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Potential side effects of surgery for adrenal gland cancer
Side effects can occur with any type of treatment for adrenal gland cancer, but not everyone has them or experiences them in the same way. Side effects of surgery will depend mainly on:
- the type of surgery
- the type of tumour
- how well the hormone levels are controlled before surgery
- the person’s overall health
Side effects can happen any time during, immediately after, or a few days or weeks after surgery. Most side effects go away after surgery. Late side effects can occur months or years after surgery. Some side effects may last a long time or be permanent.
It is important to report side effects to the healthcare team.
Pain often occurs because of trauma to the tissue during surgery. Pain-relieving medications are used to control pain. It may take time for pain to go away after surgery, depending on the procedure done and how the person heals or tolerates pain. If pain does not go away or pain medications do not relieve the pain, check with your doctor.
Bleeding or hemorrhage can occur if a blood vessel is not sealed off during surgery or if the person has a blood clotting disorder. Nursing staff frequently check bandages and drains for too much bleeding right after surgery. If bleeding occurs and is severe enough, the surgeon may have to take the person back to the operating room to find where bleeding is coming from and to stop it.
A small amount of bloody drainage may be expected after surgery. Report large amounts to the doctor or the healthcare team.
Some people develop a wound infection after surgery. This is not a common side effect, but it can potentially occur after any type of surgery. Sometimes tubes are placed into the wound to drain extra fluid. Antibiotics may be used to help prevent or treat an infection. Wound infections are a temporary side effect of surgery.
Report signs of infection, such as redness, pus or foul-smelling drainage, increased swelling or tenderness of the incision site and increased temperature (fever), to the doctor or the healthcare team.
Urinary output may be decreased because of the hormonal effects of surgery to remove the adrenal gland. Urinary output is closely monitored following surgery. It is managed by drinking plenty of fluids, keeping electrolytes balanced and taking medication.
Excess hormones produced by the tumour can cause a change in blood pressure during and after surgery for pheochromocytomas. Blood pressure is monitored closely during and after surgery.
- High blood pressure during and after surgery is caused by the release of high amounts of hormones during anesthesia or while the tumour is being handled.
- Medications are given to control the blood pressure during and after surgery.
- A sudden drop in blood pressure during surgery, caused by the sudden change in hormones after the tumour has been removed, may require rapid volume replacement (intravenous fluids) and medications.
- Low blood pressure after surgery is managed mainly by volume expansion (increasing fluid intake).
There is less cortisol in the body after a cortisol-secreting tumour is removed. After surgery, a steroid hormone medication (called a glucocorticoid) is given to replace cortisol and avoid adrenal deficiency. If both adrenal glands are removed, people need steroid replacement for the rest of their lives.
Blood sugar levels may drop following surgery to remove the adrenal gland. The adrenal gland produces hormones that help control insulin production. When the adrenal gland is removed, insulin levels may increase, causing lower blood sugar levels. The blood glucose is monitored in the first few hours after surgery. If needed, the person is given intravenous therapy to increase blood sugar levels.