Definition Adenocarcinoma is the name of a broad category of cancers. This type of cancer comes from cells that line organs such as the bowel, lung, and breast.
What is going on in the body? Structures within the body are covered with layers of tissue. One of these layers of tissue is called the epithelium. It covers the inside of hollow organs and milk ducts in the breast. When cancer occurs in one of the cells of the epithelium, it is called an adenocarcinoma. The cancer is also categorised by the kind of tissue it arose from, such as breast or lung.
Cancer occurs when a cell undergoes changes that make it grow and multiply uncontrollably. The abnormal cell grows into a tumour. Cancer cells from the tumour can break off and spread to other parts of the body, or metastasise. New tumours may then form. In addition to spreading, adenocarcinoma also destroys tissue around it. If adenocarcinoma is not effectively treated, it will cause death from tissue destruction.
What are the signs and symptoms of the disease? Symptoms depend on which organ is affected by the tumour. Small adenocarcinomas can be difficult to detect. The tumour must be large enough to cause symptoms that prompt a person to investigate. For example, a breast cancer must be about the size of a fingertip to be felt. Large tumours destroy tissue around them, which can cause symptoms. A bowel adenocarcinoma may cause blood to appear in the stool when it is large enough to erode into a blood vessel.
What are the causes and risks of the disease? Smoking increases the risk for almost every kind of cancer. There may be other risk factors for adenocarcinomas in different organ sites. Each site may have different factors. For example, hormone replacement therapy may increase the risk of uterine adenocarcinoma. Bowel adenocarcinoma may be related to a diet high in fats or low in fibre. Similarly the risk for adenocarcinoma of the small intestine increases with a history of Crohn's disease or coeliac disease.
What can be done to prevent the disease? Avoiding risk factors like smoking is important to good health in general. There are no health behaviours that can prevent all cancers. It is important to detect cancer early. Routine physical examinations, breast self examination and testicular self examination help to find cancer in an early stage.
How is the disease diagnosed? When a lump is found, a piece of it must be taken in a biopsy and examined to see what it is. If adenocarcinoma is found, other tests may be done to determine the extent of the disease. This process is called staging, and usually includes specialised x-rays.
What are the long-term effects of the disease? If the cancer is not successfully treated, adenocarcinoma is fatal.
What are the risks to others? There are no risks to others. Adenocarcinoma is not spread from one person to another.
What are the treatments for the disease? Early stage
Adenocarcinoma is treated with one or more of the following: chemotherapy, radiation therapy, and surgery. Early stage disease is localised, and may be treated by surgery alone. The whole tumour and the tissue around it are removed. Sometimes chemotherapy is given after surgery to make sure that any cancer left behind is killed. This is called adjuvant therapy. The goal is to prevent the return of the cancer. Radiation may also be given to the area of the tumour to kill any disease left behind after surgery.
Advanced stage
The goal of treating adenocarcinoma that has spread is to improve the person's quality of life. This is done by shrinking tumours that are causing symptoms such as pain. Either radiation therapy or chemotherapy can be used. Radiation is a local therapy. Chemotherapy is absorbed into the blood stream and will act systemically. Advanced adenocarcinoma is not curable.
What are the side effects of the treatments? Side effects depend on the type of treatment chosen and the intensity of the therapy. The side effects of therapy are usually manageable. Treatment for advanced stage disease is designed to relieve symptoms, so side effects are minimised.
What happens after treatment for the disease? People who have early stage disease are followed to make sure the cancer does not return. People with advanced adenocarcinoma are followed to make sure that the disease is not progressing. If the disease does return or progress, then a different treatment can be tried.
How is the disease monitored? People who have been treated for adenocarcinoma should have routine physical examinations to look for signs of recurrence. The frequency of these examinations will decrease over time, if the disease has been successfully treated. For those whose disease has returned or is not controlled, physical examinations, specialised x-rays, and other tests are needed to monitor the response to therapy. Close monitoring will allow for changes in therapy if needed to maintain the best possible quality of life.
Author: Miriam P. Rogers, EdD, RN, AOCN, CNS Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 25/04/2005 Contributors Potential conflict of interest information for reviewers available on request
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