Adrenal glands are triangular-shaped organs located on top of each kidney. They are primarily responsible for the release of hormones that have a stimulating effect on the heart, blood flow and dilation of arteries.
Each adrenal gland is divided into an outer cortex and an inner medulla. The adrenal cortex produces steroid hormones that maintain blood pressure and salt balance. The adrenal medulla is derived from nerve cells and is a source of catecholamines (adrenaline and noradrenaline), which are “stress hormones” that increase alertness, strength and speed in an emergency.
Surgery is the frontline treatment for cancers and other diseases of the adrenal gland. Normally, the entire affected adrenal gland is removed (adrenalectomy). If both adrenal glands are removed, patients will have to be on hormone therapy the rest of their lives.
Some carefully selected patients may be eligible for laparoscopic adrenalectomy, a minimally invasive surgical technique. Three or four one-centimeter incisions are made in the abdomen or the back to insert the laparoscope, which is a camera on the end of a long, slender tube, and tiny instruments that move nearby organs out of the way and excise the diseased adrenal gland. Surgeons watch their progress on video monitors mounted over the operation table. The adrenal gland is cut away from the kidney and placed in a plastic bag for removal through one of the surgical incisions. Patients who are obese or who have had prior abdominal surgery are good candidates for a retroperitoneal procedure, where incisions are made in the back rather than the abdomen.
Laparoscopic adrenalectomy usually takes about one to two hours, but might take longer for complex cases. Patients generally experience shorter hospital stays, less blood loss and shorter recovery times than with standard surgery techniques.
The best candidates for laparoscopic adrenalectomy:
Have benign tumors
Are diagnosed with pheochromocytoma, Cushing's Syndrome or adrenal adenomas
Have hormone overproduction in both adrenal glands (Cushing's disease)
Other candidates for laparoscopy include patients with isolated metastases to the adrenal gland from other sites (lung, breast, and melanoma).
Patients with suspected adrenocortical carcinoma are best treated with a standard, open surgical procedure to remove the tumor and other affected tissue. For patients with advanced adrenocortical carcinoma, chemotherapy with mitotane may be used to relieve symptoms from progressing disease. This type of cancer is not sensitive to radiation therapy.
Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage of diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, support is available. Below is a list that includes ways to find help and hope.
Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also several online support Web sites or message boards for those who may not have access to a traditional meeting.
Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, Tai Chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression, and traditional Eastern medicine such as acupuncture.
Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.
Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.
Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers.
Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own Web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.