43-year-old Cannes Film Festival winner dies of cancer! Doctor: These body changes are a cry for help

March 16, 2024

Famous Belgian actresses

Émilie Dequenne

Died of adrenal cortical carcinoma

Only 43 years old

It was only a little over a year from diagnosis to death.

Adrenal cortical carcinoma is a very malignant tumor

The disease has a poor prognosis

The 5-year overall survival rate is only 15% to 44%.

Tumor stage is a key prognostic factor

The expected 5-year survival rate for stage I patients is 80%

The 5-year survival rate of patients in stage IV is only 13%.

Why is adrenal cortical carcinoma so dangerous?

How to detect it early?

What is adrenocortical carcinoma?

The adrenal glands are like two small hats, located above the kidneys on both sides. Although they are only the size of a thumb, they secrete a variety of hormones that play a key role in the body, such as cortisol, aldosterone and sex hormones . These hormones play an indispensable role in regulating the body's metabolism , maintaining the body's water and electrolyte balance , and affecting the function of the reproductive system .

Adrenal tumors are common and most are benign. Adrenal cortical carcinoma is a rare malignant tumor that originates from adrenal cortical cells and is prone to metastasize to organs such as the liver, lungs, and bones, causing great harm.

Why is it so dangerous?

1Rare and difficult to diagnose

The incidence rate is extremely low.

Early hormone abnormalities are often mistaken for "sub-health" (such as fatigue, obesity) and are easily missed during routine physical examinations (such as abdominal B-ultrasound).

2. Highly invasive

Adrenal cortical carcinoma grows extremely rapidly . When diagnosed, the tumor is often larger than 5 cm and can easily break through the capsule to invade the kidneys and large blood vessels, and even compress surrounding organs.

Adrenal cortical carcinoma can also cause the adrenal glands to secrete excessive hormones, causing metabolic disorders and accelerating the deterioration of the disease.

3. Limited treatment options

Although surgical resection is one of the important treatment methods, it is difficult to completely remove the tumor if it has invaded surrounding important tissues or has metastasized.

Other auxiliary treatments such as radiotherapy and chemotherapy have relatively limited effectiveness for adrenal cortical carcinoma, and it is difficult to completely control the development of cancer cells.

How to detect it early?

1Beware of symptoms related to hormone abnormalities

(1) Excessive cortisol (similar to Cushing's syndrome)

Short-term waist and abdominal obesity: slender limbs but fat accumulation in the abdomen.

Skin changes: Purple streaks (commonly on the abdomen and thighs), increased acne, and slower wound healing.

Metabolic disorders : high blood pressure, high blood sugar, osteoporosis (easy fractures).

(2) Excessive androgen (mainly in women)

Masculine characteristics: increased body hair, deepening voice, irregular or absent menstruation.

Precocious puberty in children (rare but important).

(3) Abnormal aldosterone

Refractory hypokalemia (fatigue, muscle cramps), refractory hypertension.

2 Active screening of high-risk groups

Those with a family history of adrenal tumors (such as patients with Li-Fraumeni syndrome) should undergo active screening.

An unexpected adrenal mass (>4 cm or growing rapidly) discovered during a physical examination requires further evaluation.

3 Targeted screening methods

Imaging: Enhanced CT/MRI is used to assess tumor size, boundaries, and extent of invasion.

Hormone testing: 24-hour urinary free cortisol confirms whether cortisol secretion is excessive; dexamethasone suppression test distinguishes physiological fluctuations from pathological secretion; androgen/aldosterone testing clarifies the type of hormone secretion.

References

1. Expert consensus on the diagnosis and treatment of adrenocortical carcinoma[J]. Journal of Modern Urology, 2021, 26 (11): 902-908.