Medicines for Phaeochromocytoma

What it is

A phaeochromocytoma is a rare, usually non-cancerous tumour of the adrenal glands (which sit on top of the kidneys), or of related tissue, that produces excess amounts of the "fight or flight" hormones adrenaline and noradrenaline. These hormone surges cause characteristic episodes of symptoms, classically a combination of severe headaches, palpitations (a pounding or racing heart), heavy sweating, and high blood pressure, which may be persistently raised or come in dramatic spikes. Other symptoms can include anxiety, tremor, pallor, and feeling generally unwell during an episode. Because it can cause very high blood pressure that is potentially dangerous, and because it is a treatable and often curable cause of high blood pressure, it is important to recognise — though it is rare and most high blood pressure is not due to it. It is diagnosed with blood and urine tests measuring the hormones, and imaging to locate the tumour.

How it is treated

The main treatment is surgery to remove the tumour, which usually cures the condition. Crucially, before surgery, the effects of the excess hormones must be controlled with specific medicines (started well in advance) to safely lower and stabilise blood pressure and prevent dangerous surges during the operation — this careful preparation is an essential part of treatment. After successful surgery, blood pressure and symptoms usually resolve. Because a small proportion are cancerous or can recur, and some are linked to inherited conditions, follow-up and, where appropriate, genetic testing and family screening are arranged. During the pre-treatment phase, certain triggers and some medicines that could provoke a hormone surge are avoided. Care is coordinated by hormone (endocrine) and surgical specialists. The reassuring message is that this rare condition is usually curable with proper preparation and surgery.