Metastatic adrenal cancer means the cancer has spread beyond the adrenal gland to distant parts of the body. Cancer at this stage usually isn’t curable, but treatments can address symptoms and improve quality of life.

The adrenal glands sit on top of the kidneys and produce hormones that help regulate the salt in your body and help manage blood pressure. They also are involved with stress response. When cancer starts in these glands, this is adrenal cancer.

Adrenal cancer is very rare. While the exact number of cases diagnosed in the United States is not known, the American Cancer Society estimates it to be 200 cases a year.

Metastatic adrenal cancer is cancer that started in the adrenal glands but has spread to other organs and areas of the body. The most common organs that adrenal cancer spreads to are the liver and the lungs.

In this article, we take a look at the symptoms of metastatic adrenal cancer, as well as the diagnosis, treatment, and outlook for people with this stage of adrenal cancer.

Symptoms of metastatic adrenal cancer are usually related to the areas of spread. For instance, if you have a tumor in your lungs, you may have difficulty breathing.

But with adrenal cancer, symptoms may also be related to the hormones being made and can include:

Because many of these symptoms can be signs of a variety of diseases, it’s always best to see a medical professional if you notice anything unusual or out of the ordinary for you.

By the time a person usually notices any symptoms of adrenal cancer, the cancer has typically already grown and spread. Sometimes the cancer is found accidentally, and at an early stage, when tests are done for a completely unrelated issue.

To diagnose metastatic adrenal cancer, a doctor will do a physical exam, as well as take a complete medical history. Based on your symptoms and what they see, the doctor may order a variety of tests, including:

  • blood and urine tests (to check levels of adrenal hormones)
  • imaging tests (to look for small tumors)
  • angiography, which looks to see if any blood vessels are being affected by a possible tumor

Metastatic adrenal cancer is stage 4 adrenal cancer. At this stage, it’s not usually curable by surgery. But if doctors believe it’s possible to remove all of the cancer surgically, then they’ll recommend surgery.

Even if it’s not possible to completely remove the cancer, surgery called debulking may be performed. This is when as much tumor as possible is removed.

To relieve symptoms and shrink any remaining tumors, doctors may use radiation therapy. Chemotherapy may also be used to help ease symptoms and lower the amount of hormones being made, or even block the effects of the hormones.

Mitotane (Lysodren) is the most commonly used chemotherapy drug for treating adrenal cancer. It blocks the adrenal gland’s hormone production and may help to decrease tumor size.

Mitotane may also be combined with other drugs to treat advanced-stage adrenal cancer. These drugs may include:

Depending on your situation, your doctor might also ask if you’d be interested in enrolling in a clinical trial for new treatments if one is available.

Medical professionals talk about survival in terms of a 5-year relative survival rate. This means the percentage of people with the disease that are still alive 5 years after being diagnosed compared to people who don’t have the disease.

According to the American Cancer Society, which uses statistics from the SEER database, the 5-year relative survival rate for adrenal cancer in the United States between 2012–2018 is as follows:

Stage of cancer5-year relative survival rate
Localized: the cancer is only in the adrenal gland73%
Regional: cancer has spread to nearby lymph nodes or structures/tissues53%
Distant (metastatic): cancer has spread to other parts or organs of the body38%
All stages combined50%

It’s important to remember that statistics are just that: numbers. They don’t take into account individual circumstances or any mitigating factors. While they can be helpful for big-picture planning, it’s also helpful to remember that they aren’t the whole story.

Factors that influence survival include:

  • the stage of the cancer at diagnosis
  • your overall health
  • your age
  • the type of treatment you receive
  • how your body responds to treatment

While metastatic adrenal cancer isn’t curable, it is treatable. Treatments are available to address symptoms and help improve quality of life.

Adrenal cancer is most likely to spread to the liver and lungs but can spread anywhere in the body. Symptoms can vary, depending on where it has spread.

Knowing what symptoms to look for can help you keep track of any changes in symptoms. Let your healthcare team know about any new symptoms you may be experiencing.