Cancer of the adrenal gland: Signs, origins, and remedies
Adrenocortical Carcinoma (ACC) is a rare and aggressive form of cancer that affects the adrenal glands, located above each kidney. Despite its rarity, understanding ACC is crucial due to its potentially serious consequences.
**Common Symptoms**
ACC often presents with hormonal syndromes, particularly in children. In over 90% of cases, virilization, characterised by excessive hair growth, acne, deepening of the voice, and changes in genitals or breasts, is observed. Hypertension is also common. Approximately one-third of cases involve Cushing syndrome, characterised by moon facies, centripetal fat distribution, and plethora. Adults and children may also experience abdominal pain, weight loss, fatigue, symptoms related to tumor mass, or metastases.
**Risk Factors**
The risk of ACC is influenced by several factors. A high frequency of the TP53 germline mutation, particularly the R337H variant, is observed in southern Brazil, leading to a significantly higher incidence of ACC in children there compared to global averages. ACC typically presents in the first 5 years of life in children, with a strong female predominance. In adults, the peak incidence is between 40 and 60 years, and women are more frequently affected. Rarely, ACC is associated with other genetic syndromes.
**Treatment Options**
Complete surgical resection, known as adrenalectomy, is the primary treatment for localised ACC. Medical therapies, such as Mitotane, cytotoxic chemotherapy, and radiotherapy, are used as adjuvants or in advanced disease. Immunotherapies, including bevacizumab and immune checkpoint inhibitors, are under investigation, but their use is currently limited.
**Prognosis**
The prognosis for ACC depends on several factors, including the tumor stage at diagnosis, completeness of resection, and presence of metastases. Two-year progression-free survival after treatment with drugs like Mitotane has been reported between 48% and 64%, with two-year overall survival rates ranging from 79% to 84% in selected studies. ACC remains a highly aggressive cancer with poor long-term prognosis in advanced cases, but outcomes are better for localised disease, especially in children who undergo complete resection.
It's important to note that most adrenal tumors affect the adrenal cortex, which is the outer part of the adrenal gland. ACC is just one type of tumor that can develop in this area, with adenomas (benign) and carcinomas (malignant) being the two main types of adrenal cortex tumors.
In conclusion, ACC is a rare but aggressive cancer that requires careful monitoring and treatment. Early detection and complete resection can significantly improve the prognosis, especially in children. Working with a medical team is essential for coordinating care for a person with ACC. Additionally, clinical trials may provide new treatment options and help researchers find better ways to manage this disease.
- Adrenocortical Carcinoma (ACC) is a type of cancer that affects the adrenal glands, a condition falling under the broad category of medical-conditions.
- In cases of ACC, understanding endocrinology, the branch of science that deals with the body's hormonal processes, is crucial due to the hormonal syndromes often associated with this cancer.
- Oncology, the study of cancer, plays a significant role in the diagnosis, treatment, and prognosis of ACC, with adjuvant therapies like Mitotane and immunotherapies like bevacizumab being used in its management.
- The prognosis for ACC can be improved through health-and-wellness practices like early detection, complete resection, and participation in therapies-and-treatments such as clinical trials, which are often instrumental in the development of new treatments and better management strategies for this rare and aggressive cancer.
