The primary treatment for a pheochromocytoma is surgery to remove the tumor. Before you undergo surgery, your doctor will prescribe medications to stabilize your blood pressure and lower the risk of complications during surgery.
You will likely take two different drugs for a period of seven to 10 days that help lower blood pressure before surgery.
- Alpha blockers prevent noradrenaline from stimulating the muscles in the walls of smaller arteries and veins. Because these blood vessels remain open and relaxed, blood flow improves and blood pressure lessens. Examples of alpha blockers include phenoxybenzamine (Dibenzyline), doxazosin (Cardura), prazosin (Minipress) and terazosin (Hytrin). Side effects may include irregular heartbeat, dizziness, fatigue, vision problems, sexual dysfunction in men and swelling in your limbs.
- Beta blockers, which inhibit the effect of adrenaline, result in your heart beating more slowly and with less force. Beta blockers also help keep blood vessels open and relaxed by slowing the release of a particular enzyme from your kidneys. Examples of beta blockers include atenolol (Tenormin), metoprolol (Lopressor, Toprol) and propranolol (Inderal, Innopran). Side effects may include fatigue, upset stomach, headache, dizziness, constipation, diarrhea, irregular heartbeat, difficulty breathing and swelling in the limbs.
- Other medications that lower blood pressure may be prescribed if your blood pressure is not stabilized with alpha blockers and beta blockers.
In most cases, the entire adrenal gland with a pheochromocytoma is removed with laparoscopic, or minimally invasive, surgery. Your surgeon will make a few small openings through which he or she inserts wand-like devices equipped with video cameras and small tools.
The remaining healthy adrenal gland carries out the functions normally performed by two, and blood pressure usually returns to normal.
In some unusual situations, such as when the other adrenal gland has already been removed, a surgery may be considered to extract only the tumor and spare some of the healthy tissue.
If a tumor is cancerous (malignant), surgery may be effective only if the tumor and any metastasized tissues are isolated. However, even if all of the cancerous tissues are not removed, surgery may limit hormone production and provide some control of blood pressure.
As cancer is rare among cases of pheochromocytoma, the research about the best treatments is still relatively limited. Treatments for malignant tumors and metastasized cancer related to a pheochromocytoma may include the following:
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- Radionuclide treatment. This radiation therapy combines MIBG, a compound that attaches to adrenal tumors, with a type of radioactive iodine. The treatment goal is to deliver radiation therapy to a specific site and kill cancerous cells.
- Chemotherapy. Chemotherapy is the use of powerful drugs that kill fast-growing cancer cells.
- Targeted cancer therapies. These medications inhibit the function of naturally occurring molecules that promote the growth and spread of cancerous cells.
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