The Aga Khan University Hospital, Pakistan > Diseases and Conditions

Adrenal Cancer

The abnormal growth of malignant cells in the outer layer of the adrenal glands (either of the two glands located above each kidney and produces hormones that give instructions to almost all the organs and tissues in the body) is termed as adrenal cancer. It is a rare form of cancer that is usually aggressive but treatable if caught in the early stages. You may be at higher risk of adrenal cancer if you have any of the following genetic diseases:

  • Li-Fraumeni syndrome: a rare hereditary predisposition to cancer, including breast cancer, bone cancer (osteosarcoma) and soft tissues cancer

  • Beckwith-Wiedemann syndrome: a hereditary disorder caused by genetic mutation. It is characterized by an overgrowth syndrome, irregularities including macrosomia (large body size), macroglossia (large tongue), defects in the formation of the abdominal wall, kidney abnormalities, hypoglycaemia (low blood sugar) in the infancy years, and deformed ear creases or pits

  • Carney complex: a hereditary condition characterized by spotty skin pigmentation and an increased risk of multiple benign tumours 

Symptoms of adrenal cancer occur due to the excess hormones (cortisol, aldosterone, testosterone, or oestrogen) secreted by the functioning tumour or the pressure on the surrounding structures in case of a large tumour. A non-functioning tumour may not cause symptoms in the early stages.

You may feel symptoms caused by a large tumour:

  • Pain in the abdomen or back

  • Feeling of fullness

  • A lump in the abdomen​

Symptoms due to excessive production of cortisol include:

  • Weight gain in the face, arms and trunks but thin arms and legs

  • Puffed up face

  • A lump of fat on the back of the neck

  • Growth of fine hair on the face, back or arms

  • High blood sugar

  • High blood pressure

  • Weakened muscles

  • Deepening of the voice

  • Swelling of the sex organs​

Symptoms due to excessive production of aldosterone include:

  • Frequent need to urinate

  • Feeling excessive thirst

  • High blood pressure

  • Weakened muscles or cramps​

Symptoms due to excessive production of testosterone include:

In women:

  • Deepening of the voice

  • Acne

  • Baldness

  • Absence of menstrual periods

  • Growth of fine hair on face, back or arms​

In men:

  • No distinguishable symptoms​

Symptoms due to excessive production of oestrogen include:

In women:

  • Irregular menstrual period

  • Menstrual period post menopause​

In men:

  • Breast enlargement

  • Decreased sex drive

  • Impotence​

Schedule a consultation with our doctors working with the Oncology Service Line at the Aga Khan University Hospital, if you suffer from any of the above mentioned symptoms. Take action immediately if you notice a lump and unsettling pain in the abdominal area.​​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​​​

You may have to undergo extensive testing for the diagnosis of adrenal cancer which can be challenging and overwhelming. But the detailed testing will help your doctor make an accurate diagnosis of the size, spread and stage of the cancer, to allow the formulation of an effective treatment plan.

Initially, your doctor may ask you about your medical history including any cases of adrenal cancer in your family and the signs and symptoms you are experiencing. A physical exam may also be carried out which will include a detailed examination on your abdomen for signs of lumps. You may be asked to undergo the following tests:

  • Blood test to determine:​

    • The levels of testosterone and oestrogen. High levels of these hormones may indicate the presence of adrenal cancer.

    • The levels of certain substances, such as sodium and potassium. Higher or lower levels than normal indicate the presence of a disease.

    • The levels cortisol. Abnormally high level of cortisol may indicate the presence of adrenal cancer.

  • Urine test in which you may be asked to collect your urine for twenty four hours to check the levels of cortisol. Higher than normal levels may indicate a disease in the outer layer of the adrenal glands.​

  • Computed Tomography (CT) scan in which a series of detailed images of your body will be taken by a computer. A dye maybe injected in the vein or given orally to help the organs and tissues appear clearer. The images will then be studied by the doctor to determine the size and spread of the tumour.

  • Positron Emission Tomography (PET) scan in which a small amount of radioactive glucose (sugar) will be injected in your veins. Since the cancerous cells use up sugar faster than normal cells, the radioactivity will concentrate on the cancer. This concentration will be detected by the PET scanner, which rotates around the body and an image will be produced. The malignant cells will appear brighter in the image.

  • Magnetic Resonance Imaging (MRI) of the abdomen in which a series of detailed images of the body will be made on the computer using a magnet and radio waves.

  • Laparoscopy in which a small camera on a thin flexible tube will be inserted into the abdomen through a small incision, to see the spread and size of the tumour.

  • Biopsy in which a sample of the cancerous cells will be removed to be studied under the microscope.​

Due to its aggressive nature, cure from adrenal cancer is only possible if there is complete removal of all the cancerous cells. Your doctor will discuss your treatment options with your depending on the stage of your cancer, which may include:

  • Surgery to remove the tumour, including:​

    • ​Laparoscopic adrenalectomy in which the tumour will be removed through a small incision.

    • Posterior surgery in which the tumor will be removed through an incision in your back.

    • Transabdominal surgery in which the tumour will be removed through an incision in your abdomen.

    • Thoracoabdominal surgery in which large tumours will be removed through large incision through your chest and abdomen.

  • Radiation therapy to kill the cancerous cells using high energy X-ray radiation. In external radiation therapy the radiations are sent to the cancer using a machine outside the body. In internal radiation therapy, the substance sealed in a wire, needles, seeds or catheter is placed directly into or near the cancer. ​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.​