Medical Oncologist
CION Cancer Clinics
Adrenal metastases: when surgery helps | CION Cancer Clinics
Surgery for cancer that has spread to the adrenal gland is considered for a small group: people whose only spread is in that gland, whose original cancer is under control, and who are fit to recover. For most people with spread in several places, treatment through the whole body does more. This page explains what the team weighs, the other options, and what no page can decide for you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- When is surgery for cancer spread to the adrenal gland considered?
- What does the team weigh before suggesting surgery?
- How is the decision usually reached?
- What do the words in your report mean?
- How does surgery compare with focused radiotherapy?
- What do families believe, and what is actually true?
- What can this page not tell you?
- Common questions about surgery for adrenal metastases
The short answer
When is surgery for cancer spread to the adrenal gland considered?
Surgery is considered for a small, carefully chosen group: people whose cancer has spread only to the adrenal gland, and whose original cancer is under control. For most people with spread to more than one place, treatment through the whole body is used instead.
What adrenal metastasis means
A metastasis is a cancer that started somewhere else and travelled to a new part of the body. The adrenal gland, which sits on top of the kidney, is a common place for this to happen. Lung cancer, kidney cancer, melanoma and bowel cancer are the ones that spread there most often. The cells in the adrenal lump are still cells of the original cancer, so it is treated as that cancer, not as adrenal cancer.
Why surgery is sometimes offered
When the adrenal gland is the only place the cancer has gone, removing it may give long control of the disease for some people. Doctors call this limited spread oligometastatic disease. The evidence comes mostly from studies of selected patients, so it is hard to know how much surgery itself adds.
Who it does not suit
Surgery is unlikely to help if cancer is also in the liver, bones, brain or several lymph nodes, if the original cancer is still growing, or if you are too unwell to recover from an operation.
Before anyone suggests it
What does the team weigh before suggesting surgery?
No single test decides. The team puts several things together, and each one can tip the balance.
Is this the only spread?
A PET-CT and other scans look for cancer anywhere else. Surgery is weighed only when the adrenal gland appears to be the one place involved.
Is the original cancer controlled?
If the first cancer has been removed or treated and is not growing, taking out the adrenal spread makes more sense. If it is still active, surgery rarely changes the course.
How has the cancer behaved?
Spread found a long time after the first treatment tends to behave more slowly than spread found at diagnosis. How the cancer responds to drug treatment also tells the team a lot.
The team often looks at
- The time since first treatment
- Response to chemotherapy or immunotherapy
Can you recover from it?
Your heart, lungs, kidneys and daily strength all matter. The other adrenal gland must be working, or you will need lifelong steroid tablets afterwards.
Not sure whether this applies to you?
Ask an oncologistThe pathway
How is the decision usually reached?
Confirm what the lump is
Many adrenal lumps are harmless, even in people with cancer. Scans help tell them apart, and sometimes a biopsy, a small sample of tissue, is taken to be sure.
Check the hormones first
Blood and urine tests make sure the lump is not an adrenaline-making tumour. A needle in that kind of tumour can cause a dangerous rise in blood pressure, so this test comes before any biopsy.
Tumour board discussion
Surgeons, medical oncologists and radiation oncologists look at your scans together and compare surgery with the other options.
The options are explained to you
You hear what each choice involves, what it cannot do, and what happens if you choose none. Bring the family member who will decide with you.
On your report
What do the words in your report mean?
- Primary cancer
- The place where the cancer first started, such as the lung or kidney. It decides which drugs are used.
- Metastasis or metastatic
- Cancer that has spread from where it started to another part of the body.
- Oligometastatic
- Spread limited to one or a few places, rather than widely through the body.
- Adrenal incidentaloma
- An adrenal lump found by chance on a scan done for another reason. Most are harmless.
- Stereotactic radiotherapy (SBRT)
- Very focused radiation given in a small number of sessions, sometimes used instead of surgery.
- Clear margin
- No cancer cells were found at the edge of what was removed.
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Side by side
How does surgery compare with focused radiotherapy?
Surgery
Focused radiotherapy (SBRT)
Removes the gland, so the lab can study the whole lump
Treats the lump in place; nothing is removed for testing
Needs a general anaesthetic and a hospital stay
No cut or anaesthetic; you go home after each session
Recovery of a few weeks before other treatment resumes
Often fits more easily around drug treatment
Harder if you are frail or have had many belly operations
Harder if the lump sits very close to the bowel or stomach
Commonly believed
What do families believe, and what is actually true?
"If they remove the lump, the cancer is gone for good."
Surgery removes the spread that can be seen. Cancer cells too small for any scan may remain, which is why drug treatment and regular scans usually continue afterwards. Surgery is one part of a plan, not the end of it.
"If surgery is not offered, the doctors have given up."
Very often, surgery is not offered because other treatment will do more. When cancer is in several places, treatment through the whole body reaches all of them. An operation on one lump would delay that without helping.
"Any lump on the adrenal in someone with cancer must be spread."
Harmless adrenal lumps are common in adults. Scans and sometimes a biopsy are needed to tell the difference, and this step matters before anyone talks about surgery.
"A bigger operation is always the stronger treatment."
For some people, focused radiotherapy or ablation, which destroys the lump with heat or cold, controls the spread as well without a cut. The right choice depends on the lump, the cancer and your health.
Being straight with you
What can this page not tell you?
This page cannot tell you whether surgery is right for you or your parent. That depends on scans, reports and a conversation that only your treating team can have. What it can do is help you ask better questions.
It cannot tell you how long the cancer will stay controlled
Nobody can promise how an individual cancer will behave after surgery. The type of primary cancer matters more than the operation, and results published in studies come from people chosen because they were likely to do well.
Questions worth asking
Ask whether the adrenal gland is really the only place the cancer has spread. Ask what the other options are, including focused radiotherapy, ablation and drug treatment, and what each involves. Ask whether surgery would be keyhole or open, and whether your centre does this operation often. Ask whether drug treatment would pause, and for how long.
If you want a second opinion
It is reasonable to ask another team to look at the scans, especially when the choice is close. A good team will not mind, and sending the reports and scan discs saves time.
Choosing not to have surgery is also a valid decision. Your team will still plan treatment with you.Questions we are asked
Common questions about surgery for adrenal metastases
Is surgery for adrenal metastasis worth it?
For some carefully selected people, it may give longer control of the cancer. For most people with wider spread, it does not add enough to justify the recovery. Whether it is worth it for you depends on where else the cancer is, how controlled the primary is, and your health. Your team weighs these together.
Which cancers spread to the adrenal gland?
Lung cancer is the most common. Kidney cancer, melanoma, bowel cancer and breast cancer can also spread there. The treatment plan follows the original cancer, so a lung cancer in the adrenal gland is still treated as lung cancer, with lung cancer drugs.
Is the operation keyhole or open?
Smaller lumps that have not grown into nearby organs are often removed by keyhole surgery. Larger lumps, or ones stuck to the kidney, liver or major blood vessels, may need open surgery. Ask your surgeon which route is planned and why.
Will I need chemotherapy or immunotherapy after surgery?
Often, yes. Spread to the adrenal gland means cancer cells have travelled once, so treatment through the whole body is usually continued or restarted. Your medical oncologist decides this based on the primary cancer and how it has responded so far.
Will I need steroid tablets after removing one gland?
Usually not, if the other gland is healthy. You will need them if both glands are removed or the remaining one is also affected. Some cancer drugs can also affect hormone glands, so your doctors may check your cortisol levels during treatment.
What if cancer is found in both adrenal glands?
Removing both glands means lifelong hormone replacement, so teams think very carefully before recommending it. Radiotherapy or drug treatment is often preferred. If both are removed, you will be taught how to manage the tablets and what to do when you are unwell.
Why do they need hormone tests if it is cancer spread?
Because the lump might not be spread at all. An adrenaline-making tumour can look similar on a scan, and operating on it or putting a needle into it without preparation can be dangerous. The tests are simple blood and urine checks, and they protect you.
Is this surgery covered by Aarogyasri or insurance?
Cancer surgery approved as part of a treatment plan is often covered under Aarogyasri, CGHS, ECHS, EHS or cashless insurance, subject to pre-approval. Coverage varies, so call the helpline with your card or policy details and we will help you understand what applies.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- Cancer Research UK — Adrenal gland cancer
- National Cancer Institute — Metastatic Cancer: When Cancer Spreads
- Cancer.Net — Adrenal Gland Tumor
- American Cancer Society — Understanding Advanced and Metastatic Cancer
- NHS — Phaeochromocytoma
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Why an Adrenal Gland Is RemovedThe other reasons an adrenal gland is taken outLaparoscopic vs Open AdrenalectomyHow the route to the gland is chosenDeciding on Cancer SurgeryHow to weigh any operation with your teamPET-CT scan guideThe scan used to look for spread elsewhereImmunotherapy guideTreatment through the whole body that may continue after surgery
Talk to us
Been told cancer has reached the adrenal gland?
Send us the scans and reports or call the helpline. We will help you reach a specialist who can explain the options in your case. One helpline serves every CION centre.