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Adenocarcinoma

What Is It, Causes, Signs, and More

Author:Lily Guo

Editors:Alyssa Haag,Ian Mannarino, MD, MBA,Kelsey LaFayette, DNP, RN, FNP-C

Illustrator:Jessica Reynolds, MS

Copyeditor:David G. Walker


What is adenocarcinoma?

Adenocarcinoma refers to cancer of the glandular epithelial cells, which are cells that line various organs of the body, including the esophagus, lungs, breasts, pancreas, salivary glands, stomach, colon, rectum, and prostate

Abnormal epithelial cells in the lungs and esophagus.

Is adenocarcinoma an aggressive form of cancer?

Adenocarcinoma may be aggressive depending on the organ involved. For example, adenocarcinoma of the lung is the leading cause of cancer deaths in the United States. Lung adenocarcinoma is fairly aggressive and results in a 5-year survival rate of 59.8% if there is no metastasis at the time of diagnosis. If the cancer has metastasized by the time of diagnosis, the 5-year survival rate is reduced to approximately 6.3%. In contrast, breast adenocarcinoma is generally less aggressive with a 5-year survival rate of 99.0%, if the cancer has not metastasized. Additionally, breast cancers are able to be detected earlier using more specific screening methods, whereas other cancers, such as lung cancer, are typically detected later on in the disease course due to poorly defined, non-specific symptoms and screening methods. 

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What causes adenocarcinoma?

The cause of adenocarcinoma depends on the organ affected. Esophageal adenocarcinoma is associated with tobacco and alcohol use, as well as a condition known as Barrett esophagus, where acid refluxes from the stomach into the esophagus, causing irritation and cellular damage. The most common causes of lung adenocarcinoma include smoking tobacco; secondhand smoke exposure; exposure to toxins, such as radon, air pollution, and asbestos; arsenic consumption through drinking water; previous radiation to the lungs; and a genetic predisposition to lung cancer

Breast cancers may be inherited through genetic mutations (e.g., BRCA1 and BRCA2 gene). Risk factors for breast cancer include increased age, obesity, early menarche, and late menopause

Pancreatic adenocarcinoma may be due to smoking, diabetes mellitus, chronic pancreatitis, and obesity.

Stomach cancer can be caused by chronic bacterial infection by Helicobacter pylori, tobacco use, and genetic inheritance of specific genes (i.e., CDH1, MLH1, MSH2 genes). 

Colorectal cancer is attributed to diets low in fiber and high in fat, family history of colorectal cancer, and a personal history of irritable bowel disease. 

Lastly, prostate cancer is attributed to obesity, older age, and increased levels of testosterone

What are the signs and symptoms of adenocarcinoma?

The signs and symptoms of adenocarcinoma depend on the organ affected. Unexplained weight loss due to cancerous cells constantly dividing and using the body’s energy can be a non-specific indicator of a malignant process, such as adenocarcinoma metastasis. 

Esophageal adenocarcinoma presents with difficulty swallowing, heartburn, pain or pressure in the chest, and hoarseness of voice. 

Those with lung adenocarcinoma may experience a persistent cough, chest pain, difficulty breathing, blood in the sputum (i.e., hemoptysis), and wheezing. 

Adenocarcinoma of breast tissue can present with a new lump in the breast or armpit; swelling of the breast; skin dimpling overlying the breast; breast or nipple pain; nipple retraction; red, dry or flaky skin of the breast; and nipple discharge. 

Those with pancreatic cancer may experience back pain, nausea and vomiting, bloating, loss of appetite, and fatty stools. 

Stomach adenocarcinoma typically presents with abdominal pain, bloating, and the sensation of being full without ingesting much food. 

Colon adenocarcinoma presents with diarrhea, abdominal pain, constipation, and unexplained weight loss. 

Lastly, prostate adenocarcinoma may present with erectile dysfunction, blood in the urine (i.e., hematuria), and the frequent need to urinate (i.e., polyuria). 

How is adenocarcinoma diagnosed?

Diagnosis of adenocarcinoma usually begins with a general patient interview and physical examination followed by imaging and laboratory testing to narrow down the diagnosis. Specific blood testing may be ordered depending on the suspected organ affected (e.g., a PSA blood test for prostate adenocarcinoma). Imaging of the entire body or certain parts of the body through computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used. Imaging can help the clinician determine whether there is an adenocarcinoma or another underlying pathology causing the symptoms, which organ is affected, and whether the cancer has spread. Lastly, a biopsy of the tumor can be obtained to confirm the diagnosis of adenocarcinoma and determine the grade (i.e., the degree of abnormality in cellular shape and growth). In certain tumors, such as breast adenocarcinoma, biopsies of surrounding lymph nodes can help determine spread, or metastasis, of the tumor. 

In addition to a timely and accurate diagnosis, screening is important for those at risk for adenocarcinoma. Those at high risk for lung adenocarcinoma (e.g., smokers) may receive regular lung cancer screenings through low-dose CT scans. Those with suspicion for breast adenocarcinoma or at high risk may undergo regular screening mammograms. Those with an average risk for colorectal cancer (i.e., do not have a family history, do not have a personal history of colon cancer or inflammatory bowel disease) are recommended to start regular screening at age 45 using colonoscopies or fecal immunochemical test (FIT), which is a non-invasive test that detects blood in the stool. 

How is adenocarcinoma treated?

Treatment for adenocarcinoma depends on the location, size, and type of cancer. The presence or absence of metastasis may also dictate treatment plans. Typically, surgery is the first line treatment for adenocarcinoma, which allows for removal at the site of the tumor and some of the surrounding tissue. Chemotherapy may be administered at a specific site or systemically through intravenous injection or an oral pill to halt the growth of cancerous cells. Examples of chemotherapeutic medications used during chemotherapy include paclitaxel, etoposide, carboplatin, docetaxel, cisplatin, and gemcitabine. Very frequently, these agents are used in conjunction with each other within a chemotherapy regimen to ensure that all cancer cells at varying points of the cell cycle are eliminated. Lastly, radiation therapy can be used with a combination of the aforementioned methods to directly target adenocarcinomas while leaving the healthy peripheral tissues intact.

What are the most important facts to know about adenocarcinoma?

Adenocarcinoma is a type of cancer that affects the glandular cells that line the organs of the body, including the esophagus, stomach, salivary glands, pancreas, lung, breast, colon, rectum, and prostate. There are multiple lifestyle, environmental, and genetic causes for adenocarcinoma. Common causes of adenocarcinoma include smoking, drinking alcohol, obesity, inhaling toxins, and poor diet. In several cases, having a family history of adenocarcinoma can predispose an individual to inheriting the genetic mutation for the malignancy. Depending on where the adenocarcinoma forms and grows, the cancer can be aggressive or non-aggressive. Diagnosis is made with the aid of imaging, laboratory testing, and biopsy. Routine screening is recommended for certain cancers depending on risk factors and family history. Lastly, treatment involves surgery, chemotherapy, and radiation depending on the type of adenocarcinoma. 

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Related links

Breast cancer: Pathology review
Esophageal cancer
Pancreatic neuroendocrine neoplasms

Resources for research and reference

Breast Cancer. Centers for Disease Control and Prevention. Accessed March 4, 2021. https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm

Cancer Stat Facts: Female Breast Cancer. Surveillance, Epidemiology, and End Results Program. Accessed March 4, 2022. https://seer.cancer.gov/statfacts/html/breast.html

Chabner BA, Roberts TG. Timeline: Chemotherapy and the war on cancer. Nature Reviews Cancer. 2005;5(1):65-72. doi:https://doi.org/10.1038/nrc1529

Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM. Gastric adenocarcinoma. Annals of Surgery. 2005;241(1):27-39. doi:https://doi.org/10.1097/01.sla.0000149300.28588.23

Hutchinson BD, Shroff GS, Truong MT, Ko JP. Spectrum of lung adenocarcinoma. Seminars in Ultrasound, CT and MRI. 2019;40(3):255-264. doi:https://doi.org/10.1053/j.sult.2018.11.009

Landi MT, Dracheva T, Rotunno M, et al. Gene expression signature of cigarette smoking and Its role in lung adenocarcinoma development and survival. Albertson D, ed. PLoS ONE. 2008;3(2):e1651. doi:https://doi.org/10.1371/journal.pone.0001651