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Did you know lung cancers can spread beyond the chest? The term “metastasis” refers to cancer that has spread from its original spot to one or more other parts of the body. Lung cancers frequently spread to the adrenal glands in addition to the brain, liver, and bones.
How do you know if your lung cancer has spread to your adrenal glands? What types of lung cancers are more likely to have adrenal gland metastases? Here, we’ll discuss what to expect when lung cancer spreads to the adrenal glands.
Adrenal glands are small glands that sit above the kidneys. The brain sends signals to the adrenal glands that tell them to make and release hormones into the bloodstream. These hormones are important for the following:
When the adrenal glands aren’t working well, any of the above processes might be affected.
Many people who have lung cancer that spreads to their adrenal glands don’t have symptoms. This can make it hard finding adrenal gland metastases difficult. Symptoms of adrenal gland metastasis can come about because the tumor is causing the adrenal glands to not work properly. This is more likely if the cancer has spread to both adrenal glands because neither one may be able to produce the right amount of hormones. Symptoms also tend to be general and similar to other types of tumors.
Symptoms might include:
One member of MyLungCancerTeam described their experience of having lung cancer with adrenal gland metastasis: “I was so sick. Just walking was hard, and I needed help with everything. I was on oxygen 24/7. Simply walking from the car into the building was hard.”
Because symptoms aren’t always specific, it is important to talk to your doctor if you develop any new symptoms or start feeling worse.
How well you can recover or live after adrenal gland metastasis is different for everyone. It depends on many factors, including:
Metastasis is a sign that your cancer is in an advanced stage of illness. Some people with lung cancer may live only a few months after cancer has spread to their adrenal glands. Others live for years after treatment for their adrenal gland metastasis.
Importantly, every case of adrenal gland metastasis is different. Staying positive and vigilant with your doctor appointments is important for giving yourself the best chance of feeling better.
Metastasis in the adrenal glands happens in both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). These are the two most common types of lung cancer; however, NSCLC makes up between 80 percent and 85 percent of all lung cancer cases, while SCLC accounts for between 10 percent and 15 percent of lung cancers.
In one study with participants diagnosed with NSCLC, nearly 17 percent had adrenal gland metastases. Additionally, people with NSCLC tumor cells without mutations (changes in their genes) are more likely to have adrenal metastasis.
An adrenal gland metastasis diagnosis is often incidental, especially if the person doesn’t have symptoms. This means that doctors often find cancer growth when they are looking for something else. Several types of tests can help doctors make an adrenal gland metastasis diagnosis.
There are several types of tests your medical team can run to get images of the adrenal glands that may help identify changes.
Ultrasound is a type of imaging that uses sound waves to look at your soft tissue or organs. Computed tomography (CT) scans use X-ray radiation to get many side-by-side scans of the inside of your body.
Your doctor will likely use a combination of ultrasound and CT to see if there are any unusual masses in your chest or abdomen. Neither imaging technology is 100 percent perfect, so the combination is useful for getting a more accurate read. CT and ultrasound can help your doctor see if there is a mass on the adrenal gland, but it won’t tell them if the mass is cancerous. These two technologies are frequently used to help perform an accurate biopsy, which we will discuss in the next section.
Positron emission tomography (PET) is another type of imaging that is helpful for diagnosis. When doctors know what type of cancer you started with, like a specific type of lung cancer, they are better able to detect cancerous masses on the adrenal glands with a PET scan.
A biopsy is a procedure where your doctor will take a sample of an organ or other tissue and analyze it under a microscope. They can test the sample to see if the cells are cancerous.
Blood tests that look at your hormone levels can be helpful for diagnosing adrenal gland metastases. Cancer in the adrenal glands can disrupt the amount of hormones made by your body. It can make your adrenal glands overproduce hormones; this condition is known as Cushing’s syndrome. Cancer in the adrenal glands can also lead to the underproduction of hormones, known as adrenal insufficiency.
You and your doctor will base your treatment for adrenal gland metastasis on your individual needs. Different types of treatment options might work for you.
In treating cancer where there are no metastases, many doctors’ first treatment choice is to surgically remove the primary tumor. Removing the tumor from the adrenal glands is not always the first treatment choice, though some people have successful removal surgeries. Some people may also choose to get an adrenalectomy, a surgery that removes the adrenal glands. This may be recommended for people who were diagnosed with adrenal metastases more than seven months after their original lung cancer diagnosis and who don’t have other metastases.
Radiation treatment, where radiation particles are delivered to the tumor, is useful for pain management and containing the spread. Specifically, a procedure called stereotactic body radiation therapy is the radiation treatment for adrenal gland metastases. This type of radiation therapy can deliver high amounts of radiation specifically to the tumor rather than to other parts of the body. Adrenal metastases are rarely treated with radiation.
Systemic treatments are medicines that work throughout the whole body. Systemic treatments that fight cancer include chemotherapy, targeted therapy, and immunotherapy. Doctors often use these treatments along with radiation or surgery, especially when cancer has spread to the adrenal glands.
To choose the best medicine, doctors test the cancer for specific markers, which are specific proteins, genes, or other molecules found in or on cancer cells. In the past, if these markers weren’t found, people with lung cancer would mainly receive chemotherapy. Now, doctors often use immunotherapy, alone or with chemotherapy, because it helps people with lung cancer live longer and keeps the cancer from getting worse quickly. Because of these new options, it’s quite rare for people diagnosed with lung cancer to receive only chemotherapy nowadays.
MyLungCancerTeam is the social network for people with lung cancer and their loved ones. More than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.
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Leonora Valdez Rojas, M.D.
received her medical degree from the Autonomous University of Guadalajara before pursuing a fellowship in internal medicine and subsequently in medical oncology at the National Cancer Institute.
Learn more about her here.
Hannah Actor-Engel, Ph.D.
is a multidisciplinary neuroscientist who is passionate about scientific communication and improving global health through biomedical research.
Learn more about her here.
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