Adrenal Gland Cancer Samples

Bay Biosciences provides high quality, clinical grade, fresh frozen tumor tissue bio-specimens, cryogenically preserved sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid samples from patients diagnosed with Adrenal Gland Cancer.

The sera (serum), plasma and PBMC biofluid specimens are processed from patient’s peripheral whole-blood using customized collection and processing protocols. The adrenal gland cancer fresh frozen tumor tissue samples and biofluids are collected from unique patients diagnosed with adrenal gland cancer and are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.

Detailed clinical data, adrenal gland cancer patients history, symptoms, complete blood count (CBC), serology, chemotherapy information, fresh frozen tumor tissue, elevated biomarker levels, genetic and metabolic information, histopathological findings, annotations associated with adrenal gland cancer specimens is provided to a valued customer for research, development and drug discovery.

The adrenal gland cancer sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid are processed from patients peripheral whole-blood using customized collection and processing protocols.

Adrenal Gland Tumor’s Overview

A tumor begins when healthy cells change and grow out of control, forming a mass. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

An adrenal gland tumor can sometimes produce too much of a hormone. When it does, the tumor is called a “functioning tumor.” An adrenal gland tumor that does not produce hormones is called a “nonfunctioning tumor.” The symptoms and treatment of an adrenal gland tumor depend on:

Whether the tumor is functioning or nonfunctioning
Which hormones is produced in excess
Whether the tumor started in the adrenal gland or spread from another organ

Functional adrenal gland tumors may produce any hormone made in the adrenal gland. In rare cases, they may produce more than one hormone.

A primary adrenal gland tumor starts in an adrenal gland. An adrenal gland tumor may also result from a cancer that began in another organ, such as the lungs, and then spread to the adrenal gland through a process called metastasis. Primary adrenal gland tumors include the following:

Adenoma: This is the most common type of adrenal gland tumor. It is a noncancerous, nonfunctioning tumor of the adrenal cortex. An adenoma usually does not cause symptoms and, if it is small, often does not need treatment. Adenoma is also called an adrenocortical adenoma,
Adrenocortical carcinoma: Adrenocortical carcinoma is rare. However, it is the most common type of cancerous adrenal gland tumor. It is also known as adrenal cortical carcinoma. Approximately 4 to 12 out of one million people develop this type of cancer, which begins in the adrenal cortex. Adrenocortical carcinoma can be a functioning or nonfunctioning tumor. If the tumor is functioning, it may produce more than 1 hormone.
Neuroblastoma: This is a type of childhood cancer that can begin in the adrenal medulla.
Pheochromocytoma: This type of neuroendocrine tumor most often begins in the adrenal medulla.

Adrenal Gland Cancer Signs and Symptoms

Following are the common signs and symptoms the adrenal gland cancer patients may experience. Sometimes, patients with an adrenal gland tumor do not have any of these changes. Or, the cause of a symptom may be another medical condition that is not a tumor.

High blood pressure
Low potassium level
Heart palpitations
Nervousness
Feelings of anxiety or panic attacks
Headaches
Excessive perspiration
Diabetes
Abdominal pain
Unexplained weight gain or weight loss
Fatigue
Abdominal stretch marks
Excessive hair growth
Changes in genitalia
Unusual acne
Change in libido (sex drive)

In addition, pheochromocytoma may cause dangerous surges of the hormones that regulate blood pressure and the body’s response to stress. A hormonal surge can cause blood pressure to rise very quickly, increasing the risk of a heart attack, stroke, hemorrhage, or sudden death.

Causes of Adrenal Gland Cancer

Exact causes of most cancerous adrenal gland is unknown. However, patients with certain hereditary conditions have a higher risk of developing an adrenal gland tumor. People with a high risk of developing an adrenal gland tumor because of their family history should be examined and evaluated by their doctor every year. Following are the hereditary conditions that raise risk of developing adrenal gland tumors:

Multiple endocrine neoplasia type 2 (MEN2)
Li-Fraumeni syndrome
Von Hippel-Lindau syndrome
Neurofibromatosis type 1
Carney complex

Researchers continue to look into what factors causing adrenal gland tumor and what people can do to lower their personal risk. There is no proven way to completely prevent developing adrenal gland cancers, but there may be steps you can take to lower your risk.

Diagnosis of Adrenal Gland Cancer

To diagnose an adrenal gland cancer, blood and urine tests are performed to look for the presence of certain substances to help determine whether the tumor is functional or nonfunctional. A computed tomography (CT or CAT) scan or a magnetic resonance imaging (MRI) scan may be useful in making a diagnosis and evaluating whether an adrenal gland tumor is cancerous. Imaging tests may also be used to find out whether a cancerous tumor has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

This list describes options for diagnosing adrenal gland tumor, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

The type of tumor suspected
Your signs and symptoms
Your age and medical condition
The results of earlier medical tests

In addition to a thorough physical examination, the following tests may be used to diagnose an adrenal gland tumor:

Blood and urine tests: Blood and urine tests help measure the amount of adrenal hormones, which can detect a functional tumor. A 24-hour urine sample may also be needed. This test requires a person to collect all of his or her urine for an entire 24-hour period, so it can be used for laboratory testing. The test results help the doctor track how quickly various hormones are produced. One specific hormone doctors look for with these tests is the stress hormone cortisol. A specific test, called a dexamethasone-suppression test, checks for cortisol levels. For this test, you may be asked to take a pill the evening before. This pill contains a drug that acts like cortisol in the body. When someone who does not have an adrenal gland tumor takes this drug, his or her body will make less cortisol and other hormones. However, if someone has an adrenal gland tumor, cortisol levels will remain high even after taking the drug. Tell your doctor about any medications that you take, even over-the-counter drugs, vitamins, and herbal medications, because this information is needed to correctly interpret the results.
Biopsy: A biopsy is the removal of a small amount of tissue for examination under a microscope. If the doctor suspects that cancer has spread to the adrenal gland from another part of the body, a biopsy may be done to find out where the cancer began, which can help the doctor plan treatment. If this is necessary a narrow, hollow needle is used to collect the tissue. This is called a fine-needle biopsy or fine-needle aspiration. The biopsy is performed by a radiologist who uses specialized imaging procedures, such as CT scans (see below), to guide the needle directly into the tumor. A pathologist then analyzes the sample(s) removed during the biopsy. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.
CT or CAT scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye is often injected into a patient’s vein through a peripheral intravenous (IV) line. This line is a short, plastic tube inserted into the vein that allows the health care team to give medication or fluids.
MRI: An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.
Metaiodobenzylguanidine (MIBG) scan: MIBG is a chemical similar to adrenaline that will collect in a neuroendocrine tumor. A MIBG scan can show a tumor of the adrenal medulla that may not show up on an x-ray. The scan takes place over 2 consecutive days. On the first day, an injection of MIBG is given in the arm. Several hours later, pictures are taken with a special camera that can show if or where in the body the MIBG has collected. The following morning, more pictures are taken, and the process may be repeated if needed.
Adrenal Vein Sampling (AVS): In rare cases, a patient may have symptoms of a hormone-producing tumor, but CT or MRI scans may not identify a tumor or the patient may have small masses on both adrenal glands. In cases like this, an interventional radiologist can test the blood from the veins of each adrenal gland. The blood from each gland is tested to determine whether extra hormone is coming from the adrenal gland with the mass. This procedure is performed only by specialists and is done in a special radiology center.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is a tumor, these results also help the doctor describe it. This is called staging.

Treatment of Adrenal Gland Cancer

For an adrenal gland tumor, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Up to twenty five percent of adrenal tumors may be linked to a genetic syndrome. When planning treatment, it may be helpful to talk with a genetic counselor to learn whether the tumor is associated with a specific syndrome. If you are diagnosed with an adrenal tumor, it is important to learn if any other members of your family may have had any types of endocrine disease in the past. If so, the syndrome may affect other family members as well, and specific genetic tests may be recommended for them.

Descriptions of the most common treatment options for an adrenal gland tumor are listed below. Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

Adrenal Gland Cancer Surgery

Surgery is the removal of the tumor and, if necessary, some surrounding healthy tissue during a surgical operation. Adrenalectomy is the surgical removal of the adrenal gland with the tumor. This may be needed to treat an adrenal gland tumor. A surgical endocrinologist is a surgeon who specializes in treating an endocrine tumor using surgery.

If the tumor is smaller than 5 cm and, based on its size or the way it looks on imaging scans, shows no evidence that it is cancerous, then laparoscopic surgery may be possible. Laparoscopic surgery is a minimally invasive technique in which the surgeon uses a lighted camera and special instruments and makes small incisions in the skin. This technique reduces pain and recovery time after surgery compared with traditional larger incisions. Laparoscopic surgery may be performed from the abdomen or back, depending on the location of the tumor and the experience of the surgeon.

If the tumor is possibly cancerous or larger than 5 cm, surgery using 1 larger incision in the abdomen or back is recommended. If the patient has previously had abdominal surgery, an incision in the back may be easier. Surgery is also the main treatment option for a pheochromocytoma, the tumor of the adrenal medulla that produces excess catecholamines. If laparoscopic surgery is performed, then the patient can usually leave the hospital in 1 to 3 days and resume daily activities within a week. If a larger incision is needed, then the patient is usually hospitalized for up to 5 to 7 days and should not lift heavy objects for 6 weeks after surgery.

Adrenal gland surgery can cause bleeding. The tumor can also make excess stress hormones, called catecholamines. If this is the case, the patient will need to be monitored and receive medication to treat high blood pressure during surgery. Patients with a tumor that produces very large amounts of hormones may require extensive medication and preparation before surgery. They may also need to stay in an intensive care unit for a short period after the surgery is performed. Talk with your surgeon before the operation about the possible side effects that you may experience and how they will be managed.

Adrenal Gland Cancer Hormone Therapy

Because adrenal gland tumors may produce excess hormones, the doctor may prescribe various medications to control the levels of these hormones before, during, or after other treatments. For example, if the tumor is a pheochromocytoma that is producing excess catecholamines, the patient may need a drug to lower the levels of these body chemicals before additional treatment can be given. Or, after surgery for an adrenocortical carcinoma that produces hormones, a patient may need medication to block the effects of excess cortisol. These drugs include metyrapone (Metopirone), metyrosine (Demser), spironolactone (Aldactone), and streptozocin (Zanosar).

Adrenal Gland Cancer Chemotherapy

Chemotherapy is the use of drugs to destroy tumor cells, usually by stopping the cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating a tumor with medication.

Systemic chemotherapy gets into the bloodstream to reach tumor cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or a combination of different drugs at the same time. Mitotane (Lysodren) is a medication used to treat cancer in the adrenal cortex. It reduces the amount of adrenocorticoids produced by the adrenal cortex.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Adrenal Gland Cancer Radiation Therapy

Radiation therapy is the use of high energy x-rays or other particles to destroy tumor cells. A doctor who specializes in giving radiation therapy to treat a tumor is called a radiation oncologist. Adrenal tumors require radiation therapy in very rare cases. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and diarrhea. Most side effects go away soon after treatment is finished.

Adrenal Gland Cancer Treatment and Side Effects

A tumor and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the tumor, an important part of care is relieving a patient’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any patient, regardless of age or type and stage of their tumor, may receive palliative care. It works best when palliative care is started as early as needed in the treatment process. People often receive treatment for the tumor and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment. Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the tumor, such as chemotherapy, surgery, or radiation therapy.

Metastatic Adrenal Gland Cancer

If an adrenal gland tumor has spread to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. The treatment may include a combination of surgery, radiation therapy, and chemotherapy. Palliative care will also be important to help relieve symptoms and side effects. For many patients, a diagnosis of metastatic cancer can be very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

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Bay Biosciences banks wide variety of human tissue samples and biological samples including cryogenically preserved -80°C, fresh, fresh frozen tissue samples, tumor tissue samples, FFPE’s, tissue slides, with matching human bio-fluids, whole blood and blood derived products such as serum, plasma and PBMC’s.

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