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What do Adrenal Glands do?

Program: Advances in the Treatment of Adrenal Cancer
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Andrew Schorr:

Our other guest from MD Anderson is very experienced with this over many years.  That’s Dr. Rena Sellin who is also an endocrinologist, and her title these days now is clinical professor in the department of endocrine neoplasia and hormonal disorders at MD Anderson.  She’s been with MD Anderson more than 30 years now. 

Dr. Sellin, so I talk about a rare cancer.  First of all, the adrenal glands, it was imaged when he was being checked for his kidneys.  Where are the adrenal glands?  What do they do? 

Dr. Sellin:

The adrenal glands are two small glands on top of the kidneys.  They look a little bit like, you know those triangular paper boats that you can make, put that upside down with the peak on top.  It’s like a little triangular cap on top of the kidney.  That’s what they normally look like.  And they make several types of hormones.  One is cortisol, which is, it’s steroid but a physiologic one.  It regulates the body’s fluids and electrolytes.  It’s essential for life. 

Another hormone regulates blood pressure and the salt balance of the body.  And those are the hormones that are made by the outer rim of the adrenal gland, which is usually what gets involved with the adrenal cancer that we’re talking about.  There are some other parts to the adrenal that are probably off topic.

Andrew Schorr:

And if this cancer is not treated, chemotherapy and surgery as David had, what happens if it’s just left alone?  Is this a bad cancer, if you will? 

Dr. Sellin:

Adrenal cancer is generally, unfortunately, a very aggressive tumor, and because it is hiding in a rather silent part of the body it often gets to grow a lot without any symptoms, and that is a problem.  But of course not everything is the same.  There are some adrenal cancers that may grow more slowly and co-exist with their host pretty well for many years and a priori you can’t tell which is going to be which.  So we have to consider that we have to worry that we’re dealing with the fast-growing type and react quickly.  We can’t just sit around and see what happens.

Andrew Schorr:

Dr. Habra, there are statistics as, you know, anybody would look up, David looked up or I looked up when I was diagnosed with leukemia.  You see these statistics and then you immediately start to apply them for yourselves.  Dr. Sellin was just sort of getting at some variability here.  What do you tell people when they come to you at MD Anderson and maybe they’ve read the statistics and they think, well, that necessarily is me? 

Dr. Habra:

That’s exactly the case.  The statistics is just pulled from a group of patients, but sometimes if you’re pressed hard about providing numbers you provide numbers, but you don’t apply to an individual basis because you really cannot predict it.  This is just from a pool of patients, meaning there are some patients who did even worse and some who did better.  There is no way to apply all statistics with different ways to treat patients to the patient whom you’re dealing with.  But each patient has his own different expectations and you can--I mean, someone like David who was able to withstand chemotherapy followed by major surgery.  Others might not be able to, so I cannot really tell them up front, okay, this is the prognosis and this is what you’re going to follow.  No, this doesn’t work.

Andrew Schorr:

Well, there’s so much more to talk about including what are the treatment options today and where are we headed with understanding this cancer and refining treatment for it.  So we’re going to take a quick break.  When we come back we’re going to get Dr. Sellin to help us understand what are the symptoms if some are there.  Is it more common in some groups versus others, and we’ll also learn from both our medical experts more about treatment.  Before we’re done we’re going to get a message from David on what he would say to any of our listeners who may be just finding out that this may be going on for them or a loved one and what course of action he might suggest that they take.  It’s all coming up as we continue Patient Power right after this.

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