Diagnosing Adrenal Cancer
Any patient who is suspected of having adrenal cancer should undergo a complete medical evaluation. Many tests may be necessary in order to know for sure. The most important steps to make a diagnosis of adrenal cancer are:
- Clinical history and physical exam. The doctor will obtain detailed information about symptoms and personal and family history. A thorough physical exam and blood and urine tests will be done.
- Urine and blood hormone tests. The adrenal gland makes different hormones, which travel in the blood before being passed out of the body with the urine. Blood tests and 24-hour urine sampling can be very helpful to see what kind of cancer is in the body, especially adrenal cancers. Occasionally, blood can be taken directly from the site where the hormones are produced: the veins of the adrenal gland.
- Activating and inhibitory blood tests. The hormone production of the adrenal glands is under strict regulation in the body. Injections of certain medications to increase or decrease hormones made by the adrenal glands will usually lead to more or less hormone being detected in the blood. Cancer, however, does not usually react to these stimuli.
Imaging Tests
- Ultrasonography. This test uses sound waves to look for abnormalities. The sound waves bounce off body parts and send back an image, like sonar on a submarine. A computer then looks at the signals sent back by the sound waves and creates an image of the body using those signals. This test is very helpful in seeing if an adrenal tumor is a cyst, a fluid-filled sac that is probably not cancer, or a solid tumor, which is more likely to be cancer. Ultrasound can also estimate the size of the mass.
- Computed tomography (CT) scan. A CT scan uses X-rays. In this test, an X-ray beam moves around the body and takes pictures of the body from many angles. These different pictures are then combined by a computer, giving the doctor a very detailed cross-section of the body. CTs can measure size well and can suggest the density of the mass, which may help in telling the difference between a benign mass and cancer.
- Magnetic resonance image (MRI). An MRI uses magnets and radio waves to take pictures of the inside of the body. It yields detailed pictures, a lot like a CT scan. MRIs can be useful because they show more detail than other types of imaging tests.
- Nuclear imaging tests. For these tests, slightly radioactive substances are injected into the body. Depending on the substance, it may be more likely to collect in cancer cells or in different types of adrenal tumors. The radiation can then be detected with a special type of camera, showing where the tumors are.
- Biopsy. If a doctor finds something that may be cancer, the doctor may want to take a small sample of the tumor with a hollow needle. This is called a biopsy. The sample taken during a biopsy is looked at under a microscope by a doctor, called a pathologist, who specializes in looking for cancer. The pathologist looks at the cells to see if cancer is present.
Trial Administration