Endocrine cancer

A cancer that occurs in any part of the endocrine system. The endocrine system consists of hormone secreting endocrine glands such as the pituitary, thyroid, adrenal, pancreatic and adrenal glands. Cancers of these organs usually results in excessive hormone secretion. Examples of endocrine system cancers include adrenocortical carcinoma, thyroid cancer and Cushing's syndrome or adrenal tumor.

Endocrine cancers are a mixed group of diseases in which cancer cells are found in tissues of the endocrine system, which includes the thyroid, adrenal, pancreas, parathyroid, and pituitary glands. More than 25,000 people are diagnosed with thyroid cancer in the United States each year, but other types of endocrine cancer are rare. Although tumors of other endocrine glands are not uncommon, they are almost always benign.The difference between a cancer and a benign tumor (“adenoma”) is that cancers spread by invading neighboring or distant tissue, whereas benign tumors do not spread. Because endocrine glands normally secrete hormones, tumors of these glands may also secret hormones, often in abnormal amounts.

Cancers of the endocrine system affect the glands that make hormones, which serve as the body's chemical messengers. These uncommon cancers often can be treated successfully when found early. Organs affected by endocrine cancers include the thyroid gland, adrenal glands, islets of the pancreas, parathyroid glands, hypothalamus and pituitary gland.

Symptoms depend on where the cancer is growing in the body. A thyroid tumour may cause swelling in the neck, in the area of the thyroid. Other symptoms can include the effects of hormonal changes, which vary considerably from tumour to tumour.

Genes are typically found in normal human cells, but certain kinds of mutations may transform the normal cells. Inherited defects may cause a genetic mutation, whereas exposure to a carcinogen may cause an acquired mutation. Current evidence indicates that carcinogenesis results from a complex interaction of carcinogens and accumulated mutations in several genes.

Glands discharge hormones directly into the bloodstream. They have built in feedback mechanisms that maintain a proper balance of hormones, and prevent excess hormone secretion. Low concentrations of a hormone will often trigger the gland to secrete. Once the concentrations of the hormone in the blood rise this may cause the gland to stop secreting, until once again hormone concentrations fall. This feedback mechanism (which is characteristic of most glands) causes a cycle of hormone secretions.

Advances in diagnosis and treatment of endocrine cancer, a longer and better life is possible for patients today. Treatment planning takes into account the size and location of the tumor, whether it is likely to grow slowly or rapidly, and the general health and age of the patient. Four types of treatments may be used: Surgery is the most common treatment for endocrine cancer. The goal of the surgery is to completely remove the tumor and a safe margin of the tissue around it.

It is sometimes difficult to decide whether hyperparathyroidism in MEN1 is severe enough to need treatment, especially in a person who has no symptoms. The usual treatment is an operation to remove the three largest parathyroid glands and all but a small part of the fourth. After parathyroid surgery, regular testing of blood calcium should continue, since the small piece of remaining parathyroid tissue can grow larger and cause recurrent hyperparathyroidism. People whose parathyroid glands have been completely removed by surgery must take daily supplements of calcium and vitamin D to prevent hypocalcemia (low blood calcium).

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