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National Cancer Institute

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Adrenocortical carcinoma


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the adrenal cortex?
STAGE EXPLANATION
Stages of cancer of the adrenal cortex
Stage I
Stage II
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How cancer of the adrenal cortex is treated
Treatment by stage
STAGE I ADRENOCORTICAL CARCINOMA
STAGE II ADRENOCORTICAL CARCINOMA
STAGE III ADRENOCORTICAL CARCINOMA
STAGE IV ADRENOCORTICAL CARCINOMA
RECURRENT ADRENOCORTICAL CARCINOMA
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


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 statement.

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, and 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 (less 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:

1. Surgery to remove the cancer. Lymph nodes in the area may also be removed (lymph node dissection).

2. A clinical trial of radiation therapy.

3. 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:

1. Chemotherapy. Clinical trials are testing new drugs.

2. Radiation therapy to bones where the cancer has spread.

3. 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

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the adrenal cortex, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can help answer your questions.

The Cancer Information Service also has a variety of booklets about cancer that are available to the public and can be sent on request.

The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get materials and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 10/1997


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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