Comprehensive Guide to Adrenal Cancer Treatment in India

Adrenal gland cancer is a rare but aggressive form of urological cancer with an estimated annual incidence of 0.5–2 cases per million people in the world.

Why Choose India for Adrenal Cancer Treatment?

World-Class Medical Expertise

India has some of the top oncologists and specialists in adrenal cancer treatment. Many of these cancer professionals have international experience and training, making them highly skilled in diagnosing and managing adrenal cancer with advanced techniques.

Advanced Treatment Options

India offers a range of advanced and innovative treatments for adrenal cancer, from surgery to chemotherapy and radiotherapy. Robotic-assisted surgery, for instance, is commonly used to remove adrenal tumors with minimal invasion, leading to faster recovery and less risk of complications. Additionally, India is adopting the latest in immunotherapy and targeted therapy, offering patients access to world-class treatment options not widely available in many other countries.

Cost-effective Care

One of the most compelling reasons to choose India for adrenal cancer treatment is the cost-effectiveness of the services. Treatment costs in India are much lower as compared to treatment in countries like the US or the UK, without compromising the quality of care. This makes India an attractive destination for international patients seeking affordable yet high-quality healthcare.

High-Quality Infrastructure and Technology

The best oncology hospitals in India are equipped with the latest medical technologies and infrastructure to ensure effective diagnosis and treatment of adrenal cancer. Some cutting-edge imaging techniques such as PET scans, CT scans, and MRIs are widely available to identify tumours early and create a personalised treatment plan.

What is Adrenal Cancer and its Symptoms?

The adrenal glands are endocrine glands located on top of each kidney. These glands are essential for regulating various bodily functions by producing hormones. 

• The Adrenal Cortex, which is the outer layer, produces steroid hormones such as cortisol, aldosterone, and androgens.
• Adrenal Medulla, which is the inner layer, produces catecholamines like epinephrine and norepinephrine.

Adrenal tumours can cause an overproduction of hormones, Hyperaldosteronism, leading to symptoms such as:

• High blood pressure: If the tumour produces excess hormones like aldosterone or cortisol, it leads to persistent high blood pressure.
• Excessive hair growth (hirsutism) in women.
• Irregular or missed periods in women.
• Development of male characteristics (deep voice, increased muscle mass) in women or breast tissue enlargement (gynecomastia) in men.
• Cushing’s syndrome: It is characterised by excess weight gain, round face, and easy bruising, due to presence of excessive cortisol.

Adrenal cancer is an aggressive cancer originating in the cortex of the adrenal gland with a poor prognosis. Adrenal cancer can be classified into different types based on the part of the adrenal gland affected and the nature of the tumour. 

Adrenocortical Carcinoma (Adrenal Cortex Cancer)

This is a rare and aggressive cancer that originates in the outer layer, i.e,cortex of the adrenal gland. Cancer of adrenal cortex leads to overproduction of several hormones, leading to Cushing syndrome or Hyperaldosteronism.

Pheochromocytoma (Adrenal Medulla Tumor)

This is a benign tumour developed in the adrenal medulla, the cancer of which leads to excessive hormone secretion and fight or flight symptoms such as episodes of high blood pressure, excessive sweating, anxiety, and headaches.

Neuroblastoma

This is a rare form of adrenal cancer that primarily affects children below the age of 5 and develops in the immature nerve cells of the adrenal medulla. 

Secondary Adrenal Cancer (Metastatic Cancer)

This occurs when cancer from another part of the body spreads to the adrenal glands. Some common primary cancers that spread to the adrenal glands include lung, breast, kidney, and melanoma cancers.

Some other rare adrenal tumours include:

• Myelolipomas: These are benign tumours composed of fat and bone marrow-like tissue.
• Adrenal Sarcomas: These arise from the connective tissues of the adrenal gland and are extremely rare in occurrence
• Adenomas: These are benign tumors of the adrenal cortex that may cause hormone-related symptoms but are not cancerous in nature.

Like any other cancer, Adrenal cancer, though rare, can present with some common symptoms such as abdominal pain or discomfort and unexplained weight loss.

Stages of Adrenal Cancer

A staging system is used to describe the cancer spread. The standard staging systems [American Joint Committee on Cancer (AJCC) and the ENSAT (European Network for the Study of Adrenal Tumors)] are based on TNM categories.

1. T - Denotes the size of the primary tumour and whether it has spread (metastasised) to nearby organs
2. N - Indicates cancer spread to lymph nodes near the adrenal gland 
3. M - Denotes cancer’s spread to distant sites, such as other organs or lymph nodes.

After determining the TNM category, it is combined with stage grouping to assign an overall stage (numbered I through IV). The lower the number, the less cancer has spread.

• In stage I, the tumour size is 5 centimetres or smaller and is only found in the adrenal gland.
• In stage II, the tumour is > 5 centimetres and is only found in the adrenal gland.
• In stage III, the size of the tumour is variable, and it spreads to Nearby lymph nodes; Nearby tissues or organs (kidney, diaphragm, pancreas, spleen, or liver) or large blood vessels (renal vein or vena cava) may have spread to nearby lymph nodes
• In stage IV, the tumour is of any size and may spread to nearby lymph nodes and other body parts, such as the lung, bone, or peritoneum.

Approaches for Adrenal Cancer Treatment

Surgery

• Adrenalectomy: This involves surgical removal of one or both adrenal glands and is performed based on the tumour’s size and spread.

Sometimes, in the case of advanced cancer stage, that is, beyond stage 3, removing adjacent tissues or organs affected by metastasis is suggested.

• Laparoscopic Surgery: It is a minimally invasive adrenal cancer surgery in India used for smaller or early-stage adrenal tumors.
• Robotic Surgery: Robotic-assisted adrenalectomy is a cutting-edge procedure for adrenal cancer removal. This is considered among the minimal invasive adrenal cancer surgery options in India, currently being offered at top cancer hospitals in India. It enhances precision and minimises complications while surgically removing adrenal cancer cells.

It is offered at the top cancer centers in India with benefits including- reduced scarring, quicker recovery, and shorter hospital stays.

Radiation Therapy

Radiation therapy is incorporated post-surgery in order to eliminate residual cancer cells. Also, radiation therapy is used as palliative care for advanced-stage cancer.

Chemotherapy

A standard chemotherapeutic drug specifically effective for adrenal cancer is Mitotane. It works by suppressing adrenal hormone production and thus shrinking tumours.

Targeted Therapy

By blocking specific proteins or pathways that fuel cancer growth, this approach is gaining traction in India’s leading cancer hospitals.

Hormonal Therapy

• This therapy manages hormone overproduction caused by the tumour.
• For example- high cortisol levels lead to Cushing’s syndrome, high aldosterone levels lead to Hyperaldosteronism, and excess androgens or estrogens cause Virilization or feminisation.
• By managing these hormones, the symptoms and associated syndromes can be controlled.

Radiotherapy

Radiotherapy has evolved significantly to deliver more precise and effective treatment for adrenal cancer treatment in India, especially when the tumour is inoperable or to control the residual or recurrent disease. Two advanced forms of radiation therapy include:

• Stereotactic Body Radiation Therapy (SBRT)

SBRT uses advanced imaging (CT, MRI, PET scans) to precisely locate the tumor and target it with high precision.

• In approximately 1–5 sessions (compared to 20–30 sessions for conventional radiation), high radiation doses are effective at killing cancer cells, even in cases where surgery is not possible

SBRT is a preferred approach in the case of:

• Unresectable adrenal cancer
• Patients unfit for surgery due to their health conditions
• Palliation of symptoms in advanced or metastatic cases

Intensity-Modulated Radiation Therapy (IMRT)

IMRT is another advanced radiotherapy technique that uses multi-leaf collimators to sculpt the radiation dose according to the tumor’s 3D shape.

• In approximately 20-30 sessions, high radiation doses are effective at killing large-size tumours.

IMRT is a preferred approach in the case of:

• Complexly shaped Adrenal tumour.
• Large or irregularly shaped adrenal tumours

Proton Therapy

This is a form of targeted radiation that spares surrounding healthy tissues, reducing collateral damage and side effects compared to conventional radiation therapy.

We know that adrenal tumours are located near critical organs, such as the kidneys, liver, pancreas, and spinal cord, making precise targeting essential. Proton therapy is beneficial because it delivers radiation in a controlled way.

Success Rates of Adrenal Cancer Treatment in India

Considering the treatment of localised Adrenal Cancer, when surgery is combined with appropriate adjuvant therapy, offers a survival rate of 50-70% over five years.

Considering the treatment of Advanced Adrenal Cancer in India, Survival rates range between 20 and 30%. These rates are comparable to global standards, reflecting India’s competence in handling complex cancer cases. However, it depends on metastasis and patient response to therapy.

Adrenal Cancer Treatment Cost in India

The cost of adrenal cancer treatment in India is influenced by the choice of treatment, hospital infrastructure, and individual patient needs. 

Type and Stage of Cancer:

• Advanced stages or aggressive forms of adrenal cancer (e.g., adrenocortical carcinoma) require prolonged treatments, which increase the overall cost.

Treatment Type:

• Advanced therapies like proton therapy, targeted therapy, or immunotherapy tend to be more expensive compared to conventional chemotherapy or surgeries.
• Surgical options such as robotic adrenalectomy or minimally invasive laparoscopic surgeries also involve higher costs.

Hospital and Location:

• Premium hospitals in metropolitan cities like Delhi, Mumbai, or Bangalore charge more compared to smaller cities or government hospitals.

Technology Used:

• Cutting-edge technologies, such as robot-assisted surgery, Stereotactic Body Radiation Therapy (SBRT), or Intensity-Modulated Radiation Therapy (IMRT), may significantly increase costs but enhance precision and reduce side effects.

Number of Cycles or Sessions:

• Treatments requiring multiple sessions, such as chemotherapy, radiation, or immunotherapy, add to the cumulative expense.

Patient Factors:

• Co-existing medical conditions, complications, or the need for supportive care like hormone management or ICU stays can raise treatment costs.

Cost of Adrenal Cancer Treatment in India

Treatment Type	Cost in INR	Cost in USD
Adrenal Cancer Surgery	65,000 to 75,000	$ 7000 to $ 9000
Robotic Surgery	6,25,000	$ 11,000
Chemotherapy (per cycle)	30,000 to 40,000	$600 to $700
Targeted Therapy (per cycle)	1,00,000 to 1,50,000	$1,800 to $2,700
Radiation Therapy	2,00,000 to 3,00,000	$4,000 to $6,000
IMRT	3,00,000 to 4,00,000	$ 5,300 to $ 7,000

Best Doctors For Adrenal Cancer Treatment In India

Dr. Ramesh Sarin: Dr. Ramesh Sarin is one of the most highly-experienced Surgical Oncologists with an experience of over 40 years. He is keenly interested in breast reconstructive surgeries and surgical management.

Dr. Jalaj Baxi: Dr. Jalaj Baxi is a renowned Surgical Oncologist with over 28 years of experience. After completing his MS and DNB in General Surgery, he received a Diploma in Advanced Laparoscopic Oncologic Surgery in Japan. 

Dr. Vikram Pratap Singh: Dr. Vikram Pratap Singh is a highly-experienced Surgical Oncologist with over 35 years of experience. His clinical interest lies in Modern radiation techniquesClinical Oncology, Intensity Modulated Radiotherapy (IMRT), Stereotactic Radiotherapy and Radiosurgery, Image-Guided Radiotherapy (IGRT), 3-D Brachytherapy, Stereotactic Body Radiotherapy (SBRT), etc.

Dr. Shabber S Zaveri: Dr. Shabber S Zaveri is a renowned Surgical Oncologist with an experience of over 28 years. He has expertise in Head & Neck Tumor Surgery, Lung Cancer Treatment, Breast Cancer Treatment, Mastectomy, etc.

Dr. Sangram Keshari Sahoo: Dr. Sangram Keshari Sahoo is a highly skilled and internationally trained Surgical Oncologist with over 27 years of experience. His clinical interest includes head & neck oncology, thoracic oncology, GI & HPB oncology, breast and gynecological oncology, urological oncology, bone & soft tissue tumors, sentinel node biopsies, and HIPEC, among others.

Best Hospitals for Adrenal Cancer Treatment in India

If you are seeking treatment for adrenal cancer in India, here’s a guide to some top institutions. These hospitals are recognised for their comprehensive approach and are accredited by JCI and NABH.

Medanta - The Medicity, Gurgaon

Established in 2009, Medanta offers state-of-the-art cancer care, including advanced techniques like robotic and minimally invasive adrenalectomy for precise tumour removal. The hospital also provides cutting-edge options such as proton therapy and advanced radiotherapy techniques like SBRT and IMRT, ensuring precision and minimal side effects.

Kokilaben Dhirubhai Ambani Hospital, Mumbai

Since 2008, Kokilaben Hospital has been a leader in cancer care with its dedicated oncology unit. For adrenal cancer, the hospital provides a multi-disciplinary approach, offering treatments such as targeted therapy, immunotherapy, and advanced radiation techniques. Personalised treatment plans are developed based on the tumour’s stage and the patient’s condition.

BLK-Max Super Speciality Hospital, Delhi

With a strong reputation in oncology since 1959, BLK-Max offers comprehensive adrenal cancer care. The hospital provides advanced diagnostic imaging and cutting-edge treatments, including laparoscopic surgeries, chemotherapy, and innovative therapies like hormone management for functional adrenal tumours.

Apollo Hospitals, Greams Road, Chennai

Apollo Hospitals houses a world-class cancer institute known for its multi-modal approach to adrenal cancer. From early detection and advanced imaging to robotic surgeries, proton therapy, and personalised medicine, Apollo integrates prevention, treatment, and rehabilitation to provide holistic care.

Fortis Memorial Research Institute (FMRI), Gurgaon

FMRI has been a known destination for cancer care since 2001. It has been offering a multi-disciplinary team of specialists for adrenal cancer treatment. The hospital is renowned for minimally invasive surgeries, including robot-assisted adrenalectomy, alongside advanced therapies like SBRT, chemotherapy, and comprehensive post-treatment support, including psychological counselling for patients and families.

What Happens Before, During, and After Adrenal Cancer Surgery?

Before Adrenal Cancer Surgery

• Your doctor will perform some blood tests to assess hormone levels and overall health.
• Some imaging studies like CT, MRI and PET scans determine the size, location, and spread of the tumour.
• You need to stop smoking and make some dietary modifications to optimise recovery potential.

An endocrinologist evaluates whether the tumour is functional (producing hormones) and adjusts medications to stabilise hormone levels before surgery.

If the tumour is overproducing hormones (e.g., cortisol or adrenaline), medications are prescribed to control these levels as a part of hormonal therapy.

During Adrenal Cancer Surgery

General anaesthesia is administered a few hours prior to surgery to ensure that you remain unconscious and feel no pain during the entire surgery.

• Laparoscopic Adrenalectomy:

It is a minimally invasive option where small incisions and a camera are used to remove the tumour.

It is recommended if you have smaller, benign, or localised tumours.

• Open Adrenalectomy:

It is done with a large incision and performed when the tumour is large, invasive, or suspected to be malignant.

Since it requires a larger incision, it is recommended when adjacent tissues or organs need to be removed.

After Adrenal Cancer Surgery

• Patients are moved to a recovery area for close monitoring until the effects of anaesthesia diminishes off.
• For functional tumours, hormone levels are checked to ensure they normalise.
• Patients may receive temporary hormone replacement therapy if both adrenal glands are removed.

The average hospital stay is 2–7 days, depending on the surgical approach and individual recovery.

Rehabilitation and Follow-up Care After Adrenal Cancer Surgery in India

In India, Rehabilitation and follow-up care go beyond clinical treatments. The best hospitals in India ensure that the adrenal cancer treatment here is comprehensive and the treatment plan is based on the patient’s needs.

• Right after surgery, light activities like walking become your first step in recovery. Skilled physiotherapists in India work closely with you and create exercise plans to gently rebuild your strength.
• A well-balanced, protein-packed diet isn’t just food; it’s fuel for your body’s healing process. India’s top hospitals have expert dietitians who guide you on how to eat right and heal faster.
• Routine visits with your doctor include advanced blood tests and scans to ensure everything’s on track. Think of these as milestones in your recovery story.
• If you’ve had both adrenal glands removed, hormone replacement therapy becomes your trusted partner. Your care team will ensure you’re equipped to manage this seamlessly.

Your medical team keeps a close watch for signs of recurrence, so you can focus on living your life fully and confidently.

Frequently Asked Questions Related to Adrenal Cancer Treatment in India

What are the risk factors for Adrenal Cancer?

Adrenocortical carcinoma typically develops sporadically without a genetic link. In some cases, this cancer has been associated with genetic conditions, including Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, Carney complex, Lynch syndrome, Multiple endocrine neoplasia, and type 1 (MEN 1).

What is the survival rate of adrenal cancer treatment in India?

The 5-year survival rate for localised adrenal cancer is approximately 70%, while for advanced stage, it is less than 15% among patients with metastatic disease. 

What is the cost of treatment of adrenal cancer in India?

The cost of the treatment will vary based on the type of treatment, which can either be surgery, radiation therapy or proton therapy, location of the hospital and condition of patient health. The adrenal cancer treatment cost in India is relatively affordable in comparison to many developed nations which ranges between $ 7000 and $ 12000.

Do hospitals in India have facilities for treatment involving complicated adrenal cancer?

Yes, many top cancer hospitals in India provide advanced adrenal cancer treatments such as robotic surgery, targeted therapy, and high-precision radiation.

How do I choose the best hospital for adrenal cancer treatment in India?

You should look for JCI or NABH-accredited hospitals with dedicated oncology departments and experienced specialists for adrenal cancer.

How often are follow-up visits required after adrenal cancer surgery in India?

You should know that at initial stages of recovery, follow-ups are frequent, but they can reduce with time based on recovery outcomes.

Are treatment options in India personalised for adrenal cancer patients?

Yes, treatment plans are highly individualised based on the patient’s condition and cancer stage. In India, the best cancer hospitals have a team of endocrinologist, surgical and medical oncologists to offer personalised treatment to the patient.