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Pheochromocytoma: Treatment, Procedure, Cost and Side Effects

Last Updated: May 15, 2024

What is the treatment?

Pheochromocytoma is also known as the tumor of the adrebal glands.

How is the treatment done?

The catecholamines, epinephrine, nonepinephrine and dopamine hormones which are produced by the adrenal gland induce adrenaline rush in human beings. These are the hormones that allow a person to combat a grave situation and the secretion of these hormones are followed by temporary high blood pressure, sweating, increased heart beat and dry mouth. However these fight or flight hormones are produced profusely (the action being detrimental to good health), when Pheochromocytoma or a tumor develops in the adrenal glands. The condition is followed by high blood pressure, lightheadedness, nausea and other such symptoms.

The treatment of adrenal tumors revolves around the elimination of these tumors via surgery. If the aforementioned symptoms persist then the doctor initially assesses whether the level of these hormones are high in the body and that is found out after a simple blood test or a urine test. Sometimes an imaging test can also be conducted to evaluate the disposition of the tumor in the adrenal gland.

If the tumor is found or the level of these hormones are found to be abnormally high then eliminating the tumor through surgery is the best possible measure. The surgery should be preceded by blood pressure control regime. Blood pressure needs to be controlled during the surgery as well.

Who is eligible for the treatment? (When is the treatment done?)

The treatment of Pheochromocytoma is preceded by proper diagnosis.

Either 24 hour urine collection (which involves the collection of urine over a period of 24 hours) or blood test is performed to assess the level of the catecholamines, epinephrine, nonepinephrine and dopamine hormones in the body. If these hormones exceed the normal level by two times then imaging tests are conducted to evaluate the condition of the tumor. It is detected by either an MRI scan or a CT scan. If these scans fail to show the tumor another test called a 131-I-MIBG scan can be done. This test encompasses the injection of a radioactive iodine molecule into the bloodstream. The component is centralized around the area of the tumor thereby making it visible.

Control of blood pressure is crucial before and after the surgery. Alpha blockers drugs are given surgery and to regulate the response of the body during anesthesia beta blockers drugs are also infused into the system. Pheochromocytoma rarely becomes malignant. But if it is found to be cancerous surgery is usually followed by radiation or chemotherapy.

Currently the use of Tyrosine Kinase Inhibitors drugs for the treatment of adrenal gland tumor, in some cases have proven to be a viable remedy. However, the complete legitimacy of the drugs is yet to be formalized.

Who is not eligible for the treatment?

Some of the symptoms of Pheochromocytoma include high blood pressure, palpitation, profuse sweating and headache. A person who is observing these symptoms all of a sudden should definitely go for the diagnosis. If blood, urine or imaging tests show that the person has developed tumor then surgery would be performed on him/her. A person who has a family history of Pheochromocytoma can also take the tests if he/she notices the aforementioned symptoms.

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Are there any side effects?

Pregnant or lactating women are barred from taking the imaging test. In such cases blood pressure control routine is opted to prevent further damage.

What are the post-treatment guidelines?

Pheochromocytoma surgery is risky in that the blood pressure can rise to an abnormally high level when the patient is etherized. This condition is called hypertensive crisis. To prevent this situation from arising blood pressure control before and during the surgery is of utmost importance. A patient undergoing this surgery is advised to consult an endocrinologist who is qualified to devise methods for the treatment.

How long does it take to recover?

After the treatment the patient may develop bronchitis, pneumonia or urinary tract infection, all of which can be prevented by taking the prescribed medicines regularly. Surgery in the adrenal gland can lead to the cessation of the production of the steroids prerequisite for the body. Therefore, a patient might have to take steroid medications throughout his/her life post surgery. Apart from that he/she should also undergo blood tests annually.

What is the price of the treatment in India?

If a laparoscopic surgery is performed on the patient then it should not take more than 1 to 2 weeks to recover. However, in case of an adrenalectomy recovery time can extend to 4 weeks.

What are the alternatives to the treatment?

Pheochromocytoma treatment wards off the chances of the adrenal gland developing another tumor for a long time to come. However, the ailment can recur after 20 years and can develop either at the site or opposite to it. It can also develop in organs other than the adrenal gland. Therefore, a person who has undergone this surgery should stay under observation.

References

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Written ByDr. Praveen ChaudharyMBBS,PGD IN ULTRAASONOGRAPHY,Non invasive cardiology course,MD - MedicineInternal Medicine
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