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Adrenal Cancer Medical Negligence Claim

Adrenal cancer usually involves the cortex of the adrenal gland, which is the outer layer of the gland. It is an uncommon type of cancer affecting 1 to 2 individuals per million in the population. It affects adults who are middle aged, with a median age of 44 years at the time of diagnosis. It is completely treatable if confined to the adrenal gland at the time it is diagnosed; however, only 30 percent of these cancers are confined to the cortical adrenal gland when diagnosed. Adrenal cancer is an aggressively growing tumor that tends not to be found until it has spread to nearby or distant organs.

Symptoms of adrenal cortical cancer include flank pain on the side of the tumor or abdominal pain. Some produce excessive adrenal hormones that yield their own set of symptoms. Sixty percent of these tumors will produce too much hormone, such as corticosteroids. The symptoms of excessive corticosteroids include truncal obesity, a buffalo hump, stretch marks and a high blood pressure. If there are adrenal metastases, the most common areas of metastases are in the liver, lung and bone.

Evaluation of an adrenal cancer includes testing of the blood for the amount of hormones made by the adrenal gland. This includes levels of cortisol (corticosteroids), estrogen, aldosterone and testosterone. A high level doesn't mean that an adrenal cancer exists because benign adenomas of the adrenal gland can also produce high hormone levels. It simply means there is something in the adrenal tissue that is over-producing the adrenal hormones. It can be cancerous or not.

The doctor will follow up the blood testing by doing radiological tests. This can include an MRI or a CT scan of the adrenal area, which will show the cancer and possibly can define any metastatic disease. Such tests do not tell whether or not the tumor is cancerous or not and surgery may be the only way to determine that. There are some angiographic tests which can be done, such as an adrenal venogram. It can tell where the blood supply of the tumor is coming from and where it is going to in order to define where metastatic disease is located. It helps the surgeon decide how to proceed with the surgery to remove the tumor. Angiographic testing can better define the location of the tumor within the adrenal gland and can identify whether or not the tumor is actually in the adrenal gland or whether it is, in fact, a tumor of the upper pole of the affected kidney.

There are several adrenal syndromes associated with the excessive secretion of hormones in adrenal cancer. Patients may, in fact, seek treatment not because they feel flank or abdominal pain but because they have symptoms related to the hormone production of the adrenal cancer. It can take up to three years to have changes associated with adrenal cancer that produces hormones. The following are the main syndromes associated with adrenal cancer and its overproduction of hormones:

• There can be an andrenogentital syndrome, in which excessive amounts of sex hormones are made.
• Virilization can occur if the tumor produces excessive amounts of testosterone. This can cause excessive hair growth, irritability, increased sex drive and oily skin.
• Feminization syndrome involves the overproduction of female hormones. It can cause postmenopausal vaginal bleeding, abnormal vaginal bleeding in premenopausal women, or the development of secondary sexual characteristics in men, such as breast formation.
• Precocious puberty can occur if the tumor produces sex hormones in younger children who have adrenal tumors. They reach puberty at a very young age and develop secondary sexual characteristics early in their life.
• Hyperaldosteronism is called Conn's syndrome and results from the adrenal cancer producing excessive aldosterone. The end result is high blood pressure and a low potassium syndrome.
• Hypercortisolism is also known as Cushing's disease. It is a result of the adrenal cancer making too much cortisol.

The treatment of adrenal cancer is excision of the tumor in surgery, which may involve removal of the kidney and surrounding lymph nodes. Metastatic disease requires chemotherapy to kill any other cancer cells within the body. Several chemotherapy drugs are used to treat this type of cancer.

The prognosis of adrenal cancer is dependent upon the stage of the cancer. Overall, the five year survival rate is about 40 percent with approximately 80 percent of cases recurring in less than ten years.