Adrenal cancer is a tumor that develops in the glands that produce the most important hormones – substances that help our body control blood pressure, sugar, salt and water levels, and respond to stress. It is considered malignant because its cells can germinate into nearby tissues, destroy them and spread throughout the body, creating metastases in various parts of it – additional neoplasms.
What are the adrenal glands and how does cancer occur in them?
The adrenal glands are small but very important organs located above each of the kidneys. They consist of the outer part, the cortex, and the inner cerebral layer, which produce hormones, substances that regulate the actions of other tissues: their work and rest, the production or absorption of various compounds.
The cortical layer produces:
-
cortisol, involved in the control of blood pressure, blood sugar levels, the immune system and stress reactions;
- aldosterone, which balances the levels of salt and water in the body;
sex hormones, such as estrogen, which is necessary for the proper functioning of the female reproductive system, and testosterone, which is involved in the production of spermatozoa.
The brain layer produces adrenaline and norepinephrine, which we need to respond to threats. They constrict blood vessels, increase blood pressure, and increase heart rate.
Cancer begins with the appearance of just one altered cell in the adrenal gland. They are constantly formed in every person's body, but they are almost always detected and destroyed by the immune system. Unfortunately, our natural defenses cannot always identify and destroy them. If such a cell manages to survive, it multiplies very quickly and gradually forms a neoplasm that grows into the nearest tissues, disrupts their work and destroys them.
Its dangerous properties do not end there.
Unlike ordinary cells, whose lifetime is set by a built-in "program", cancerous cells do not die at the end of this life cycle and live extremely long. In addition, they are able to detach from the main focus, spread with blood and lymph throughout the body and create metastases in different parts of it – additional tumors.
The disease is most often detected:
- Accidentally during an examination that had nothing to do with the search for adrenal cancer
- In the production of hormones that cause weight gain and fluid retention in the body, early puberty in children or excessive hair growth on the face and body in women
- When symptoms appear caused by the growth of a neoplasm that presses on other organs of the abdominal cavity, causing pain or discomfort.
Most life-threatening tumors do not start in the adrenal glands. As a rule, they are metastases of other types of cancer – for example,
lungs,
breast and
меланомы.
The tactics used to control the disease depend on several factors, including:
- depends on the stage – the size of the neoplasm and the number of tissues damaged by it;
- properties of its cells;
- the general state of human health.
The main treatment methods include:
- Surgical interventions– operations to remove a tumor and its damaged tissues
- Radiation therapy– destruction of cancer cells by high-energy rays or particles
- Chemotherapy– drugs that destroy altered cells
- Drugs that block the production of hormones by a neoplasm and their effect.
Surgery for adrenal cancer
The main treatment method is adrenalectomy, or removal of one or two adrenal glands, and as many affected tissues as possible.
In some cases, other structures have to be removed, including the lymph nodes. These small organs filter lymph, the fluid that washes all body tissues, neutralize dangerous substances and trap altered cells. If they are enlarged, the specialist removes them and checks for cancer.
A small tumor can be removed through an incision in the back that runs slightly below the ribs.
Most often, the operation is performed through an incision in the front of the abdomen.
This tactic allows the surgeon to better see not only the neoplasm itself, but also its spread to the nearest tissues and organs, such as the kidneys or fat and muscles located next to the adrenal glands.
In addition to the tumor itself and the adrenal glands, other structures may need to be removed, including parts of the liver affected by cancer or the inferior vena cava, a large vessel carrying blood from the lower body to the heart.
The specialists of the European Medical Center perform not only classic open surgeries, but also high-tech
малоинвазивные that do not require damage to a large number of tissues. Laparoscopic interventions, including
on the Da Vinci robot, they are performed using a laparoscope, a thin hollow tube with a light source and a small video camera at the end.
The surgeon makes not one large, but several small incisions, into which special instruments are inserted. This method has an important advantage – it significantly reduces the recovery time of the patient.
Unfortunately, it cannot always be used in the treatment of this type of cancer, since a large tumor cannot always be extracted through a tiny incision, and splitting it into several parts increases the risk of the spread of altered cells to other tissues. In addition, using this technique, it is extremely difficult to remove cancer that has affected the nearest structures and lymph nodes.
Radiation therapy for adrenal cancer
Radiation therapy is the destruction of altered cells using high–energy particles or X-rays. This technique is not often used as the main first treatment for adrenal cancer, as its cells are difficult to destroy by radiation. It is more often used as adjuvant therapy after surgery to prevent relapse or recurrence of the disease. In addition, it is used to fight metastases – additional neoplasms in bones, brain or other parts of the body.
Remote radiation therapy is radiation emitted by a special device that focuses clearly on the tissues affected by the tumor. Treatment is usually carried out 5 days a week for several weeks. The procedure is absolutely painless and takes a minimum of time, but the preparation for it can take half an hour or even more. Before the start of exposure, specialists determine the optimal dose of radiation and the correct angles at which the radiation will be applied.
Side effects include nausea, vomiting, fatigue, and changes in blood composition.
Chemotherapy for adrenal cancer
Chemotherapy is drugs that are administered intravenously or taken like regular pills, enter the bloodstream, spread throughout the body and destroy altered cells in any of its areas. Currently, the development of the most effective drugs for this type of cancer is underway. As a rule, the drugs already available today are used at common stages of the disease in the event that the neoplasm cannot be surgically removed.
Mitotan is most often used, which blocks the production of hormones and destroys tumor cells. In addition, it can suppress the functioning of a healthy adrenal gland. This medicine is prescribed, among other things, as adjuvant therapy after surgery to destroy all remaining altered cells in the body and prevent recurrence or recurrence of cancer.
If the tumor has not been completely removed or has developed again, the drug can reduce its size. In some patients, it does not reduce the neoplasm, but it reduces the production of excess hormones and relieves symptoms.
Other substances are also used to treat adrenal cancer, often in combination with mitotane.
Chemotherapy kills not only cancerous cells, but also normal cells, causing severe side effects such as nausea and vomiting, diarrhea, loss of appetite, hair loss, skin rash, fatigue, shortness of breath, and others.
Fortunately, they can be minimized or prevented. The specialists of the European Medical Center carry out treatment with individually selected premedication – the use of drugs that weaken the negative effects of "chemistry" on the body, and use href="https://www.emcmos.ru/programs_and_services/services/institut-onkologii-emc-v-moskve-himioterapiya-bez-poteri-volos/"> modern techniques to avoid alopecia, or hair loss.
Palliative treatment of adrenal cancer
The goal of palliative care is not to completely cure cancer, but to improve well-being, alleviate symptoms, and improve the patient's quality of life.
It includes, among others:
- surgical interventions that do not involve the removal of all foci of the disease, but reduce the size of the tumor;
- radiation therapy that destroys metastases in the brain, bones, or other tissues;
- chemotherapy, which can be used to reduce the size of the neoplasm, slow down its growth or stop the production of hormones.
The EMC Palliative Care Department provides any kind of support, including psychological support, to both patients and their loved ones.
Our specialists monitor the symptoms and possible side effects of treatment, teach home care and emotion management techniques, organize on-site consultations with doctors and medical staff, select optimal nutrition schemes and advise on any issues.
Treatment of adrenal cancer by stages
stages 1 and 2
The main method of fighting cancer at these stages is surgery, or removal of the affected adrenal gland, and, if necessary– the nearby lymph nodes. There are 2 such organs in the human body, and removing one of them usually does not cause problems for the patient.
Quite often, no further treatment is required. If experts believe that altered cells may have remained in the body, they prescribe radiation therapy, possibly in combination with mitotane. Radiation and chemotherapy prevent or reduce the likelihood of disease recurrence. As a rule, they are used if the tumor has grown to a large size, has grown rapidly, or when examined under a microscope, it has been found that its cells are very noticeably different from normal ones.
stage 3
Treatment in the third stage usually consists of surgical removal of the cancerous tumor, the affected adrenal gland, surrounding tissues and nearby lymph nodes. If necessary, part of the liver is also removed, which eventually recovers to its original size, and the kidney located next to the cancer site is completely or partially removed.
After surgery, radiation therapy is prescribed to prevent recurrence, either as an independent treatment or in combination with mitotane.
stage 4
Surgical intervention may be prescribed:
- In the event that specialists have the opportunity to remove the entire tumor While spreading its cells to other areas of the body, it will not be possible to completely cure cancer with its help.
- To remove as much of the neoplasm as possible, make you feel better, and reduce hormone production.
Radiation therapy and chemotherapy can also be used to relieve symptoms, including those caused by the spread of altered cells throughout the body and the proliferation of metastases.
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