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Adrenal cancer is a rare malignant tumor originating from the adrenal cortex, accounting for a very small proportion of all cancers but with high malignancy. It is most common in people aged 40 to 60, with women slightly more affected than men, and is often easily overlooked. The disease can manifest due to abnormal hormone secretion, presenting as Cushing’s syndrome, hyperaldosteronism, or androgen excess, and is often misdiagnosed as other endocrine disorders.
Adrenal cancer is globally distributed. More cases have been reported in developed countries such as the United States, Germany, and Italy, while in Asia, China, India, and Japan are representative. In Southeast Asian countries such as Thailand, the Philippines, and Vietnam, the number of cases has increased yearly, possibly related to improvements in diagnostic techniques. If not controlled in advanced stages, it may metastasize to multiple organs such as the liver, lungs, and lymph nodes, with short survival periods and poor prognosis.
Stage I: Localized tumor, resectable
Stage I adrenal cancer tumors are less than 5 cm in diameter, confined to the adrenal gland, with no signs of spread. Patients at this stage often have no obvious symptoms, and the disease is usually discovered during physical examinations. Surgical resection rates are high, with a 5-year survival rate of about 60%–70%.
Stage II: Tumor enlargement but not beyond adrenal capsule
In stage II, tumors are larger than 5 cm but remain confined within the adrenal capsule. Hormonal abnormal symptoms become more obvious, such as facial hirsutism or elevated blood pressure. The 5-year survival rate decreases to about 40%–50%.
Stage III: Local invasion and lymph node metastasis
At this stage, tumors have invaded adjacent tissues or spread to regional lymph nodes. Symptoms are significant, often accompanied by flank pain or abdominal distension. The prognosis is poor, with a 5-year survival rate of 20%–30%.
Stage IV: Distant metastasis and systemic symptoms
Stage IV presents with distant metastasis, such as to the lungs, liver, or bones, often accompanied by systemic fatigue, significant weight loss, and cancer-related pain. The 5-year survival rate is very low, usually less than 10%.
1. Dull or aching pain in the waist and back
Some patients may experience persistent dull pain in the kidney or lumbar area, often mistaken for kidney stones or muscle strain, delaying timely medical consultation.
2. Progressive abdominal mass
As the tumor grows, a hard, immobile mass may sometimes be felt in the upper abdomen or waist, usually appearing in advanced stages.
3. Facial hirsutism and acne
Especially in female patients with excessive androgen secretion, symptoms such as increased facial or body hair, deepened voice, and severe acne may appear, indicating masculinization.
4. Persistent uncontrolled hypertension
Abnormal aldosterone secretion causes sodium retention, leading to hypertension that is difficult to control with medication, often accompanied by headaches and palpitations.
5. Menstrual disorders or amenorrhea
In female patients, hormonal imbalance may lead to menstrual irregularities or amenorrhea, commonly seen in functional adrenal cancers.
6. Coexistence of obesity and edema
Excess cortisol secretion can cause Cushing’s syndrome, manifesting as a round face, abdominal obesity, thin limbs, and significant edema.
7. Mood swings, anxiety, and irritability
Hormonal imbalance significantly affects the nervous system, and patients often present with anxiety, irritability, emotional instability, and sleep disorders.
8. Loss of appetite and weight loss
In advanced stages, patients may develop cachexia, with significant weight loss, persistent anorexia, and systemic weakness.
9. Hyperglycemia and metabolic abnormalities
Prolonged excess cortisol stimulation may lead to elevated blood glucose or even diabetes, with symptoms such as fatigue, polydipsia, and polyuria.
10. Recurrent infections or delayed wound healing
Long-term hormonal abnormalities affect immunity, making patients prone to skin infections or delayed postoperative wound healing.
Experts at United Life International Medical Center remind us that although adrenal cancer is rare, it is highly malignant and insidious in the early stage. When unexplained hypertension, hirsutism, or abdominal masses are detected, timely medical examination and screening are essential. Systematic staging assessment and multidisciplinary treatment plans, combined with immune reconstruction cell therapy, may improve prognosis and extend survival. Early detection and diagnosis remain the key to combating this disease.
