Adrenocortical Carcinoma Treatment
By ncbi.nlm.nih.gov
This PDQ cancer information summary has current information about the treatment of adrenocortical carcinoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.
Adrenocortical carcinoma is a rare disease in which malignant (cancer) cells form in the outer layer of the adrenal gland.
There are two adrenal glands. The adrenal glands are small and shaped like a triangle. One adrenal gland sits on top of each kidney. Each adrenal gland has two parts. The outer layer of the adrenal gland is the adrenal cortex. The center of the adrenal gland is the adrenal medulla.
Anatomy of the adrenal gland. There are two adrenal glands, one on top of each kidney. The outer part of each gland is the adrenal cortex; the inner part is the adrenal medulla.
The adrenal cortex makes important hormones that:
Balance the water and salt in the body.
Help keep blood pressure normal.
Help control the body's use of protein, fat, and carbohydrates.
Cause the body to have masculine or feminine characteristics.
Adrenocortical carcinoma is also called cancer of the adrenal cortex. A tumor of the adrenal cortex may be functioning (makes more hormones than normal) or nonfunctioning (does not make more hormones than normal). Most adrenocortical tumors are functioning. The hormones made by functioning tumors may cause certain signs or symptoms of disease.
The adrenal medulla makes hormones that help the body react to stress. Cancer that forms in the adrenal medulla is called pheochromocytoma and is not discussed in this summary. See the PDQ summary on Pheochromocytoma and Paraganglioma for more information.
Adrenocortical carcinoma and pheochromocytoma can occur in both adults and children. Treatment for children, however, is different than treatment for adults. (See the sections on Cancer of Adrenal Cortex and Pheochromocytoma and Paraganglioma in the PDQ summary on Unusual Cancers of Childhood Treatment for more information.)
Having certain genetic conditions increases the risk of adrenocortical carcinoma.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Risk factors for adrenocortical carcinoma include having the following hereditary diseases:
Li-Fraumeni syndrome.
Beckwith-Wiedemann syndrome.
Carney complex.
Symptoms of adrenocortical carcinoma include pain in the abdomen.
These and other signs and symptoms may be caused by adrenocortical carcinoma:
A lump in the abdomen.
Pain the abdomen or back.
A feeling of fullness in the abdomen.
A nonfunctioning adrenocortical tumor may not cause signs or symptoms in the early stages.
A functioning adrenocortical tumor makes too much of one of the following hormones:
Cortisol.
Aldosterone.
Testosterone.
Estrogen.
Too much cortisol may cause:
Weight gain in the face, neck, and trunk of the body and thin arms and legs.
Growth of fine hair on the face, upper back, or arms.
A round, red, full face.
A lump of fat on the back of the neck.
A deepening of the voice and swelling of the sex organs or breasts in both males and females.
Muscle weakness.
High blood sugar.
High blood pressure.
Too much aldosterone may cause:
High blood pressure.
Muscle weakness or cramps.
Frequent urination.
Feeling thirsty.
Too much testosterone (in women) may cause:
Growth of fine hair on the face, upper back, or arms.
Acne.
Balding.
A deepening of the voice.
No menstrual periods.
Men who make too much testosterone do not usually have signs or symptoms.
Too much estrogen (in women) may cause:
Irregular menstrual periods in women who have not gone through menopause.
Vaginal bleeding in women who have gone through menopause.
Weight gain.
Too much estrogen (in men) may cause:
Growth of breast tissue.
Lower sex drive.
Impotence.
These and other signs and symptoms may be caused by adrenocortical carcinoma or by other conditions. Check with your doctor if you have any of these problems.
Imaging studies and tests that examine the blood and urine are used to detect (find) and diagnose adrenocortical carcinoma.
The tests and procedures used to diagnose adrenocortical carcinoma depend on the patient's signs and symptoms. The following tests and procedures may be used:
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Twenty-four-hour urine test: A test in which urine is collected for 24 hours to measure the amounts of cortisol or 17-ketosteroids. A higher than normal amount of these in the urine may be a sign of disease in the adrenal cortex.
Low-dose dexamethasone suppression test: A test in which one or more small doses of dexamethasone are given. The level of cortisol is checked from a sample of blood or from urine that is collected for three days. This test is done to check if the adrenal gland is making too much cortisol.
High-dose dexamethasone suppression test: A test in which one or more high doses of dexamethasone are given. The level of cortisol is checked from a sample of blood or from urine that is collected for three days. This test is done to check if the adrenal gland is making too much cortisol or if the pituitary gland is telling the adrenal glands to make too much cortisol.
Blood chemistry study: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as potassium or sodium, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). An MRI of the abdomen is done to diagnose adrenocortical carcinoma.
Adrenal angiography: A procedure to look at the arteries and the flow of blood near the adrenal glands. A contrast dye is injected into the adrenal arteries. As the dye moves through the arteries, a series of x-rays are taken to see if any arteries are blocked.
Adrenal venography: A procedure to look at the adrenal veins and the flow of blood near the adrenal glands. A contrast dye is injected into an adrenal vein. As the contrast dye moves through the veins, a series of x-rays are taken to see if any veins are blocked. A catheter (very thin tube) may be inserted into the vein to take a blood sample, which is checked for abnormal hormone levels.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
MIBG scan: A very small amount of radioactive material called MIBG is injected into a vein and travels through the bloodstream. Adrenal gland cells take up the radioactive material and are detected by a device that measures radiation. This scan is done to tell the difference between adrenocortical carcinoma and pheochromocytoma.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The sample may be taken using a thin needle, called a fine-needle aspiration (FNA) biopsy or a wider needle, called a core biopsy.
Certain factors affect the prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
The stage of the cancer (the size of the tumor and whether it is in the adrenal gland only or has spread to other places in the body).
Whether the tumor can be completely removed in surgery.
Whether the cancer has been treated in the past.
The patient's general health.
The grade of tumor cells (how different they look from normal cells under a microscope).
Adrenocortical carcinoma may be cured if treated at an early stage.
Source: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032533/
Monday, May 11, 2026
Prazosin - Patient guide
Prazosin is an alpha-1 adrenergic receptor blocker with clinical applications that span blood pressure management and an additional well-studied indication for reducing trauma-related nightmares in patients with post-traumatic stress disorder. Understanding both the antihypertensive mechanism and the psychiatric application helps patients and their families appreciate the full clinical picture when prazosin is prescribed. Alpha-1 adrenergic receptors respond to norepinephrine by triggering vasoconstriction in arterial smooth muscle. Blocking these receptors prevents this response, allowing arteries to remain more relaxed. The result is reduced peripheral vascular resistance and lower blood pressure. This mechanism is shared across the alpha-blocker drug class, including doxazosin and terazosin. In hypertension management, prazosin is typically used as an additional agent when first-line medications have not produced adequate blood pressure control rather than as a first-choice agent. The ALLHAT trial, a large landmark trial comparing antihypertensive drug class outcomes, found that the alpha-blocker arm had higher rates of heart failure events compared to the diuretic arm, which shifted prescribing guidelines away from alpha-blockers as primary agents for uncomplicated hypertension. However, prazosin remains clinically useful in combination regimens and in patients with specific co-existing conditions. For men with elevated blood pressure who also have symptomatic benign prostatic hyperplasia, alpha-blockers like prazosin relax smooth muscle in both blood vessels and the prostate and bladder neck. This simultaneous action reduces blood pressure and improves urinary flow symptoms with a single medication. The additional use of prazosin for PTSD-related nightmares has been supported by clinical research. Norepinephrine release during sleep is thought to contribute to hyperarousal and vivid disturbing dreams in PTSD. Alpha-1 receptor blockade at central sites blunts this norepinephrine signaling, reducing nightmare frequency and improving sleep quality in many patients. Military veterans and civilian trauma survivors have benefited from prazosin for this indication. Orthostatic hypotension is the primary tolerability concern with prazosin, as with all alpha-blockers. The normal blood pressure maintenance response when standing depends partly on alpha-1 receptor activation. Blocking these receptors can allow blood pressure to drop significantly with position changes, particularly after the first few doses. Starting at a very low dose, taken at bedtime, reduces the impact of this first-dose effect on daytime activities. For patients learning about their antihypertensive or psychiatric treatment options, discussing prazosin for blood pressure management with a qualified provider helps clarify which of its clinical applications apply to their specific health situation. For comprehensive guidance on alpha-blocker therapy and blood pressure treatment options, reviewing blood pressure medication options and treatment guidance provides a strong foundation for informed medical conversations.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.