Therapy
As is often the case, there are two different therapeutic methods that can be used. The decision which one is more suitable must be made individually. In general, depending on the extent of the tumor and the disease, conservative treatment is attempted. However, the size of the tumor and its ingrowth into the surrounding tissues can also stand in the way of an operation. Nevertheless, it is the first priority.
Operation
If the pheochromocytoma is only present on one side, the entire adrenal gland is removed. If the disease is present on both sides, an attempt is made to preserve part of the adrenal gland in order to spare the patient hormone replacement therapy.
Conservative treatment
First, the disease is treated by trying to relieve the symptoms, i.e. to lower the blood pressure. This is done with various antihypertensives (drugs against high blood pressure). If there is an inoperable tumor, drugs are administered which inhibit the synthesis (build-up) of catecholamines (adrenaline and noradrenaline). If the tumor has already spread metastases (daughter tumors), chemotherapy is usually the only option.
Prophylaxis
As no specific factors are known for the development of pheochromocytoma, which promote the growth or outbreak of the disease. Accordingly, prevention is hardly possible. Only members of families with a history of pheochromocytoma should consider genetic counseling to find out whether preventive examinations can be performed. The probability of falling ill can also be roughly calculated at a genetic counseling center.
Prognosis
The prognosis is different. After the tumor has been surgically removed, normal blood pressure is achieved in 80% of patients who have had a benign pheochromocytoma. All other patients with removed benign tumor have a so-called essential hypertension.
Thus, blood pressure remains high due to other causes. For benign tumors, the 5 – year survival rate is about 95%. If there is a malignant tumor that has already spread metastases (daughter metastases), the 5-year survival rate is only 44%.
