lysodren) is a medication used to treat cancer in the adrenal cortex. It reduces the amount of adrenocorticoids produced by the adrenal cortex.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is the use of high energy x-rays or other particles to destroy tumor cells. A doctor who specializes in giving radiation therapy to treat a tumor is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Getting care for symptoms and side effects

A tumor and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the tumor, an important part of care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care can help a person at any stage of illness. People often receive treatment for the tumor and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the tumor, such as chemotherapy, surgery, and radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and supportive care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care.   

Metastatic adrenal gland tumor

If an adrenal gland tumor has spread to another location in the body, it is called metastatic cancer. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials studying new treatments.

Your health care team may recommend a treatment plan that includes a combination of surgery, radiation therapy, and chemotherapy. Supportive care will also be important to help relieve symptoms and side effects.

For many patients, a diagnosis of metastatic cancer can be very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED. 

A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that a tumor will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the tumor returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if it does return. Learn more about coping with the fear of recurrence.

If the tumor does return after the original treatment, it is called a recurrent tumor. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether the tumor’s stage has changed. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the therapies described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent tumor.

People with a recurrent adrenal gland tumor often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with recurrence.

If treatment fails

Recovery from an adrenal gland tumor is not always possible. If treatment is not successful, the disease may be called advanced or terminal.

This diagnosis is stressful, and this is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help cope with the loss. Learn more about grief and loss.

The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

Doctors and scientists are always looking for better ways to treat patients with an adrenal gland tumor. To make scientific advances, doctors create research studies involving people, called clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and managing the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent cancer.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating adrenal gland tumors. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with an adrenal gland tumor.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” The use of placebos in cancer clinical trials is rare. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options, so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

For specific topics being studied for adrenal gland tumors, learn more in the Latest Research section.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

The next section helps explain the areas of research going on today about this type of tumor. Use the menu on the side of your screen to select Latest Research, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of tumor and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about adrenal gland tumors, ways to prevent them, how to best treat them, and how to provide the best care to people diagnosed with them. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

Immunotherapy. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight a tumor. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. The effectiveness of immunotherapy as a treatment for an adrenal gland tumor is being researched in clinical trials. Learn more about immunotherapy.

Molecular markers. Studies analyzing the role of genes and proteins in a person’s tumor are underway. The focus of these studies is to help fine-tune the diagnosis of adrenal gland tumors and predict treatment results.

Succinate dehydrogenase (SDH) tumors. SDH is a specialized protein that plays an important role in the body’s metabolism. Researchers think that when this gene is inactivated, it results in cancer, including tumors of the adrenal gland.

Supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current adrenal gland tumor treatments in order to improve patients’ comfort and quality of life.

To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases now.

The next section addresses how to cope with the symptoms of the disease or the side effects of its treatment. Use the menu on the side of your screen to select Coping with Side Effects, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of a tumor, but it may help to know that preventing and controlling side effects is a major focus of your health care team. This is called palliative or supportive care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

Common side effects from each treatment option for an adrenal gland tumor are described in detail within the Treatment Options section. Learn more about the most common side effects of a tumor and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the tumor’s stage, the length and dosage of treatment(s), and your overall health.

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with an adrenal gland tumor. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your medical care

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the After Treatment section or talking with your doctor.

The next section helps explain medical tests and check-ups needed after finishing treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide. 

Adrenal Gland Tumor - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will read about your medical care after treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for an adrenal gland tumor ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years.

If the adrenal gland that did not have the tumor is still working correctly after surgery, it should be able to provide enough of the hormones needed by the body. Sometimes, a person needs hormone replacement therapy, such as steroids, because the body can’t produce enough hormones. Over time, the person often can decrease the dosage and even stop taking the hormone replacement drug. An endocrinologist, a doctor who specializes in the endocrine system, should carefully monitor this process.

The endocrine system is a complex collection of hormone-producing glands that control many essential functions. If both adrenal glands have been removed, long-term medication is needed to replace the hormones normally produced by these glands, and you should wear a medical-alert bracelet to inform health care professionals of your condition in case you ever become sick or unconscious and are unable to do so.   

Follow-up care may include imaging scans and blood/urine tests every year. For some people who’ve had an adrenal gland tumor, the risk of developing a tumor in the other gland is 10% or higher. Because of this, people treated for an adrenal gland tumor may need regular check-ups with an endocrinologist to monitor recovery and detect any new tumor growth. In particular, adrenal cortical carcinoma can grow and spread quickly. Because it is rare, a person may want to participate in a clinical trial at a medical center with experience treating and monitoring this type of cancer. Talk with your doctor about locating these studies.

ASCO offers treatment summary forms to help keep track of the treatment you received and develop a survivorship care plan once treatment is complete.

People recovering from an adrenal gland tumor are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, limiting alcohol, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about the next steps to take in survivorship, including making positive lifestyle changes.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

  • What type of adrenal gland tumor do I have?
  • Is the tumor cancerous?
  • Is the tumor functional or nonfunctional? What does this mean?
  • Is the tumor located only in the adrenal gland?
  • Can you explain my pathology report (laboratory test results) to me?
  • What is my prognosis?
  • What are my treatment options?
  • What clinical trials are open to me? Where are they located, and how do I find out more about them?
  • What treatment plan do you recommend? Why?
  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?
  • Who will be part of my health care team, and what does each member do?
  • Who will be coordinating my overall treatment and follow-up care?
  • Should I talk with a genetic counselor before I start treatment?
  • Is surgery required? If so, what type of surgery? Will the entire adrenal gland be removed?
  • How experienced is the surgeon with this type of surgery?
  • Are there radiation therapy and surgery options to treat the tumor?
  • Can chemotherapy control the tumor?
  • Will I need hormone replacement therapy? For how long?
  • What are the possible side effects of each treatment, both in the short term and long term?
  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
  • Could this treatment affect my sex life? If so, how and for how long?
  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?
  • If I’m worried about managing the costs related to my medical care, who can help me with these concerns?
  • What are the chances the tumor could come back after treatment?
  • What follow-up tests will I need, and how often will I need them?
  • What support services are available to me? To my family?
  • Could my family members be at risk for an adrenal gland tumor? Should they talk with a genetic counselor?
  • Whom should I call for questions or problems?

The next section offers some more resources that may be helpful to you. Use the menu on the side of your screen to select Additional Resources, or you can select another section, to continue reading this guide.

Adrenal Gland Tumor - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Adrenal Gland Tumor. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond. Here are a few sections that may get you started in exploring the rest of Cancer.Net:

This is the end of Cancer.Net’s Guide to Adrenal Gland Tumor. Use the menu on the side of your screen to select another section to continue reading this guide.