Adrenal Cancer: Early Signs, Risk Factors, and How It Is Treated

Adrenal cancer is a rare cancer that starts in the adrenal glands, which sit above the kidneys and help regulate hormones. Early signs can be subtle, but symptoms may develop when the tumor makes excess hormones or grows large enough to cause pressure, and treatment often involves surgery with additional therapies in selected cases.

Overview

Adrenal cancer is a rare cancer that begins in the adrenal glands, two small glands located above the kidneys. These glands produce hormones that help control blood pressure, metabolism, stress response, and sex hormone balance. The most common form of adrenal cancer in adults is adrenocortical carcinoma, which starts in the outer layer of the gland.

Some adrenal tumors are discovered because they cause symptoms, while others are found by chance during scans done for another reason. A key feature of adrenal cancer is that it may produce excess hormones, which can lead to noticeable body changes before the tumor itself causes pain or pressure. In other cases, the tumor does not make hormones and may remain silent until it becomes larger.

Not every adrenal mass is cancer. Many adrenal growths are benign, such as noncancerous adenomas, and many are nonfunctioning, meaning they do not make excess hormones. Because the treatment and outlook differ greatly between benign adrenal nodules and adrenal cancer, careful evaluation by an experienced team is important.

Early Signs and Symptoms

Early signs of adrenal cancer vary widely. When the tumor produces hormones, symptoms may appear sooner and may seem unrelated at first. For example, excess cortisol can cause rapid weight gain, easy bruising, muscle weakness, high blood pressure, high blood sugar, and a rounder face. Excess androgen hormones may cause increased facial or body hair, acne, irregular menstrual periods, or deepening of the voice in women. In children, early puberty may be a clue.

Some tumors produce estrogen or aldosterone, which can also create hormonal changes. Estrogen excess may lead to breast tenderness or enlargement in males, while aldosterone excess can contribute to high blood pressure, low potassium, muscle cramps, or weakness. These patterns can help doctors suspect that an adrenal tumor is active even before imaging is reviewed in detail.

When the cancer does not produce hormones, symptoms are more often related to the tumor’s size or spread. These can include persistent abdominal, flank, or back pain; a feeling of fullness; unintentional weight loss; or a lump that may be noticed on examination. Because these symptoms are not specific, adrenal cancer can sometimes be confused with other abdominal conditions, including kidney cancer.

• Hormone-related changes: weight gain, muscle weakness, high blood pressure, acne, unwanted hair growth
• Pressure symptoms: abdominal or back pain, bloating, early fullness
• General warning signs: unexplained weight loss, fatigue, a growing abdominal mass

Causes and Risk Factors

In many people, the exact cause of adrenal cancer is not known. Cancer develops when cells begin to grow in an uncontrolled way, often because of genetic changes inside the cells. These changes may occur by chance or, less commonly, as part of an inherited syndrome that increases cancer risk.

Several rare hereditary conditions are linked to adrenal cancer, including Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, familial adenomatous polyposis, and multiple endocrine neoplasia type 1. A personal or family history of unusual endocrine tumors may lead doctors to consider genetic counseling or testing, especially in younger patients or those with other suggestive features.

Most people with hormone-related symptoms do not have adrenal cancer, and most adrenal incidentalomas are benign. Still, a large adrenal mass, a rapidly growing lesion, or a tumor with irregular imaging features deserves careful specialist assessment. Doctors also consider whether the tumor may be another type of adrenal problem, such as adrenal adenoma, because management can be very different.

How Adrenal Cancer Is Diagnosed

Diagnosis begins with a detailed medical history and physical examination, focusing on hormone-related changes, blood pressure, weight changes, and family history. Blood and urine tests are usually performed to check whether the adrenal gland is making too much cortisol, aldosterone, androgens, or other hormones. These results can guide the next steps and help doctors plan treatment safely.

Imaging tests are central to evaluation. CT and MRI scans can show the tumor’s size, shape, and relationship to nearby organs, while chest or whole-body imaging may be used to look for spread. In selected cases, PET imaging may help clarify whether a lesion is likely to be cancerous or whether cancer has spread elsewhere.

Biopsy is not routinely the first step for a suspected adrenal cancer. That is because biopsy may not reliably distinguish all adrenal tumors and is usually avoided when surgery is already planned or when a hormone-producing tumor is suspected. An endocrine, oncology, radiology, and surgery team often reviews the case together before making decisions. If imaging is needed to define the adrenal mass and stage the disease, MRI and PET-CT may be part of the workup.

Treatment Options

Treatment depends on whether the cancer is localized, whether it produces hormones, and whether it can be removed completely. Surgery is the main treatment for adrenal cancer that has not spread too far and can be safely taken out. The goal is complete removal of the tumor in one piece, often along with nearby tissue if needed. Careful planning matters because rupture during surgery can make treatment more difficult.

If the cancer is advanced or has spread, treatment may include medicines aimed at slowing tumor growth, controlling hormone production, or easing symptoms. Some people receive drug therapy after surgery to reduce the risk of recurrence, while others may need treatment before or instead of surgery depending on the stage and overall condition. Radiation therapy may also be used in selected situations, such as symptom control or reducing the risk of local recurrence.

Specialists may recommend adrenalectomy when surgery is appropriate. In advanced disease, medical oncology care helps coordinate systemic treatment and supportive management. Treatment plans are individualized, and follow-up is essential because adrenal cancer can return even after an apparently complete operation.

Living With Adrenal Cancer and Follow-Up Care

Living with adrenal cancer often involves both cancer care and hormone management. Before treatment, some patients need medicines to control excess hormone effects such as high blood pressure, low potassium, or high blood sugar. After surgery, the body may need time to adjust, and some people temporarily or permanently require hormone replacement if the remaining adrenal function is not enough.

Recovery and follow-up focus on monitoring for recurrence, checking hormone levels, and watching for treatment side effects. Follow-up commonly includes regular clinic visits, blood or urine tests, and repeat imaging over time. Keeping appointments matters because recurrence can sometimes be found on testing before symptoms become obvious.

Emotional support is also important. A rare cancer diagnosis can feel isolating, and patients may benefit from clear information, counseling, and coordinated care across endocrinology, surgery, oncology, pathology, and radiology. Near the end of the care journey planning, some patients choose centers experienced in complex endocrine tumors; Acibadem International’s multidisciplinary specialists and JCI-accredited hospitals diagnose and treat adrenal cancer for international patients.

Prevention and Self-Care

There is no proven way to prevent most cases of adrenal cancer. Because the disease is uncommon and usually not linked to lifestyle alone, prevention is not as straightforward as it is for some other cancers. However, early evaluation of concerning symptoms and appropriate follow-up of an adrenal mass can help shorten the time to diagnosis.

Self-care does not replace medical treatment, but it can support overall health during evaluation and recovery. People are often advised to keep a record of symptoms such as blood pressure readings, unexplained weight changes, muscle weakness, menstrual changes, or new hair growth. This information can help doctors recognize hormone patterns more quickly.

General measures such as eating a balanced diet, staying active as tolerated, taking medicines exactly as prescribed, and attending all follow-up visits are helpful. Those with a strong family history of endocrine or rare cancers may benefit from discussing genetic counseling with a qualified doctor, particularly if more than one relative has had unusual tumors at a young age.

When to Seek Medical Care

Medical care should be sought if a person develops persistent symptoms that could suggest an adrenal hormone problem or a growing abdominal mass. Examples include new high blood pressure that is hard to control, rapid weight gain with muscle weakness, unexplained bruising, irregular periods, voice changes, increasing body hair, abdominal pain, or unintentional weight loss. These symptoms do not necessarily mean cancer, but they do deserve evaluation.

Prompt assessment is also important when an adrenal tumor is found incidentally on a scan. Many incidental adrenal masses are benign, but the next steps depend on the size of the lesion, whether it makes hormones, and what it looks like on imaging. A specialist can help decide whether monitoring, more testing, or treatment is needed.

Urgent care may be needed if symptoms are severe, such as very high blood pressure, significant weakness, dehydration, or worsening pain. Anyone with a previous adrenal cancer diagnosis should contact their care team if symptoms return or new symptoms appear between scheduled visits.

Frequently asked questions

Is adrenal cancer the same as an adrenal adenoma?

No. An adrenal adenoma is usually a benign, noncancerous growth, while adrenal cancer is a malignant tumor that can invade nearby tissues or spread to other parts of the body. Both can sometimes produce hormones, so testing is needed to tell them apart.

What is usually the first sign of adrenal cancer?

The first sign may be a hormone-related change rather than pain. Some people notice rapid weight gain, high blood pressure, muscle weakness, acne, irregular periods, or increased hair growth, while others develop abdominal discomfort or discover a mass on imaging done for another reason.

Can adrenal cancer be cured?

Some cases can be treated successfully, especially when the tumor is found early and removed completely with surgery. The outlook depends on the stage, whether the cancer has spread, and whether the tumor can be fully removed. Ongoing follow-up remains important because recurrence is possible.

Do all adrenal tumors need surgery?

No. Many adrenal tumors are benign and may only need monitoring, especially if they are small and do not produce hormones. Surgery is more likely to be recommended when the mass is large, suspicious for cancer, or causing significant hormone excess.

How is adrenal cancer confirmed?

Doctors usually combine hormone tests, CT or MRI imaging, and specialist review to make the diagnosis and assess the stage. In many cases, the final confirmation comes after surgical removal and examination of the tumor by a pathologist rather than from a needle biopsy alone.

Is adrenal cancer hereditary?

Most cases are not inherited, but some are linked to rare genetic syndromes. If adrenal cancer occurs at a young age or there is a strong family history of unusual cancers or endocrine tumors, genetic counseling may be recommended.

References

• National Cancer Institute
• National Comprehensive Cancer Network
• American Cancer Society
• European Society for Medical Oncology
• Endocrine Society

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.