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Adrenal activity in patients with advanced carcinomas
Surgery, Gynecology & Obstetrics
|April 1, 1981
Summary
Symptoms mimicking adrenal insufficiency in cancer patients often indicate increased, not decreased, adrenal activity. This study found heightened cortisol and catecholamine levels, suggesting a stress response rather than impaired function.
Area of Science:
- Endocrinology
- Oncology
Background:
- Disseminated carcinoma can present with symptoms resembling adrenal insufficiency.
- Adrenal gland metastases were excluded in this patient cohort.
Purpose of the Study:
- To investigate adrenal function in cancer patients exhibiting symptoms of adrenal insufficiency.
- To determine if these symptoms correlate with impaired cortisol secretion or altered adrenal activity.
Main Methods:
- Evaluated 39 patients with disseminated carcinoma, divided into symptomatic (Group B) and asymptomatic (Group A) groups.
- Assessed adrenal activity via plasma cortisol, dexamethasone suppression/ACTH stimulation tests, and urinary cortisol, epinephrine, and norepinephrine.
- Group B patients received cortisone acetate treatment post-evaluation.
Main Results:
- Symptomatic patients (Group B) showed increased cortisol secretion and epinephrine/norepinephrine excretion compared to Group A.
- Both groups responded appropriately to dexamethasone suppression and ACTH stimulation tests.
- Limited improvement was observed with cortisone acetate treatment in Group B.
Conclusions:
- Symptoms mimicking adrenal insufficiency in disseminated carcinoma are not indicative of impaired cortisol secretion.
- Elevated adrenal activity, likely a stress response, is common in these patients.
- Cortisone acetate treatment showed minimal efficacy in this context.