21st Century Adult Cancer Sourcebook: Adrenocortical Carcinoma, Cancer of the Adrenal Cortex - Clinical Data for Patients, Families, and Physicians
Edition 1.0 - September 2011
National Cancer Institute
Smashwords Edition
Copyright 2011 Progressive Management
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PART ONE
Chapter 1A: Adrenocortical Carcinoma Patient Information
Chapter 2A: Adrenocortical Carcinoma Health Professional Information
Chapter 3A: Adrenocortical Carcinoma NCI Drug Information
Chapter 4A: Adrenocortical Carcinoma Clinical Trials
PART TWO
Chapter 1B: Levels of Evidence for Adult and Pediatric Cancer Treatment Studies (NCI)
Chapter 2B: Glossary of Clinical Trial Terms
Chapter 3B: Clinical Trials Background Information
Chapter 4B: Cancer Clinical Trials -The Basic Workbook
Chapter 5B: Cancer Clinical Trials - The In-Depth Program
Chapter 6B: Clinical Trials at NIH
Chapter 7B: How To Find A Cancer Treatment Trial: A Ten Step Guide
Chapter 8B: Taking Part in Cancer Treatment Research Studies
Chapter 9B: Cancer Clinical Trials
Chapter 10B: Access to Investigational Drugs
Chapter 12B: Taking Time: Support for People with Cancer
Chapter 13B: Facing Forward - Life After Cancer Treatment
Chapter 14B: Chemotherapy and You
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PART ONE
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Chapter 1A: Adrenocortical Carcinoma Patient Information
Definition of adrenocortical carcinoma: A rare cancer that forms in the outer layer of tissue of the adrenal gland (a small organ on top of each kidney that makes steroid hormones, adrenaline, and noradrenaline to control heart rate, blood pressure, and other body functions). Also called adrenocortical cancer and cancer of the adrenal cortex.
Adrenocortical Carcinoma Treatment
Last Modified: 07/15/2011
Patient Version
General Information About Adrenocortical Carcinoma
Key Points for This Section
* Adrenocortical carcinoma is a rare disease in which malignant (cancer) cells form in the outer layer of the adrenal gland.
* Having certain genetic conditions increases the risk of developing adrenocortical carcinoma.
* Possible signs of adrenocortical carcinoma include pain in the abdomen and certain physical changes.
* Imaging studies and tests that examine the blood and urine are used to detect (find) and diagnose adrenocortical carcinoma.
* Certain factors affect the prognosis (chance of recovery) and treatment options.
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.
The adrenal cortex makes important hormones that:
* Balance the water and salt in the body.
* Help keep blood pressure normal.
* Help manage the body's use of protein, fat, and carbohydrates.
* Cause the body to have masculine or feminine characteristics.
The adrenal medulla makes hormones that help the body react to stress.
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 hormones). The hormones made by functioning tumors may cause certain signs or symptoms of disease.
Cancer that forms in the adrenal medulla is called pheochromocytoma.
Having certain genetic conditions increases the risk of developing 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. People who think they may be at risk should discuss this with their doctor. Risk factors for adrenocortical carcinoma include having the following hereditary diseases:
* Li-Fraumeni syndrome.
* Beckwith-Wiedemann syndrome.
* Carney complex.
Possible signs of adrenocortical carcinoma include pain in the abdomen and certain physical changes.
These and other symptoms may be caused by adrenocortical carcinoma:
* A lump in the abdomen.
* Pain the abdomen or back.
A nonfunctioning adrenocortical tumor may not cause symptoms in the early stages.
A functioning adrenocortical tumor makes too much of a certain hormone (cortisol, aldosterone, testosterone, or 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 symptoms.
Too much estrogen (in women) may cause:
* Irregular menstrual periods in women who have not gone through menopause.
* Menstrual bleeding in women who have gone through menopause.
Too much estrogen (in men) may cause:
* Growth of breast tissue.
* Lower sex drive.
* Impotence.
These and other symptoms may be caused by adrenocortical carcinoma. Other conditions may cause the same symptoms. A doctor should be consulted if any of these problems occur.
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 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 is given. The level of cortisol is checked from a sample of blood or from urine that is collected for three days.
* High-dose dexamethasone suppression test: A test in which one or more high doses of dexamethasone is given. The level of cortisol is checked from a sample of blood or from urine that is collected for three days.
* 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.
* Blood tests: Tests to measure the levels of testosterone or estrogen in the blood. A higher than normal amount of these hormones that may be a sign of adrenocortical carcinoma.
* 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 gland. A contrast dye is injected into the adrenal arteries. As the dye moves through the blood vessel, 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 gland. A contrast dye is injected into an adrenal vein. As the contrast dye moves through the vein, 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.
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.
Adrenocortical carcinoma may be cured if treated at an early stage.
Glossary Terms
abdomen (AB-doh-men) * The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
abnormal (ab-NOR-mul) * Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
acne (AK-nee) * A disorder of the skin in which oil glands and hair glands become inflamed.
adrenal cortex (uh-DREE-nul KOR-tex) * The outer part of the adrenal gland (a small organ on top of each kidney). The adrenal cortex makes androgen and corticosteroid hormones.
adrenal gland (uh-DREE-nul...) * A small gland that makes steroid hormones, adrenaline, and noradrenaline. These hormones help control heart rate, blood pressure, and other important body functions. There are two adrenal glands, one on top of each kidney. Also called suprarenal gland.
adrenal medulla (uh-DREE-nul meh-DOO-luh) * The inner part of the adrenal gland (a small organ on top of each kidney). The adrenal medulla makes chemicals such as epinephrine (adrenaline) and norepinephrine (noradrenaline) which are involved in sending nerve signals.
adrenocortical carcinoma (uh-DREE-noh-KOR-tih-kul KAR-sih-NOH-muh) * A rare cancer that forms in the outer layer of tissue of the adrenal gland (a small organ on top of each kidney that makes steroid hormones, adrenaline, and noradrenaline to control heart rate, blood pressure, and other body functions). Also called adrenocortical cancer and cancer of the adrenal cortex.
angiography (an-jee-AH-gruh-fee) * A procedure to x-ray blood vessels. The blood vessels can be seen because of an injection of a dye that shows up in the x-ray.
artery (AR-tuh-ree) * A blood vessel that carries blood from the heart to tissues and organs in the body.
Beckwith-Wiedemann syndrome (BEK-with-VEE-deh-mahn SIN-drome) * A rare, overgrowth disorder in which babies are large at birth and may develop low blood sugar. Other common symptoms are a large tongue, large internal organs, and defects of the abdominal wall near the navel. Beckwith-Wiedemann syndrome increases the risk of developing certain cancers, especially Wilms tumor.
blood (blud) * A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
blood chemistry study (blud KEH-mih-stree STUH-dee) * A procedure in which a sample of blood is examined to measure the amounts of certain substances made in the body. An abnormal amount of a substance can be a sign of disease in the organ or tissue that produces it.
blood pressure (blud PREH-sher) * The force of circulating blood on the walls of the arteries. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80).
blood vessel (blud VEH-sel) * A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.
breast (brest) * Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
cancer (KAN-ser) * A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
carbohydrate (KAR-boh-HY-drayt) * A sugar molecule. Carbohydrates can be small and simple (for example, glucose) or they can be large and complex (for example, polysaccharides such as starch, chitin or cellulose).
Carney complex (KAR-nee KOM-plex) * A rare, inherited disorder marked by dark spots on the skin and tumors in the heart, endocrine glands, skin, and nerves. There are two types of Carney complex, which are caused by mutations (changes) in different genes. Also called Carney syndrome.
catheter (KA-theh-ter) * A flexible tube used to deliver fluids into or withdraw fluids from the body.
cell (sel) * The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
contrast material (KON-trast muh-TEER-ee-ul) * A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.
CT scan (… skan) * A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.
cure (kyoor) * To heal or restore health; a treatment to restore health.
dexamethasone (DEK-suh-MEH-thuh-sone) * A synthetic steroid (similar to steroid hormones produced naturally in the adrenal gland). Dexamethasone is used to treat leukemia and lymphoma and may be used to treat some of the problems caused by other cancers and their treatment.
diagnosis (DY-ug-NOH-sis) * The process of identifying a disease, such as cancer, from its signs and symptoms.
dose (dose) * The amount of medicine taken, or radiation given, at one time.
estrogen (ES-truh-jin) * A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
functioning tumor (FUNK-shuh-ning TOO-mer) * A tumor that is found in endocrine tissue and makes hormones (chemicals that travel in the bloodstream and control the actions of other cells or organs).
glucose (GLOO-kose) * A type of sugar; the chief source of energy for living organisms.
hereditary (huh-REH-dih-tayr-ee) * Transmitted from parent to child by information contained in the genes.
high blood pressure (hy blud PREH-sher) * A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called hypertension.
hormone (HOR-mone) * One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
impotence * In medicine, refers to the inability to have an erection of the penis adequate for sexual intercourse. Also called erectile dysfunction.
injection (in-JEK-shun) * Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."
kidney (KID-nee) * One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.
Li-Fraumeni syndrome * A rare, inherited predisposition to multiple cancers, caused by an alteration in the p53 tumor suppressor gene.
malignant (muh-LIG-nunt) * Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.
menopause (MEH-nuh-pawz) * The time of life when a woman’s ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.
menstrual cycle (MEN-stroo-ul SY-kul) * The monthly cycle of hormonal changes from the beginning of one menstrual period to the beginning of the next.
MRI * A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging.
nonfunctioning tumor (non-FUNK-shuh-ning TOO-mer) * A tumor that is found in endocrine tissue but does not make extra hormones. Nonfunctioning tumors usually do not cause symptoms until they grow large or spread to other parts of the body. Also called endocrine-inactive tumor.
organ (OR-gun) * A part of the body that performs a specific function. For example, the heart is an organ.
PET scan (… skan) * A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.
pheochromocytoma (FEE-oh-KROH-moh-sy-TOH-muh) * Tumor that forms in the center of the adrenal gland (gland located above the kidney) that causes it to make too much adrenaline. Pheochromocytomas are usually benign (not cancer) but can cause high blood pressure, pounding headaches, heart palpitations, flushing of the face, nausea, and vomiting.
physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun) * An exam of the body to check for general signs of disease.
potassium (puh-TA-see-um) * A metallic element that is important in body functions such as regulation of blood pressure and of water content in cells, transmission of nerve impulses, digestion, muscle contraction, and heartbeat.
prognosis (prog-NO-sis) * The likely outcome or course of a disease; the chance of recovery or recurrence.
protein (PROH-teen) * A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.
radioactive (RAY-dee-oh-AK-tiv) * Giving off radiation.
risk factor (... FAK-ter) * Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.
scanner (SKA-ner) * In medicine, an instrument that takes pictures of the inside of the body.
sodium (SOH-dee-um) * A mineral needed by the body to keep body fluids in balance. Sodium is found in table salt and in many processed foods. Too much sodium can cause the body to retain water.
stage * The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
surgery (SER-juh-ree) * A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
symptom (SIMP-tum) * An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
testosterone (tes-TOS-teh-RONE) * A hormone made mainly in the testes (part of the male reproductive system). It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Testosterone may also be made in the laboratory and is used to treat certain medical conditions.
tissue (TIH-shoo) * A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer) * An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
urine (YOOR-in) * Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.
vein (vayn) * A blood vessel that carries blood to the heart from tissues and organs in the body.
venography (veh-NAH-gruh-fee) * A procedure in which an x-ray of the veins is taken after a special dye is injected into the bone marrow or veins.
x-ray (EX-ray) * A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.
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Stages of Adrenocortical Carcinoma
Key Points for This Section
* After adrenocortical carcinoma has been diagnosed, tests are done to find out if cancer cells have spread within the adrenal gland or to other parts of the body.
* There are three ways that cancer spreads in the body.
* The following stages are used for adrenocortical carcinoma:
* Stage I
* Stage II
* Stage III
* Stage IV
After adrenocortical carcinoma has been diagnosed, tests are done to find out if cancer cells have spread within the adrenal gland or to other parts of the body.
The process used to find out if cancer has spread within the adrenal gland or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:
* CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen or chest, 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) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A substance called gadolinium may be injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
* Adrenal angiography: A procedure to look at the arteries and the flow of blood near the adrenal gland. A contrast dye is injected into the adrenal arteries. As the dye moves through the blood vessel, 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 gland. A contrast dye is injected into an adrenal vein. As the contrast dye moves through the vein, 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.
* Cavagram: A procedure to look at the inferior vena cava and the flow of blood through the inferior vena cava. A contrast dye is injected into a blood vessel. As the contrast dye moves through the blood vessel to the inferior vena cava, a series of x-rays are taken to see if there are any changes to the inferior vena cava and the flow of blood through the inferior vena cava.
* Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the vena cava, and make echoes. The echoes form a picture of body tissues called a sonogram.
* Adrenalectomy: A procedure to remove the entire adrenal gland. A tissue sample is viewed under a microscope by a pathologist to check for signs of cancer.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
* Through tissue. Cancer invades the surrounding normal tissue.
* Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
* Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for adrenocortical carcinoma:
Pea, peanut, walnut, and lime show tumor sizes.
Stage I * In stage I, the tumor is 5 centimeters or smaller and is found only in the adrenal gland.
Stage II * In stage II, the tumor is larger than 5 centimeters and is found only in the adrenal gland.
Stage III * In stage III, the tumor can be any size and may have spread to fat or lymph nodes near the adrenal gland.
Stage IV * In stage IV, the tumor can be any size and has spread:
* to fat or organs and to lymph nodes near the adrenal gland; or
* to other parts of the body. Adrenocortical carcinoma commonly spreads to the lung, liver, bones, and peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen).
Glossary Terms
abdomen (AB-doh-men) * The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
abdominal (ab-DAH-mih-nul) * Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
abnormal (ab-NOR-mul) * Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
adrenal gland (uh-DREE-nul...) * A small gland that makes steroid hormones, adrenaline, and noradrenaline. These hormones help control heart rate, blood pressure, and other important body functions. There are two adrenal glands, one on top of each kidney. Also called suprarenal gland.
adrenalectomy (uh-DREE-nul-EK-toh-mee) * Surgery to remove one or both adrenal glands (a small organ on top of each kidney).
adrenocortical carcinoma (uh-DREE-noh-KOR-tih-kul KAR-sih-NOH-muh) * A rare cancer that forms in the outer layer of tissue of the adrenal gland (a small organ on top of each kidney that makes steroid hormones, adrenaline, and noradrenaline to control heart rate, blood pressure, and other body functions). Also called adrenocortical cancer and cancer of the adrenal cortex.
angiography (an-jee-AH-gruh-fee) * A procedure to x-ray blood vessels. The blood vessels can be seen because of an injection of a dye that shows up in the x-ray.
blood (blud) * A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
blood vessel (blud VEH-sel) * A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.
bone cancer (bone KAN-ser) * Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).
breast cancer (brest KAN-ser) * Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
capillary (KA-pih-layr-ee) * The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.
catheter (KA-theh-ter) * A flexible tube used to deliver fluids into or withdraw fluids from the body.
cell (sel) * The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
centimeter (SEN-tih-MEE-ter) * A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.
contrast material (KON-trast muh-TEER-ee-ul) * A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.
CT scan (… skan) * A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.
hormone (HOR-mone) * One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
inferior vena cava (in-FEER-ee-er VEE-nuh KAY-vuh) * A large vein that empties into the heart. It carries blood from the legs and feet and from organs in the abdomen and pelvis.
injection (in-JEK-shun) * Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."
invasive cancer (in-VAY-siv KAN-ser) * Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.
liver (LIH-ver) * A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lung * One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
lymph (limf) * The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.
lymph node (limf node) * A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
lymph vessel (limf ...) * A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.
lymphatic system (lim-FA-tik SIS-tem) * The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.
metastasis (meh-TAS-tuh-sis) * The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).
MRI * A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging.
organ (OR-gun) * A part of the body that performs a specific function. For example, the heart is an organ.
pathologist (puh-THAH-loh-jist) * A doctor who identifies diseases by studying cells and tissues under a microscope.
peritoneum (PAYR-ih-toh-NEE-um) * The tissue that lines the abdominal wall and covers most of the organs in the abdomen.
primary tumor (PRY-mayr-ee TOO-mer) * The original tumor.
sonogram (SAH-noh-gram) * A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called ultrasonogram.
stage * The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stage I adrenocortical cancer (... uh-DREE-noh-KOR-tih-kul KAN-ser) * Cancer of the adrenal gland that is smaller than 5 centimeters (smaller than 2 inches) and is found in the adrenal gland only.
stage II adrenocortical cancer (... uh-DREE-noh-KOR-tih-kul KAN-ser) * Cancer of the adrenal gland that is larger than 5 centimeters (about 2 inches) and is found in the adrenal gland only.
stage III adrenocortical cancer (... uh-DREE-noh-KOR-tih-kul KAN-ser) * Cancer of the adrenal gland that has spread into fat and lymph nodes near the adrenal gland.
stage IV adrenocortical cancer (... uh-DREE-noh-KOR-tih-kul KAN-ser) * Cancer of the adrenal gland that has spread to fat or organs and to lymph nodes near the adrenal gland or to other parts of the body, such as lungs, liver, bones, and abdomen.
staging (STAY-jing) * Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.
tissue (TIH-shoo) * A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer) * An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
ultrasound (UL-truh-SOWND) * A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.