What are the treatments for pheochromocytoma? (2024)

FAQs

What is the main treatment for pheochromocytoma? ›

The great majority of pheochromocytomas are successfully treated with surgery. Surgery can only be performed safely after the careful administration of alpha-blockers (medications such as phenxoybenzamine, which render the body less sensitive to catecholmine surges) for at least two to three weeks prior to surgery.

The immunotherapy pembrolizumab (Keytruda) is being researched as a treatment for pheochromocytomas and paragangliomas in clinical trials, as is immunotherapy combined with a vaccine. Learn more about the basics of immunotherapy.

Chemotherapy. Chemotherapy may be offered to treat metastatic and recurrent cancerous pheochromocytomas. The most common combination of chemotherapy drugs used is CVD – cyclophosphamide (Procytox), vincristine (Oncovin) and dacarbazine (DTIC).

Noncardioselective beta blockers, such as propranolol (Inderal) or nadolol (Corgard), are the usual choice; however, cardioselective agents, such as atenolol (Tenormin) and metoprolol (Lopressor), also may be used.

Tumor shrinkage can lessen the clinical signs and symptoms of pheochromocytoma by reducing the production of hormones and in some cases may allow for surgery. Although not curative, medications are used to control the clinical signs and symptoms of both benign and malignant pheochromocytoma.

Pheochromocytomas are treated with surgery to remove the adrenal gland that contains the tumor. A medication called an alpha blocker is given for about 2 weeks prior to surgery to stabilize the patient's vital signs and get their blood pressure and heart rate under control.

Pheochromocytoma Triggers

Some people's attacks are set off by things like: Pressure on the tumor. Massage. Medications, especially anesthesia or beta-blockers.

Agents known to provoke a pheochromocytoma paroxysm (eg, beta-adrenergic blocker in absence of alpha-adrenergic blockade, glucagon, histamine, metoclopramide, high-dose corticosteroids) should be avoided.

Without treatment, pheochromocytomas can lead to life-threatening high blood pressure and complications including heart attack, heart arrhythmias, pulmonary edema, heart failure, and stoke, among others. With treatment, the outlook is better. In many cases, surgical removal of the tumor can cure people of the disease.

Spikes in blood pressure should be discussed with your health care provider. They can be short term or long lasting. Sudden attacks often last less than 1 hour.

Can you live with pheochromocytoma? ›

Patients with a small pheochromocytoma that has not spread to other parts of the body have a five-year survival rate of about 95%. Patients with pheochromocytoma that has grown back (recurred) or spread to other parts of the body have a five-year survival rate between 34% and 60%.

Other Typical Signs and Symptoms of Pheochrmocytoma Include:

Racing heart (tachycardia and palpitations) Anxiety and nervousness. Nervous shaking (tremors) Pain in the lower chest or upper abdomen.

The 5-year relative survival rate for a pheochromocytoma that has spread or recurred is estimated to be between 34% and 60%. Experts measure relative survival rate statistics for tumors and cancers every 5 years.

In 2007, the Endocrine Society recommended that the goal is to achieve target blood pressure of less than 130/80 mmHg when sitting and no less than 80/45 mmHg when standing, and target heart rate is about 60–70 beat per minute (bpm) when sitting and 70–80 bpm when standing (8).

The clinical hallmark of pheochromocytoma is hypertension, but some patients are normotensive and may even be hypotensive.

The main treatment for a pheochromocytoma is surgery to remove the tumor. Before you have surgery, your healthcare professional likely will prescribe certain blood pressure medicines. These medicines block high-adrenaline hormones to lower the risk of dangerously high blood pressure during surgery.

Agents known to provoke a pheochromocytoma paroxysm (eg, beta-adrenergic blocker in absence of alpha-adrenergic blockade, glucagon, histamine, metoclopramide, high-dose corticosteroids) should be avoided.