Adrenal glands are small and triangular-shaped glands located on top of both kidneys. In other words, suprarenal glands. Adrenal glands produce hormones to help regulate blood pressure, metabolism, immune system, response to stress and also other essential functions.
Adrenal Problems- Adrenal glands produce cortisol, adrenaline and aldosterone hormones. Too much or too little production can result in adrenal disorders that affect how your body functions. An adrenal crisis is a condition that happens when there is a severe lack of cortisol.
Many conditions are responsible for the adrenal gland function. The adrenal glands are small, triangular-shaped, located just above each kidney. In other words, suprarenal glands. Their job is to make hormones needed to keep your metabolism, blood pressure, immune system and also stress response balanced.
There are three types of adrenal problems:
Primary adrenal insufficiency, or Addison’s disease: If adrenal glands get damaged, it affects hormone’s production.
Secondary adrenal insufficiency: It occurs when the brain’s pituitary gland does not produce enough adrenocorticotropic. It is a hormone that influences cortisol production in the adrenal glands. This condition leads to low hormone levels.
Tertiary adrenal insufficiency: The hypothalamus part in the brain is a region that influences hormone production in the adrenal glands. In fact, it produces too little corticotropin-releasing hormone (CRH), leading to low hormone levels.
There are conditions of the adrenal glands related to tumors. These include:
Adrenal gland tumors– This type of tumors can disrupt hormone output but they are normally non cancerous.
Adrenocortical carcinoma- When the tumor forms in the adrenal gland’s outer layer, this condition is known as adrenocortical carcinoma.
Pheochromocytoma- In this condition glands make too much epinephrine and norepinephrine. In fact, it can make your heart race and raise blood pressure level.
Pituitary tumors- Abnormal growth on the pituitary gland causes adrenal gland conditions by disrupting the number of hormones made by this gland. In fact, if tumors are of big size, they may press on the normal pituitary cells and cause deficiency of ACTH and secondary adrenal insufficiency.
Signs and symptoms of adrenal cancer
Signs and symptoms of adrenal cancer include:
- Pink or purple marks on skin
- Muscles weakness
- Weight gain
- Due to harmonal change in women, excess facial hair, hair loss on the head and irregular periods
- Hormone changes in men cause enlarged breast tissue and shrinking testicles
- Nausea
- Vomiting
- Abdominal bloating
- Back pain
- Fever
- Loss of appetite
- Loss of weight without trying
Cause of adrenal cancer
It’s not clear what causes adrenal cancer. Adrenal cancer happens when something creates changes (mutations) in the DNA of an adrenal gland cell. A cell’s DNA contains the instructions that signal a cell to do its work. The mutations can tell the cell to multiply uncontrollably and continue living when healthy cells would die. In this situation, the abnormal cells accumulate and form a tumor. The tumor cells can break and spread (metastasize) to other body parts.
Risk factors of adrenal cancer
Adrenal cancer happens in people with inherited syndromes. It in fact, increases the risk of certain cancers. These inherited syndromes include:
Beckwith-Wiedemann syndrome
Carney complex
Li-Fraumeni syndrome
Lynch syndrome
Multiple endocrine neoplasia, type 1 (MEN 1)
Diagnosis of adrenal cancer
To diagnose adrenal cancer, the tests and procedures are:
Blood and urine tests- Laboratory tests of your blood and urine may reveal unusual levels of cortisol, aldosterone and androgens hormones produced by the adrenal glands.
Imaging tests- Your doctor may recommend CT, MRI or (PET) scans to understand any growths on your adrenal glands. This also helps in understanding if cancer has spread to other areas of your body, such as your lungs or liver.
Laboratory analysis of your adrenal gland- If your doctor suspects you have adrenal cancer, he may recommend removing the affected adrenal gland. Then the pathologist analyses this gland in a laboratory to study body tissues (pathologist). In fact, this analysis can confirm you have cancer and precisely the type of cells involved.
Treatment of adrenal cancer-
There is currently no cure for adrenal insufficiency, but treatments can help people manage the symptoms. These options depend on the signs and severity of the condition.
Doctors will also consider a person’s age and general health when determining the proper treatment.
Hormone replacement therapy is a common treatment for adrenal insufficiency, which involves replacing the hormones that the adrenal glands no longer produce, including cortisol.
Doctors will usually prescribe hydrocortisone as a pill several times per day to replace cortisol. They may also recommend fludrocortisone to balance minerals in the body without aldosterone.
Many people will need to take these medications for life. In fact, meople who experience an adrenal crisis may receive treatment through an intravenous drip.
Some people with primary adrenal insufficiency can benefit from specific diets, such as a high sodium diet. Consuming additional calcium and vitamin D can support bone health in people taking corticosteroids.
Surgery
Doctors do surgery to remove the entire adrenal cancer. However, in order to achieve this, doctors must remove the affected adrenal gland (adrenalectomy).
If surgeons find evidence that cancer has spread to nearby structures, such as the liver or kidney, parts or all of those organs might be removed during the operation.
Medication to reduce the risk of recurrence
The doctors use the Mitotane (Lysodren) drug to treat advanced adrenal cancer. It has shown promise in delaying the recurrence of the disease after surgery. The doctors recommend it after surgery to avoid the risk of cancer recurrence.
Radiation therapy
Radiation therapy is used to treat adrenal cancer in many cases. In this therapy, high-powered energy beams, such as X-rays and protons are used to kill cancer cells. Radiation therapy is sometimes used after surgery to kill remaining cell in the body. It also helps reduce pain and other cancer symptoms that have spread to other parts of the body, such as the bone.
Chemotherapy
Chemotherapy is also used to treat adrenal cancer. For adrenal cancers that can not be removed with surgery or that return after initial treatments, chemotherapy may be an option to slow cancer progression.
Complications of adrenal cancer
The main complication of adrenal insufficiency is adrenal shock. It can trigger severe symptoms without any warning. It is the result of stress on your body, such as an injury or surgery. The condition requires immediate medical treatment. If treatment is not given on time, adrenal shock can lead to seizures or a coma and can be fatal.
Conclusion
Adrenal insufficiency is a lifelong disease. But it can be managed by hormone replacement therapies. It causes adrenal shock. People who have adrenal shock require immediate medical care. It may also be necessary to have an emergency cortisol shot when traveling. Adrenal insufficiency affects the adrenal glands and minimizes hormone production in your body. It primarily affects cortisol and causes a wide range of symptoms.
