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Adrenal glands kya hain
Aap ki do adrenal glands hoti hain, har kidney ke oopar aik. Yeh chhoti lekin bohat ahem hain. Yeh aise hormone banati hain jo blood pressure, khoon mein namak aur potassium, jism ke tanao aur sugar sambhalne, aur kuch jinsi hormones ko qaboo mein rakhte hain.
Adrenal glands mein ganthein ban sakti hain. Zyadatar cancer nahi hoti. Yeh guide batati hai ke kaun kaun si qismein hoti hain, kuch ganthein zyada hormone ki wajah se alamaat kyun deti hain, un ki jaanch kaise hoti hai, aur asli adrenal cancer ka ilaaj kaise hota hai. Adrenal cancer nadir hai, lekin us ke liye maahir dekh bhaal ki zaroorat hoti hai.
Agar scan mein aap ki adrenal gland mein ganth nazar aayi hai to meherbani karke ghabrayein nahi. Ittefaq se milne wali zyadatar adrenal ganthein nuqsan-rahit hoti hain. Phir bhi un ki theek jaanch zaroori hai, kyunke kuch hormone banati hain aur kuch cancer hoti hain.
Adrenal ganthein kitni aam hain
Adrenal ganthein kaafi aam hain, khaas tor par umar barhne ke saath, aur bohat si ittefaq se milti hain jab kisi aur wajah se scan hota hai, masalan pait dard ya kidney ki pathri ke liye ultrasound ya CT scan. Doctors ise adrenal incidentaloma kehte hain, jis ka matlab sirf ittefaq se mili hui ganth hai. Asli adrenal cancer bohat nadir hai.
Adrenal ganth ki qismein
Mukhya imkanaat yeh hain:
- Nuqsan-rahit (benign) ganth, jise adenoma kehte hain. Yeh sab se aam hai. Bohat si kuch nahi karti aur sirf nigrani ki zaroorat hoti hai. Kuch zyada hormone banati hain.
- Aisi ganth jo zyada hormone banati hai. Kuch nuqsan-rahit ganthein bohat zyada cortisol (Cushing syndrome), ya bohat zyada aldosterone (high blood pressure aur kam potassium) banati hain.
- Phaeochromocytoma. Aik nadir ganth jo adrenaline jaise hormone banati hai. Is se sar dard, pasina aur tez dhadkan ke daure, aur bohat high blood pressure ho sakta hai. Zyadatar cancer nahi hoti, lekin kisi bhi operation ya biopsy se pehle ehtiyat se tayyari chahiye.
- Adrenal cancer (adrenocortical carcinoma). Adrenal gland ka nadir cancer. Yeh aksar bari hoti hai, tezi se barhti hai, aur hormone bana sakti hai.
- Cancer jo kisi aur jagah se adrenal gland tak phail gaya ho, jaise phephra, kidney ya chhati. Is ka ilaaj asli cancer ke mutabiq hota hai.
Sirf tests batate hain ke ganth kis qism ki hai. Meherbani karke sirf size ya alamaat se faisla na karein, aur jab tak hormone tests na ho jayein operation ya sooi se sample na lein.
Aam alamaat
Bohat si adrenal ganthein koi alamat nahi deteen. Jab alamaat hoti hain to do wajohat se aati hain.
Hormone ka zyada hona:
- Aisa high blood pressure jo mushkil se qaboo ho, ya jo kam umar mein shuru ho.
- Pait aur chehre par wazan barhna, aasani se neel parna, jamni khinchao ke nishan, patli jild, kamzor patthe, naya diabetes ya mizaj mein tabdeeli (Cushing syndrome).
- Kamzori, patthon mein khinchao ya thakan kam potassium ki wajah se, kabhi kabhi high blood pressure ke saath.
- Sar dard, pasina, dhadkan tez hona, bechaini ya peelahat ke daure, jo aate jate rehte hain.
- Kuch nadir hormone banane wale cancers mein auraton mein jism ke baal ya awaaz mein tabdeeli, ya mardon mein chhati ka barhna.
Ganth ke size ki wajah se:
- Pehlu ya pait mein halka dard ya bhaari pan.
- Bari ganth ke saath be-wajah wazan ka kam hona, bhook ka kam hona ya thakan.
Aisa high blood pressure jo mushkil se qaboo ho, ya kam umar mein bohat zyada ho, doctor ko kidneys ke saath saath adrenal glands ke baare mein bhi sochne par majboor karna chahiye.
Tashkhees kaise hoti hai
Do sawalon ka jawab chahiye: kya ganth hormone bana rahi hai, aur kya woh nuqsan-rahit lagti hai ya shak wali? Aap ka doctor aam tor par:
- Alamaat aur sehat ke baare mein poochega aur aap ka blood pressure check karega.
- Khoon aur peshab ke hormone tests likhega. Yeh tab bhi kiye jate hain jab aap ko koi alamat na ho, kyunke ganth khamoshi se hormone bana sakti hai. Kisi bhi operation se pehle yeh zaroori hain.
- CT ya MRI scan likhega. Ganth ka size aur shakal batati hai ke woh nuqsan-rahit hai ya shak wali. Chhoti, chikni, saada nazar aane wali ganth bohat imkaan se nuqsan-rahit hoti hai. Bari ya na-hamwar ganth par zyada tawajjo chahiye.
- Kabhi PET scan ya kuch mahine baad dobara scan likhega yeh dekhne ke liye ke ganth barh rahi hai ya nahi.
- Agar cancer ka shak ho to phailao ki jaanch karega.
Adrenal ganth ki sooi se biopsy ki shazo nazar zaroorat hoti hai aur agar ganth phaeochromocytoma ho to khatarnak ho sakti hai, is liye yeh sirf khaas halaat mein ki jati hai. Meherbani karke urologist ya endocrinologist se baat kiye baghair is par raazi na hon.
Agar cancer ho: marhale aasaan alfaaz mein
Jab ganth adrenal cancer ho to doctors batate hain ke woh kitna barh chuka hai. Is se ilaaj tay hota hai:
- Localised: cancer adrenal gland ke andar hai.
- Locally advanced: yeh gland se bahar aas paas ke tissue ya qareebi ozu mein, ya qareebi bari rag (vein) mein barh gaya hai.
- Phail gaya (metastatic): yeh jism ke doosre hissoon, jaise jigar, phephre ya haddiyon tak pohanch gaya hai.
Shuru ka adrenal cancer sab se zyada qabil-e-ilaaj hota hai, aur operation sab se behtar mauqa deta hai. Jab yeh phail chuka ho to ilaaj ka maqsad usay qaboo mein rakhna aur aap ko aaram mein rakhna hota hai. Aap ke doctors aap ke apne maamle mein imaandari se batayenge ke kya haqeeqat pasandana hai.
Ilaaj ke tareeqay
Ilaaj ganth ki qism, kya woh hormone banati hai, us ka size aur shakal, aur aap ki sehat par mabni hota hai. Mukhya tareeqay yeh hain:
Adrenal tumours ki behtar dekh bhaal aik team karti hai: urologist ya surgeon, endocrinologist (hormone ka maahir), aur cancer ke liye oncologist. Meherbani karke doosri raaye lene, ya is tajarbe wale markaz tak refer hone mein hichkichayen nahi.
Ilaaj ke baad zindagi
Bohat se log ilaaj ke baad aam zindagi guzarte hain. Kuch baatein madad karti hain:
- Hormone ki goliyan bilkul waise hi lein jaise likhi gayi hon, agar di gayi hon. Kabhi achanak band na karein, kabhi khatam na hone dein, aur aisa parcha ya card saath rakhein jis par likha ho ke aap yeh goliyan lete hain.
- Agar aap ko ulti, dast ya bukhar ke saath tabiyat kharab ho, ya aap goliyan na rakh paayen, to usi din apne doctor se rabta karein. Aap ko zyada sahara ya drip ki zaroorat ho sakti hai, kyunke tanao mein jism hamesha zyada hormone nahi bana sakta.
- Jo bhi doctor ya dentist aap ka ilaaj kare usay operation ya nayi dawaiyon se pehle apni adrenal surgery ke baare mein batayein.
- Apna blood pressure, khoon ka sugar aur potassium check karwayein jaisa aap ka doctor mashwara de.
- Khandani jaanch ke baare mein poochein. Kuch adrenal tumours khandan mein chalte hain ya kam umar mein hote hain. Agar aap kam umar mein mutasir hue, ya rishtedaron ko aisi ganthein hui hon, to genetic mashwaray ke baare mein doctor se poochein.
Follow-up
Ilaaj ke baad aap ko kai saal tak khoon aur peshab ke tests aur scans ke saath check-ups ki zaroorat hogi. Maqsad ganth ke wapas aane ko jaldi pakarna, hormone ki satah dekhna, aur aap ka blood pressure nigrani mein rakhna hai. Kitni dafa, yeh ganth ki qism aur ilaaj par mabni hai. Meherbani karke theek mehsoos karne par bhi in visits ko na chhodein, aur har baar apni scan reports aur nataij saath layein.
Fauran madad kab lein
Agar aap ko in mein se koi bhi ho to foran apne qareebi hospital ke emergency department jayein:
- Achanak shadeed sar dard, tez dhadkan, bohat pasina ya seene mein dard, khaas tor par agar aap jaante hon ke aap ko adrenaline jaise hormone banane wali ganth hai, ya aap ka blood pressure bohat high ho.
- Shadeed kamzori, chakkar, behoshi, baar baar ulti ya dast, uljhan ya gir jana, khaas tor par agar aap hormone replacement ki goliyan lete hon ya adrenal operation ho chuka ho. Yeh adrenal crisis ho sakta hai.
- Aap ulti ki wajah se hormone ki goliyan nahi rakh paate.
- Pehlu ya pait mein achanak shadeed dard, chakkar ya peele, pasine wale chehre ke saath.
- Operation ke baad: bukhar, zakhm ka surkh hona, behna ya khulna, shadeed dard, ya soojhi hui dardnak taang.
Meherbani karke intezar kiye baghair jaldi doctor ko bhi dikhayein agar aap ka blood pressure mushkil se qaboo hota ho, sar dard aur pasine ke baar baar daure parte hon, ya wazan barhne ke saath aasani se neel aur jamni khinchao ke nishan hon. Is ke liye emergency ki zaroorat nahi, lekin check hona chahiye.
Aam sawalaat
Scan mein meri adrenal gland mein ganth nazar aayi hai. Kya yeh cancer hai?
Zyada imkaan hai ke nahi. Ittefaq se milne wali zyadatar adrenal ganthein nuqsan-rahit hoti hain. Lekin phir bhi hormone tests aur scan ko ehtiyat se dekhna zaroori hai, yeh jaanne ke liye ke woh hormone banati hai ya shak wali lagti hai. Aap ka urologist ya endocrinologist is ka intezam karega.
Kya har adrenal ganth ke liye operation chahiye?
Nahi. Bohat si chhoti, nuqsan-rahit, hormone na banane wali ganthon ko sirf dekhne ki zaroorat hoti hai. Operation un ganthon ke liye mashwara diya jata hai jo hormone banati hain, barhti hain, ya shak wali lagti hain.
Kya main aik adrenal gland ke saath reh sakta hoon? Agar dono nikal di jayen to?
Ji haan, aam zindagi ke liye aik gland kaafi hai. Agar dono glands nikal di jayen, ya baqi gland waqti taur par band ho, to aap ko hormone replacement ki goliyon ki zaroorat hogi, aam tor par zindagi bhar, aur aap ka endocrinologist rehnumai karega.
Agar main theek mehsoos karta hoon to hormone tests kyun chahiye?
Kyunke ganth wazeh alamaat diye baghair hormone bana sakti hai, aur kuch, jaise phaeochromocytoma, agar chhoot jayein to operation khatarnak ho sakta hai.
Kya high blood pressure hamesha kidney ya tarz-e-zindagi ki wajah se hota hai?
Nahi. Thore se logon mein, khaas tor par jawan logon mein, yeh adrenal ganth ke hormone banane ki wajah se hota hai. Agar aap ka blood pressure mushkil se qaboo hota ho ya kam umar mein shuru hua ho to apne doctor se poochein.
Kya adrenal cancer qabil-e-ilaaj hai?
Jab yeh jaldi pakra jaye aur poori tarah nikala ja sake to operation kuch logon ko theek kar sakta hai. Koi bhi shifa ka waada nahi kar sakta, aur jab yeh phail chuka ho to maqsad usay qaboo karna hota hai. Aap ke doctors aap ko imaandari se batayenge ke aap ke maamle mein kya umeed rakhni chahiye.
Kya adrenal ganth khandan mein chalti hai?
Aam tor par nahi. Thore se maamlaat nadir khandani halat se jure hote hain. Agar aap kam umar mein mutasir hue, ya rishtedaron ko aisi ganthein hui hon, to meherbani karke apne doctor ko batayein.
Kya jari booti, "desi" nuskhay ya khaas khurak adrenal masail mein madad karte hain?
Un ke adrenal ganth ke ilaaj ka koi achha saboot nahi, aur kuch jari bootiyan blood pressure barhati hain ya hormone par asar daalti hain. Meherbani karke kisi nuskhay ke liye theek tests ya ilaaj mein der na karein, aur jo kuch bhi aap lete hain woh doctor ko batayein.
What the adrenal glands are
You have two adrenal glands, one sitting on top of each kidney. They are small but important. They make hormones that control blood pressure, salt and potassium in the blood, how your body handles stress and sugar, and some of the sex hormones.
Lumps can grow in the adrenal glands. Most are not cancer. This guide explains the different kinds, why some cause symptoms through extra hormones, how they are tested, and how true adrenal cancer is treated. Adrenal cancer is rare, but it needs expert care.
If a scan has shown a lump in your adrenal gland, please do not panic. Most adrenal lumps found by chance are harmless. They still need a proper check, because some make hormones and a few are cancer.
How common adrenal lumps are
Adrenal lumps are quite common, especially as people get older, and many are found by chance when a scan is done for another reason, for example an ultrasound or CT scan for tummy pain or kidney stones. Doctors call this an adrenal incidentaloma, which simply means a lump found by accident. True adrenal cancer is very rare.
Types of adrenal lump
The main possibilities are:
- A harmless (benign) lump, called an adenoma. This is by far the most common. Many do nothing and need only watching. Some make extra hormones.
- A lump that makes extra hormones. Some benign lumps make too much cortisol (causing Cushing syndrome), or too much aldosterone (causing high blood pressure and low potassium).
- A phaeochromocytoma. A rare lump that makes adrenaline-type hormones. It can cause attacks of headache, sweating and a racing heart with very high blood pressure. Most are not cancer, but they need careful preparation before any operation or biopsy.
- Adrenal cancer (adrenocortical carcinoma). A rare cancer of the adrenal gland. It is often larger, grows faster, and may make hormones.
- Cancer that has spread to the adrenal gland from somewhere else, such as the lung, kidney or breast. This is treated according to the original cancer.
Only tests can tell which type a lump is. Please do not decide from size or symptoms alone, and please do not have an operation or a needle sample until the hormone tests have been done.
Common symptoms
Many adrenal lumps cause no symptoms at all. When symptoms occur, they come from two causes.
Too much hormone:
- High blood pressure that is hard to control, or that starts at a young age.
- Weight gain around the tummy and face, easy bruising, purple stretch marks, thin skin, weak muscles, new diabetes or mood changes (Cushing syndrome).
- Weakness, muscle cramps or tiredness from low potassium, sometimes with high blood pressure.
- Attacks of headache, sweating, pounding heart, anxiety or paleness, which may come and go.
- Changes in body hair or voice in women, or breast enlargement in men, in some rare hormone-making cancers.
The size of the lump:
- A dull pain or feeling of fullness in the side or tummy.
- Unexplained weight loss, loss of appetite or tiredness with a larger tumour.
High blood pressure that is difficult to control, or very high at a young age, should always make a doctor think about the adrenal glands as well as the kidneys.
How it is diagnosed
Two questions need answering: is the lump making hormones, and does it look harmless or suspicious? Your doctor will usually:
- Ask about symptoms and health and check your blood pressure.
- Arrange blood and urine hormone tests. These are done even if you have no symptoms, because a lump can make hormones silently. They are essential before any operation.
- Arrange a CT or MRI scan. The size and the look of the lump help show whether it is harmless or suspicious. A small, smooth, simple-looking lump is very likely harmless. A larger or irregular one needs closer attention.
- Sometimes arrange a PET scan or repeat scans after a few months to see whether a lump is growing.
- Check for spread if cancer is suspected.
A needle biopsy of an adrenal lump is rarely needed and can be dangerous if the lump is a phaeochromocytoma, so it is done only in special situations. Please do not agree to one without talking to a urologist or endocrinologist first.
If it is cancer: the stages in plain words
When a lump is adrenal cancer, doctors describe how far it has grown. This guides the treatment:
- Localised: the cancer is inside the adrenal gland.
- Locally advanced: it has grown through the gland into the tissue around it or nearby organs, or into a nearby large vein.
- Spread (metastatic): it has travelled to other parts of the body, such as the liver, lungs or bones.
Early adrenal cancer is the most treatable, and surgery gives the best chance. When it has spread, treatment aims to control it and keep you comfortable. Your doctors will be honest about what is realistic in your own case.
Treatment options
Treatment depends on the type of lump, whether it makes hormones, its size and how it looks, and your health. The main options are:
Adrenal tumours are best looked after by a team: a urologist or surgeon, an endocrinologist (hormone specialist), and, for cancer, an oncologist. Please do not hesitate to ask for a second opinion, or to be referred to a centre with this experience.
Living after treatment
Many people lead normal lives after treatment. A few points help:
- Take hormone tablets exactly as prescribed, if you were given them. Never stop suddenly, never run out, and carry a note or card saying you take them.
- If you are unwell with vomiting, diarrhoea or fever, or cannot keep your tablets down, contact your doctor the same day. You may need more cover or a drip, because the body cannot always make extra hormone when stressed.
- Tell any doctor or dentist treating you about your adrenal surgery before operations or new medicines.
- Have your blood pressure, blood sugar and potassium checked as your doctor advises.
- Ask about family checks. A few adrenal tumours run in families or occur at a young age. If you were young when it was found, or have relatives with similar tumours, ask your doctor about genetic advice.
Follow-up
After treatment, you will need check-ups with blood and urine tests, and scans, for several years. This is to catch a return of the lump early, check hormone levels, and watch your blood pressure. How often depends on the type of lump and the treatment you had. Please do not skip these visits even if you feel well, and bring your scan reports and results every time.
When to seek urgent help
Go to your nearest hospital emergency department straight away if you have any of the following:
- A sudden severe headache with a pounding heart, heavy sweating or chest pain, especially if you know you have a lump that makes adrenaline-type hormones, or your blood pressure is very high.
- Severe weakness, dizziness or fainting, repeated vomiting or diarrhoea, confusion or collapse, especially if you take hormone replacement tablets or have had adrenal surgery. This can be an adrenal crisis.
- You cannot keep your hormone tablets down because of vomiting.
- Sudden severe pain in the side or tummy, with faintness or a pale, sweaty look.
- After surgery: fever, a wound that is red, leaking or opening, severe pain, or a swollen, painful leg.
Please also see a doctor soon, without waiting, if you have high blood pressure that is hard to control, repeated attacks of headache and sweating, or weight gain with easy bruising and stretch marks. It does not need the emergency department, but it should be checked.
Common questions
A scan showed a lump in my adrenal gland. Is it cancer?
Most likely not. Most adrenal lumps found by chance are harmless. But it still needs hormone tests and a careful look at the scan, to see whether it makes hormones or looks suspicious. Your urologist or endocrinologist will arrange this.
Do I need an operation for every adrenal lump?
No. Many small, harmless, non-hormone-making lumps only need watching. Surgery is advised for lumps that make hormones, grow, or look suspicious.
Can I live with one adrenal gland? What if both are removed?
Yes, one gland is enough for a normal life. If both glands are removed, or if your remaining gland is temporarily switched off, you will need hormone replacement tablets, usually for life, and your endocrinologist will guide you.
Why do I need hormone tests if I feel well?
Because a lump can make hormones without causing clear symptoms, and some, like a phaeochromocytoma, can make an operation dangerous if they are missed.
Is high blood pressure always from the kidneys or lifestyle?
No. In a small number of people, especially younger ones, it is caused by an adrenal lump making hormones. If your blood pressure is hard to control or began young, ask your doctor about it.
Is adrenal cancer curable?
When it is found early and can be removed completely, surgery can cure some people. Nobody can promise a cure, and when it has spread, the aim is to control it. Your doctors will tell you honestly what to expect in your case.
Does an adrenal lump run in families?
Usually not. A small number are linked to rare inherited conditions. If you were young when it was found, or relatives have similar lumps, please tell your doctor.
Do herbal remedies, "desi" cures or special diets help adrenal problems?
There is no good evidence that they treat adrenal lumps, and some herbal products raise blood pressure or affect hormones. Please do not delay proper tests or treatment for a remedy, and tell your doctor about everything you take.