Adrenocortical cancer (ACC)

Is it really cancer ?

The diagnosis of ACC can be suspected before the operation but can only be confirmed after analysis of the tumour in the laboratory. Rapid progression of symptoms, development of signs related to secretion of sex-hormones from the opposite gender (e.g. extensive hair in a woman, growth of the breasts in a man), a very large tumour (> 10 cm) are all raising the suspicion of ACC.

How rare is this ?

ACC is a very rare tumour - it is estimated than 1 new case will appear per million population per year.

What I need to do ?

You need to be seen in a centre with experience in adrenal surgery (at east 12 cases per year ) and with an established and experienced multidisciplinary team confident in looking after patients with ACC.

After the initial consultation, analysis of blood/urine samples will establish if the tumour produces any hormones and a whole-body scan will be done to asses the presence of metastases (i.e. growth of cancer cells in organs outside the adrenal gland, such as liver and lungs). In the absence of metastases surgery is the best treatment. Metastatic ACC might benefit from urgent surgery but many patients are being offered chemotherapy first and surgery could be considered later.

Why should I come to Oxford for treatment ?

I have the largest experience in operating patients with ACC with excellent outcomes in complex cases, some of whom were refused surgery in other centres. Since my appointment as a Consultant in Oxford in 2007 I operated over 65 patients with ACC - the largest single-centre experience in the United Kingdom. These figures should be seen in the context of official reports that patients with ACC are operated by surgeons who at most did 1 case in the previous year.

I represented the European Society o Endocrine Surgeons in a multidisciplinary European group tasked to write the guidelines for treatment of ACC (link) and I act as a medical advisor for a patients’ support group .

I would be very happy to see you in Oxford (use Contact us).