23Na‐MRI as a Noninvasive Biomarker for Cancer Diagnosis and Prognosis
Benign Adrenal Tumors Linked To Increased Cancer Risk
Individuals with nonfunctional adrenal tumors (NFATs) have an increased risk of developing cancer, according to study findings published in the Journal of the Endocrine Society.
The frequent use of high-resolution imaging techniques has resulted in higher rates of adrenal tumor identification. Although many of these tumors are benign and hormonally inactive, previous research findings link NFATs to cardiovascular and cancer-related mortality. However, the association between NFAT and cancer incidence remains unclear.
Researchers employed a population-based retrospective cohort design using Swedish national registers to examine cancer incidence among individuals diagnosed with NFATs. They identified patients with ICD-10 codes for adrenal neoplasms (D44.1 or D35.0) from 2005 to 2019, excluding individuals with prior malignancies or hormonally active tumors (eg, Cushing syndrome, pheochromocytoma).
Patients in the control group were randomly selected and matched on the basis of age, sex, and municipality. To minimize detection bias, the index date was set to 3 months after NFAT diagnosis. Sensitivity analyses were conducted among subgroups who underwent similar imaging.
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The increased cancer incidence remained in patients with NFAT irrespective of age, adrenalectomy or in the different sensitivity analyses.
The study included 17,726 patients with NFAT who were matched to 124,366 patients in the control group. A majority (60.8%) of the NFAT population were women, and the median age of NFAT diagnosis was 65 (IQR, 57-73) years.
Compared with patients in the control group, patients with NFAT had a significantly higher risk of developing cancer (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.26-1.37). This increased risk was observed among both sexes, but the incidence was slightly higher among women (aHR, 1.34; 95% CI, 1.26-1.41; P <.001).
Patients with NFAT had higher incidence rates of adrenal, thyroid, lung, stomach, small intestine, kidney, bladder, pancreatic, and other cancers than those in the control group. Breast and colorectal cancers showed only slight increases.
The risk for cancer was also slightly elevated among NFAT patients younger than 65 years of age, particularly for thyroid and kidney cancers. The researchers observed no major variations across age groups.
Among those undergoing adrenalectomy, the cancer risk remained elevated among NFAT patients compared with those in the control group (aHR, 1.40; 95% CI, 1.15-1.71).
Limitations include the lack of access to biochemical data or radiological reports, potential confounding, and potential undiagnosed adrenal tumors among the control group.
The investigators concluded, "Cancer incidence was found to be increased in patients with NFAT, with a slightly larger increase observed among females. The increased cancer incidence remained in patients with NFAT irrespective of age, adrenalectomy or in the different sensitivity analyses."
This article originally appeared on Endocrinology Advisor
Lung Cancer Resource Center
Surprising Signs You Might Have Lung CancerLearn the surprising signs that you could be dealing with lung cancer. Coughing and chest pain are the better-known ones, but, as you'll see in this WebMD slideshow, symptoms can crop up in other places in your body, too.
What Is Non-Small-Cell Lung Cancer?
About 80% of people who have lung cancer have non-small-cell lung cancer. NSCLC usually spreads more slowly than small-cell lung cancers.
Both cancers affect the lungs and have similar symptoms, but they're treated differently.
TypesThere are three main categories of NSCLC:
Adenocarcinoma: This is the most common type. It usually spreads more slowly than others, and it's more likely to be found earlier. It's often linked to a history of smoking, but it is also the most common type of lung cancer seen in nonsmokers.
It starts in the cells that make mucus, and it's usually found in the outer parts of your lung.
Squamous cell (epidermoid) carcinoma: This starts in the lining of the airways in the lungs. About a quarter of all lung cancers are this type. It's often linked to a history of smoking.
Large-cell (undifferentiated) carcinoma: This fast-growing cancer can be in any part of the lung. Because it spreads quickly, it can be harder to treat. About 10% of non-small-cell lung cancers are this type.
CausesMost lung cancers are linked to smoking. Many people who get lung cancer either smoke or have been around people who smoke.
Other things that make lung cancer more likely include:
You may not have any. NSCLC might be found during an X-ray or other exam you may have for something else.
If you do have symptoms, they can include:
If the cancer spreads to other parts of your body, you might have:
Your doctor will do an exam and ask you questions about your symptoms. They'll ask whether you smoke or have been around people who smoke. You might need tests to look for tumors in your lungs and to see whether the cancer has spread.
Tests might include:
Based on what your doctor finds, your cancer will be assigned a stage. It takes into account three things you may hear called TNM:
These three things are used together to determine the lung cancer stage: I, II, III, or IV. Some stages are subdivided into A and B. The lower the stage, the better your chances for recovery.
TreatmentThere are many of them for non-small-cell lung cancer. They're based on the spread of the cancer, as well as your overall health.
Surgery: If you have early-stage cancer, your doctor will probably suggest you have surgery to remove it. You could have all or part of your lung removed.
Radiation: This can kill the cancer cells left after surgery or may be the main treatment in place of surgery. Radiation can also shrink tumors before surgery so they're easier to remove. It uses high-energy rays to target cancer cells.
Radiofrequency ablation: High-energy radio waves are used to heat the tumor. Then electric current is passed through a probe to destroy your cancer cells. This is an option if you have small tumors that are near the outer edge of your lungs.
Chemotherapy: These drugs can be taken by IV or pills to help kill the cancer. You may get them before or after surgery, with radiation, or as the main treatment.
Targeted therapy: This focuses on the changes your cells go through when you get NSCLC. You'll usually get this when your cancer has spread. Sometimes you'll take these drugs along with chemotherapy.
Immunotherapy: This helps your own immune system fight your cancer. It does this by making it easier for your body to recognize and destroy cancer cells. You'll usually get this if your NSCLC is advanced, or after other treatments haven't worked.
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