Endocrine cancers are those found in tissues of the endocrine system, which includes the thyroid, adrenal, pancreas, parathyroid, and pituitary glands.

Adrenal Tumors

The adrenal glands are the pair of small endocrine glands located above the kidneys. They respond to signals from the nervous system and secrete hormones that regulate stress. The adrenal glands also produce hormones that help maintain metabolism as well as distinguish male and female physical and sexual characteristics.

There are two varieties of tumors that can proliferate on the adrenal glands:

  • Most growths are benign and symptoms are treatable.
  • Malignant adrenal tumors are rare, and generally grow as a result of metastasizing cancer that originated in a different organ.

Risk Factors

People with certain genetic conditions are at a higher risk for developing adrenal tumors. These include:

  • Li-Fraumeni syndrome
  • Carney Complex
  • Family history of adrenal tumors

Symptoms

Adrenal gland tumors do not always present the same group of symptoms, and may also not cause any symptoms at all. Nevertheless, the following symptoms may be warning signs:

  • Headaches
  • Unusual weight changes
  • Unusual anxiety
  • Heart palpitations or elevated blood pressure
  • Unusual hair growth
  • Disproportionate acne
  • Diminished sex drive
  • Muscle weakness
  • Easy bleeding or bruising

Diagnosis and Treatment

Your doctor can detect the presence of adrenal tumors in the following ways:

  • Biopsy: This is the most definitive diagnostic method. Doctors examine tissue samples for evidence of cancer.
  • Blood and Urine Tests: The levels of hormones produced under certain circumstances are present in blood and urine and are indicative of possible tumors.
  • Imaging: With either a CT scan or MRI, your physician can verify the existence of an adrenal tumor, as well as determine its exact size and placement.
  • Metaiodobenzylguanidine scan (MIBG): This is a special test administered during the course of two days. It is designed to show adrenal tumors that are not evident on other scans. On the first day, a patient gets an injection followed by a scan with a special camera. The next day, the scan is repeated.

After examining the results of one or more of these tests, your doctor may inform you that you have an adrenal tumor. Treatment is based on tumor size, location, and whether it is metastasizing. The primary types of treatment for adrenal tumors include: [link these to general cancer treatment pages]

  • Surgery
  • Radiation Treatment
  • Chemotherapy

Neuroendocrine Tumors

The brain and the nervous system provide the signals to the endocrine system to produce hormones that regulate bodily functions. Since these two systems are so interdependent, they are often referred to as the neuroendocrine system. Tumors that affect the functioning of cells within this system are collectively called neuroendocrine tumors.

The primary types of neuroendocrine tumors are:

  • Pheochromocytoma, which affects production of adrenaline and often presents in the adrenal glands.
  • Neuroendocrine tumors, which is a generic term for tumors that affect hormones in major organs (such as the pancreas).

Risk Factors

People are at a higher risk for developing neuroendocrine tumors because of certain factors that include:

  • Gender; men are more likely than women to develop Pheochromocytoma
  • Age; Pheochromocytoma patients are generally between 40 - 60 years old
  • Genetics

Symptoms

Each variation of neuroendocrine tumor presents specific symptoms.

  • Pheochromocytoma
  • Elevated blood pressure
  • Damp and sticky skin
  • Unusual anxiety
  • Heart palpitations
  • Nausea, headaches, fever
  • Neuroendocrine Carcinoma:
  • Hyper or hypoglycemia
  • Unusual weight changes
  • Unusual anxiety
  • Unexplained lumps
  • Jaundice
  • Unexplained bleeding
  • Unusual bowel or bladder changes
  • Ongoing night sweats

Diagnosis and Treatment

Doctors can detect the presence of neuroendocrine tumors in the following ways:

  • Biopsy: This is the most definitive diagnostic method. Doctors examine tissue samples for evidence of a tumor.
  • Blood and Urine Tests: The levels of hormones produced under certain circumstances are present in blood and urine and are indicative of possible tumors.
  • Imaging: With a CT scan, MRI, or X-ray, the doctor can usually verify the existence of a neuroendocrine tumor, as well as determine its exact size and placement.

After examining the results of one or more of these tests, your doctor may inform you that you have a neuroendocrine tumor. Treatment is based on where the tumor is located, how big it is, whether it is metastasizing, and the patient's general health. The primary types of treatment for neuroendocrine tumors include:

  • Surgery
  • Radiation
  • Chemotherapy

Parathyroid Tumors

The parathyroid glands are four pea-sized glands located in the neck near the thyroid. They secrete parathyroid hormone (PTH), which regulates calcium levels throughout the body. Tumors can form within the tissues of the parathyroid and tend to grow very slowly, impacting the body with over-production of PTH, also called hyperparathyroidism. The vast majority of parathyroid tumors are benign (not cancerous). In fact, parathyroid cancer has only been diagnosed in a few hundred cases.

Risk Factors

Besides genetics, there are no common characteristics that put people at higher risk for developing parathyroid cancer. Some patients with parathyroid cancer have already been suffering from parathyroid adenomas or hyperplasia.

Symptoms

The following symptoms may indicate the presence of a parathyroid tumor and the resulting hyperparathyroidism:

  • Lump or nodule in the neck
  • Pain in the bones or in the upper back
  • Fractures
  • Kidney stones
  • Pancreatitis
  • Muscle weakness
  • Trouble speaking
  • Vomiting
  • Fatigue
  • Weight loss
  • Constipation
  • Frequent urination
  • Extreme thirst

Diagnosis and Treatment

Cancer of the parathyroid can be difficult to detect, since symptoms are similar to those of simple hyperparathyroidism. At this time, there are no specific tests for these tumors, but an official diagnosis can emerge with the following:

  • Symptoms: A patient's symptoms strongly indicate the presence of a parathyroid tumor. The doctor surgically identifies and removes it.
  • During hyperparathyroidism surgery: During surgery to remove various non-cancerous lesions or growths from a patient with hyperparathyroidism, the surgeon may discover cancerous lesions.
  • After hyperparathyroidism surgery: Upon removal and examination of a seemingly non-cancerous lesion or growth from a patient with hyperparathyroidism, the doctor discovers it is indeed cancerous.
  • Symptoms after surgery: If a patient with hyperparathyroidism undergoes surgery but still experiences symptoms additional imaging tests can help verify the diagnosis. Tests include:
  • Scintigraphy and ultrasound for neck tumors
  • CT scan and MR scan

Surgery is the primary treatment for parathyroid tumors. Removal of nearby thyroid gland and lymph nodes may sometimes be performed. When cancer has metastasized, additional methods and drugs are necessary to help the body excrete excess calcium. These include:

  • Intravenous saline
  • Diuretics
  • Bisphosphonates
  • Gallium nitrate
  • Cinecalcet™

Pituitary Tumors

As tiny as a pea, and located towards the bottom center of the brain, the pituitary gland secretes hormones that stimulate other endocrine glands to function properly. The pituitary gland helps regulate metabolic functions, as well as growth, reproduction, and blood pressure levels.

Pituitary tumors are growths on the gland. Pituitary tumors can cause either too much or too little hormone production. In most cases, these tumors do not spread and are not considered cancerous.

Risk Factors

People are at a higher risk for developing pituitary tumors due to particular factors. These may include:

  • Age; patients are generally older
  • Family history

Symptoms

Since the pituitary gland regulates many other hormone-producing organs, symptoms can vary, depending on the affected area. Sometimes pituitary tumors themselves secrete hormones, causing biochemical symptoms.

Three or more of the following symptoms are generally present because of pituitary tumors:

  • Sexual dysfunction
  • Growth of jaw, hands, and feet
  • Breast secretion
  • Depression
  • Infertility
  • Growth issues
  • Osteoporosis
  • Joint pain
  • Excessive bruising
  • High or low blood pressure
  • Obesity
  • Cessation of menstrual periods
  • Nausea and vomiting
  • Seizures
  • Fatigue and weakness
  • Headaches or difficulty seeing
  • Unusual weight changes

Hormone-producing pituitary tumors can result in the following symptoms:

  • Weight gain in the upper back and gut
  • Development of a hump on the upper back
  • Unusual facial roundness or hardening facial features
  • Unusual growth in hands and feet
  • Leaking milky liquid from the breasts (women)
  • Breast growth (men)
  • Loss of muscle and body hair (men)
  • Irregular heart beat
  • Unusual jittery or ill-tempered moods

Diagnosis and Treatment

Your doctor can detect the presence of a pituitary tumor in the following ways:

  • Blood and Urine Samples: Abnormal hormone levels can be detected through the blood and urine.
  • Imaging: With either a CT scan or MRI, your physician can verify the existence of a pituitary tumor, as well as determine its exact size and placement.
  • Vision Tests: With an eye test, your doctor will be able to determine whether the pituitary tumor has grown large enough to significantly affect your vision.

After examining the results of one or more of these tests, your doctor may inform you that you have a pituitary tumor. Since the gland affects so many different bodily functions, the specific diagnosis is based on where the tumor is causing the majority of symptoms.

Treatment varies according to the size of the tumor, what structure it is affecting and how deeply embedded in the brain. With early detection and treatment, the prognosis for recovery is generally excellent.

  • Surgery: This is the most common option, especially in cases where the tumor is putting pressure on the optic nerve and causing vision problems
  • Radiation: This option can be used along with surgery or by itself. The two types of radiation therapy used are external beam radiation and gamma-knife radiosurgery.
  • Medication: Certain drugs can suppress overproduction of hormones and help reduce tumor size.

Thyroid Disorders

MedStar Health offers diagnosis and treatment of many thyroid disorders, including:

  • Underactivity of the thyroid
  • Overactivity of the thyroid
  • Thyroid nodules
  • Thyroid enlargement
  • Inflammation of the thyroid
  • Cancers of the thyroid

Occurrences

  • Approximately 12 million Americans are affected by thyroid disease.
    Thyroid diseases occur at least five times more frequently in women than in men.
  • As many as ten percent of women over age 65 have an underactive thyroid.
  • Thyroid dysfunction complicates between 5 percent and 9 percent of all pregnancies.
  • Thyroid nodules are common, but only between 5 and 10 percent of these are cancerous.

Diagnosis and Treatment

MedStar Health physicians work with other specialists to provide complete diagnosis, treatment, and monitoring of thyroid cancers. Diagnosis can include thyroid scans and sonograms to evaluate thyroid nodules and enlargement and to detect under or over functioning thyroids.  Fine needle biopsies of the thyroid are performed to evaluate benign or malignant growths of the thyroid These conditions can be treated with surgery or by optimizing thyroid hormone therapy or using medications to lessen thyroid gland activity.

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