Getting diagnosed and stages of adrenal cortical cancer
You will need several tests if you have symptoms of adrenal cortical cancer (ACC). These include blood and urine tests and scans such as CT and MRI scans. These all help doctors diagnose what is causing your symptoms.
If you have cancer, the tests and scans you have also 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.
CT scan
A CT scan is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. This can show where a tumour is, how big it is and whether it has spread anywhere else.
You usually have a CT scan of your chest and tummy (abdomen).
MRI scan
An MRI scan is a type of scan that uses magnetism and radio waves to take pictures of the inside of your body. It usually takes between 15 and 90 minutes.
PET-CT scan
A PET-CT scan combines a CT scan and a PET scan. This type of scan gives detailed information about your cancer. It can help to find out how big a cancer is and whether it has spread.
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.
