Getting diagnosed and stages of adrenal cortical cancer
You will need several tests if you have symptoms of adrenal cortical cancer (ACC). This includes:
- blood and urine tests
- CT and MRI scans
If you have cancer, then these tests and scans help your doctor know about the stage. The stage of a cancer tells you how big it is and whether it has spread to other parts of the body. This helps your doctor decide which treatment you need.
Tests for ACC
Diagnosing ACC can be difficult. This is because there are many other conditions that can cause the same symptoms of ACC. Most of them are much more common than ACC.
Your GP will refer you to a specialist for tests if you have symptoms that could be caused by cancer.
Blood, urine and salivary tests
You have blood and urine tests to check your general health and to find the cause of your symptoms. You might have blood tests to check:
hormone 
levels in your blood- the number of
red blood cells , white cells and platelets - how well your
liver and kidneys are working
You may also have a 24 hour urine collection. This test measures the levels of certain hormones in the urine.
Your doctor may also ask you to have a salivary test to check the levels of hormones in your body.
Scans
Scans of your body can let you know where a tumour is, how big it is and whether it has spread anywhere else. This can help to stage the cancer.
The tests you might have include:
- CT scan
- MRI scan
- PET-CT scan
CT scan
CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.
You usually have a CT scan of your chest and tummy (abdomen).
MRI scan
MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body. It usually takes between 15 and 90 minutes.
PET-CT scan
A PET-CT scan combines a CT scan and a PET scan. The PET scan uses a mildly drug to show up areas of your body where cells are more active than normal.
A PET-CT scan can help doctors decide whether you can have an operation to remove ACC.
Biopsy
A biopsy means taking a sample of cells or tissue and looking at it under a microscope.
You don’t usually need a biopsy of the adrenal glands to diagnose ACC. This is because blood tests, urine tests and scans are more useful than a biopsy in diagnosing ACC.
Your doctor might take a biopsy from other parts of your body. This can tell them whether ACC has spread to other parts of the body.
Stages of ACC
The stage of ACC tells you about the size of the tumour and whether it has spread. This helps your doctor decide what treatment you need.
In the UK, doctors usually use the TNM system to stage ACC. TNM stands for Tumour, Node, Metastasis.
- T describes the size of the tumour
- N describes whether there are any cancer cells in the
lymph nodes - M describes whether the cancer has spread to a different part of the body
The doctor gives each factor (T, N and M) a number, depending on how far the cancer has grown.
Your doctor may also use a staging system developed by the European Network for the Study of Adrenal Tumours (ENSAT). Ask your doctor to explain the staging of the cancer and what that means for you.
Tumour (T) stages
There are four T stages, from T1 to T4.
T1 means the tumour is 5 cm or less.
T2 means the tumour is bigger than 5 cm.
T3 means the tumour has grown into the surrounding tissues.
T4 means the tumour has grown into nearby organs or blood vessels such as the vena cava.
Node (N) stages
There are two N stages, N0 and N1.
N0 means there are no cancer cells in the lymph nodes.
N1 means there are cancer cells in the lymph nodes.
Metastasis (M) stages
There are two M stages, M0 and M1.
M0 means there is no sign of cancer spread.
M1 means the cancer has spread to other parts of the body, such as the liver and lungs.
Treatment of ACC
The main treatments for ACC are surgery and chemotherapy.
Coping with ACC
Coping with a diagnosis of cancer can be difficult, especially when you have a rare cancer. There are things you can do and people who can help you cope with a diagnosis of cancer.
