Uncommon conditions get exceptional treatment at Ohio State, where adrenal cancer therapies and surgeries are improving outcomes for patients with this rare form of the disease. Adrenal cancer is rare, difficult to detect and is often diagnosed in the later stages when it has metastasized. “It’s so important to have centers of excellence so patients have access to providers who are experts in treating this disease,” says Barbra Miller, MD, the co-director of The James Multidisciplinary Adrenal Clinic, a world leader in treating this type of cancer. The body’s two adrenal glands, which sit above the kidneys, are important organs that produce several different hormones that regulate blood pressure and metabolism. “They help other organs work successfully,” Miller says, adding that, in most adrenal cancer cases, only one of the two glands become cancerous. For patients with metastatic adrenal cancer, the first treatment option is chemotherapy “so we can determine how it responds and how quickly it is growing and determine whether a resection — an adrenalectomy that removes the entire adrenal gland — would be advantageous.” An adrenalectomy is a delicate procedure. “The tumor is very fragile and can grow through the capsule of the tumor into the surrounding organs and we don’t want to spread those cells [during surgery],” Miller says. “Once the surgery is completed, we look at the pathology to determine if other treatment is warranted.” A person can function quite well with one adrenal gland, Miller says, adding that if two are cancerous and removed, hormone replacement drugs are available.