This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on July 19, 2022.

Adenocarcinoma is a type of cancer that may occur almost anywhere in the body, starting in glands that line the insides of the organs. Adenocarcinoma forms in glandular epithelial cells, which secrete mucus, digestive juices or other fluids.

What is the difference between adenocarcinoma and carcinoma?

Carcinoma is the most common type of cancer overall. It begins in epithelial cells, which are found in various linings in the body, such as the skin, the mucous membranes coating the inside of the gastrointestinal tract, and the tissue layers surrounding the inside or outside of organs.

Adenocarcinoma is considered a carcinoma subtype. It develops in organs or other internal structures. The other main subtype of carcinoma is squamous cell carcinoma, which usually occurs in the skin.

Your glands help your body function properly and keep organs moist. If glandular cells begin growing out of control, spurred by mutations that occur in the body’s DNA replication process, they may form tumors. Some tumors in glandular cells are not cancerous. They’re called adenomas. The malignant tumors are adenocarcinomas, which overtake healthy tissue inside an organ and may spread to other parts of the body.

Adenocarcinomas are generally first seen as a thickened, plaque-like white mucous membrane, according to the National Cancer Institute. They often spread easily through the soft tissue where they occur.

Adenocarcinoma cancers

Many organs have glandular cells. Adenocarcinoma is often identified by its specific type, such as exocrine cancer in the pancreas, invasive ductal carcinoma in the breast or endometrial cancer in the uterus. Adenocarcinoma is most prevalent in the following diseases:

It’s possible for adenocarcinoma to appear in the brain, usually from cancer that has metastasized from other areas of the body. Adenocarcinoma may also develop elsewhere in the body.

With so many different types of cancer under the heading of adenocarcinoma—and the metastases that are possible—there are many different risk factors and symptoms, depending on the specific disease. Smoking is one risk factor that appears to apply to all adenocarcinomas.

Adenocarcinoma risk factors

Risk factors for adenocarcinoma vary depending on cancer type. It’s important to remember that risk factors don’t guarantee a cancer diagnosis; rather, they increase the odds of developing it. Some risk factors may be something you’re able to change, such as lifestyle factors.

Lung cancer: Lung adenocarcinoma is a type of non-small cell lung cancer (NSCLC) and the primary cause of death from cancer in the United States. As with other types of lung cancer, smoking is the biggest risk factor.

Other risk factors include:

  • Exposure to secondhand smoke
  • Air pollution or chemical irritants such as asbestos, radon, silica, heavy metals and diesel fumes
  • Family history of lung adenocarcinoma

Some studies have found that taking beta carotene supplements and being exposed to arsenic in drinking water may increase lung cancer risk. Using talc or talcum powder and smoking marijuana or e-cigarettes are considered unproven risk factors.

Prostate cancer: The risk of prostate cancer increases after age 50, with the majority of cases found in men older than 65, according to the American Cancer Society (ACS). Men of African ancestry are at increased risk.

A family history of the disease or inherited genetic mutations—such as the BRCA1 or BRCA2 genes—are associated risk factors, as is hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome.

Pancreatic cancer: The risk of pancreatic cancer rises with age, with most cases found in patients older than 65. Men develop pancreatic cancer more often than women, and race also plays a role, with African-Americans at a slightly higher risk.

Other risk factors include:

  • Family history of the disease
  • Inherited gene mutations causing chronic pancreatitis
  • Inherited genetic syndromes

Esophageal cancer: Men are more likely than women to develop esophageal cancer. As with some other cancers, risk increases with age. The majority of cases are found in patients older than 55, according to the ACS.

Other risk factors include:

  • Diet high in processed meat
  • Frequent drinking of extremely hot liquids
  • Tobacco use (chewing tobacco, cigarettes and cigars)
  • Alcohol use
  • Obesity
  • Family history
  • History of lung, mouth or throat cancer 
  • Human papillomavirus (HPV) infection
  • Injury to the esophagus
  • Gastroesophageal reflux disease (GERD)
  • Barrett's esophagus, a condition in which chronic acid reflux damages the esophageal lining
  • Achalasia, a condition in which the lower esophageal sphincter doesn’t function properly, causing irritation to the esophageal lining
  • Tylosis, a genetic disease that may cause small growths on the esophagus
  • Plummer-Vinson syndrome, a syndrome causing webs to form in the upper esophagus, possibly causing blockages, constriction or chronic irritation

Colorectal cancer: The greatest risk factors for colorectal cancer are age, gender and family history. Men are more likely than women to develop the disease.

Other risk factors include:

  • Diet low in fiber and high in fat and processed meats
  • Physical inactivity
  • Obesity
  • Alcohol use
  • Tobacco use
  • Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • Colorectal polyps

Breast cancer: A family history of the disease as well as inherited genetic mutations (such as BRCA1 and BRCA2) raise the risk of breast cancer. Familial inheritance accounts for 5 percent to 10 percent of breast cancers, according to the U.S. Centers for Disease Control and Prevention.

Other risk factors include:

  • Age (most cases are diagnosed in women age 55 and older)
  • Early menstruation (especially before age 12)
  • Menopause after age 55
  • Dense breast tissue
  • History of breast or ovarian cancer 
  • Prior radiation treatment to the chest area
  • Alcohol use
  • Obesity after menopause
  • Physical inactivity

Women who have taken hormone replacement therapy or birth control, have never carried a full-term pregnancy or had their first child after age 30, or didn’t breastfeed, are at increased risk—as are women who took the drug diethylstilbestrol (DES), or whose mothers took the drug.

Stomach cancer: Men are more likely to develop stomach cancer, and risk increases with age. The majority of patients are diagnosed over the age of 60. According to the American Cancer Society, stomach cancer is more often found among Hispanic-Americans, African Americans, Native Americans and Asian/Pacific Islanders than among whites in the United States.

Other factors include:

  • Long-term Helicobacter pylori (H. pylori) infection (may lead to precancerous changes to the stomach lining)
  • Excess weight or obesity
  • Diet high in processed meat
  • Alcohol and tobacco use
  • Previous stomach surgeries
  • Stomach polyps known as adenomas
  • Menetrier disease (in which excess stomach lining growth causes low levels of stomach acid; exact link to stomach cancer isn’t known)
  • Type A blood
  • Common variable immune deficiency (CVID) (in which immune system fails to make enough antibodies)
  • Previous Epstein-Barr virus infection

The following inherited conditions may also increase stomach cancer risk:

  • Hereditary diffuse gastric cancer (HDGC)
  • Hereditary non-polyposis colorectal cancer (HNPCC; Lynch syndrome)
  • Familial adenomatous polyposis (FAP)
  • Gastric adenoma and proximal polyposis of the stomach (GAPPS)
  • Li-Fraumeni syndrome (LFS)
  • Peutz-Jeghers syndrome (PJS)

Adenocarcinoma symptoms

Lung cancer

Early symptoms of adenocarcinoma of the lung include:

  • Fatigue
  • Persistent cough
  • Bloody sputum
  • Shortness of breath
  • Hoarseness
  • Loss of appetite
  • Weight loss
  • Weakness
  • Chest pain
  • Wheezing
  • Chronic or recurring infections (such as bronchitis and pneumonia)

Prostate cancer

Signs of adenocarcinoma of the prostate include:

  • Frequent urination (especially at night)
  • Difficulty fully emptying the bladder
  • Weak urine flow
  • Blood in the urine
  • Erectile dysfunction
  • Enlarged prostate that causes pain when sitting down
  • Painful or burning when urinating

Pancreatic cancer

Symptoms of adenocarcinoma of the pancreas often don’t occur until the disease has progressed. When this occurs, a patient may experience the following:

  • Jaundice (yellowing of the skin and eyes)
  • Dark or brown urine
  • Light or gray, greasy stools
  • Itchiness
  • Abdominal or back pain
  • Weight loss
  • Loss of appetite
  • Nausea Vomiting
  • Enlarged liver or gallbladder
  • Blood clots
  • Diabetes, but rarely

Esophageal cancer

Symptoms of adenocarcinoma of the esophagus include:

  • Difficulty swallowing certain types of food
  • Pain or choking with swallowing
  • Chest pressure/burning
  • Heartburn or indigestion
  • Vomiting
  • Coughing
  • Hoarseness
  • Pain behind breastbone or in throat
  • Weight loss

Colorectal cancer

Symptoms of adenocarcinoma of the colon or rectum include:

  • Changes to bowel habits, such as diarrhea, narrowed stool or constipation
  • Persistent urge to have a bowel movement
  • Rectal bleeding or bloody stool
  • Abdominal pain or cramping
  • Fatigue
  • Weakness
  • Weight loss

Breast cancer

Symptoms of adenocarcinoma of the breast include:

  • Lump in the breast or under the armpit
  • Thickening of the breast
  • Breast swelling
  • Irritation to the skin of the breast
  • Dimpled breast skin
  • Red or flaky skin around the nipple
  • Nipple discharge
  • Changes to the shape and/or size of the breast
  • Breast pain

Stomach cancer

Symptoms of adenocarcinoma of the stomach include:

  • Diminished appetite
  • Weight loss
  • Abdominal pain or discomfort
  • Fullness after eating small amounts of food
  • Heartburn or indigestion
  • Nausea
  • Vomiting (possibly with blood)
  • Abdominal bloating or fluid retention
  • Bloody stool
  • Anemia (which may cause weakness and tiredness)
  • Jaundice

Diagnosing adenocarcinoma

Because adenocarcinoma may develop in so many different areas of the body, the type of diagnostic tests used also vary.

Breast cancer is frequently found in its early stages during mammogram screenings. Prostate cancers are often detected through a prostate-specific antigen (PSA) blood test or a digital rectal exam (DRE). A colonoscopy may be used for diagnosing colon cancer, while bronchoscopy may be used to detect adenocarcinoma of the lung.

In general, the types of tests that are performed may include:

Biopsy: This procedure is used to remove a sample of abnormal tissue from the body. A pathologist will then examine the tissue under a microscope to see whether cancer is present. A biopsy may also be used to determine whether a cancer originated at the site of the biopsy or if it’s metastatic, meaning it developed in another part of the body.

CT scan: A computed tomography scan is an imaging procedure that takes detailed, three-dimensional X-ray pictures of abnormal tissue in the body. CT scans may also be used to determine how adenocarcinoma is responding to treatment.

MRI: Magnetic resonance imaging uses radiofrequency waves to create detailed cross-sectional images of different parts of the body.

Blood tests: These lab tests are used to detect specific chemicals in the blood that may be related to different adenocarcinomas.

Diagnosing adenocarcinoma at CTCA

At Cancer Treatment Centers of America® (CTCA), our oncology diagnostic team is led by oncologists and other physicians trained in a wide variety of medical specialties, including radiology, pathology, genetics and advanced genomic testing. They use sophisticated tests and procedures to measure the stage and progression of disease and identify the tumor’s type, size and location.

What does differentiation mean?

When a biopsy sample is sent to a laboratory for analysis, a pathologist examines the specimen under a microscope. Pathologists are doctors who are experts at diagnosing disease. One of the jobs of a cancer pathologist is to assess how the cancer cells appear microscopically. Cancer cells may look abnormal or similar to healthy cells.

Differentiation refers to the degree of similarity or difference between the cancer cells and healthy cells.

  • Cancer cells that appear somewhat similar to healthy cells tend to be slow-growing and are considered “well differentiated.”
  • Very abnormal-looking cancer cells are “poorly differentiated” and more likely to spread quickly.

Doctors sometimes assign a grade to a tumor based on this cell differentiation. Typically, tumors are given one of three grades:

  • Low grade, which means the cells are well differentiated
  • Intermediate grade, which means the cells are moderately differentiated
  • High grade, which means the cells are poorly differentiated

Determining a cancer’s grade is an essential part of the diagnostic process for some adenocarcinomas, including those that affect the breast, kidney and prostate. For these types of cancer, the differentiation of cells is often highly related to their growth speed, and it may help inform a patient’s prognosis and treatment. However, for other cancers, such as adenocarcinoma of the lung, differentiation is usually not an accurate method of predicting the outcome or likelihood that the cancer will spread.

Adenocarcinoma treatment

Treatment for adenocarcinoma also varies depending on where it grows in the body. Treatments may include:

Surgery: Often the first line of treatment for adenocarcinoma, surgery is used to remove the cancerous glandular tissue and some surrounding tissue. If possible, minimally invasive surgical procedures may be used to help reduce healing time and the risk of post-surgical infection.

Chemotherapy: Chemotherapy uses drugs to kill cancer cells. Chemo drugs may be used throughout the body or in a specific area.

Radiation therapy: Often used in combination with surgery and/or chemotherapy, advanced radiation therapies use image guidance before and during treatment to target adenocarcinoma tumors and spare healthy tissues and surrounding organs.

Targeted therapy: Unlike chemotherapy, which kills healthy and cancerous cells, this treatment targets cancer cells directly. The therapy is designed to attack genetic features that regulate cells’ growth and division.

Immunotherapy: Rather than attack cancer cells directly, immunotherapy alerts the body’s immune system to the presence of the abnormal cells. That, in turn, triggers the body’s own immune response to attack the cancer.

Adenocarcinoma prognosis

Adenocarcinoma describes the type of cells in which the cancer begins (epithelial cells), not where in the body the cancer forms. As a result, the survival rate of adenocarcinoma is highly dependent on the patient’s circumstances, including the cancer’s location and stage, and whether or not other illnesses are present.

Usually, doctors use a five-year relative survival rate to communicate estimated outcomes to patients. Five-year relative survival rates are based on the number of people who live five or more years after their diagnosis. Doctors can sometimes provide three survival rates for each cancer type:

  • One for those with localized disease (the cancer has not spread beyond its original location)
  • A second for regional cases (the cancer has spread to areas near the original cancer location)
  • A third for distant cancers (the cancer has spread to distant body parts)

Data from past patients is used to predict these average relative survival rates. They’re usually calculated by the cancer’s location and stage, but not by specific subtype, such as adenocarcinoma. However, the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program provides some adenocarcinoma-specific survival statistics for certain cancer stages based on the years 2012 to 2018, such as:

  • Adenocarcinoma of the lung and bronchus: The five-year relative survival rate of lung adenocarcinoma is 71.9 percent for localized cases, 45.1 percent for regional cases and 9.5 percent for distant cases.
  • Adenocarcinoma of the esophagus: The five-year relative survival rate for esophageal adenocarcinoma is 51.9 percent for localized cases, 26.9 percent for regional cases and 5.5 percent for distant cases.

It’s important to recognize that these numbers are just estimates, based on averages rather than individuals. Your care team will be able to provide you with a more specific prognosis based on the type, stage and location of your cancer.

Metastatic adenocarcinoma

Adenocarcinoma that spreads to another part of the body is considered metastatic adenocarcinoma, which is also called stage 4 adenocarcinoma. When cancer spreads to another part of the body, it’s still named for the location of origin—so breast cancer that’s spread to the lung is still called breast cancer, or metastatic breast cancer of the lung, not lung cancer.

Cancer cells sometimes spread when they break off from the original tumor. They may travel through the bloodstream or lymph system to other parts of the body. Most of these cells die along the way, but some survive and find areas to grow. In the case of lung adenocarcinoma, cancer cells may also spread through airways in the lungs. Researchers are still learning about this type of spread, called aerogenous metastasis.

Since cancer often spreads through the bloodstream or lymph system, cancer cells are more likely to spread to the organ or set of lymph nodes “downstream” from where the primary cancer started. Breast cancer, for example, tends to spread to underarm lymph nodes. Adenocarcinomas that metastasize most commonly spread to the bones, lungs, liver and/or lymph nodes, but they also may spread to other areas of the body.

In addition to nearby lymph nodes, certain types of adenocarcinomas are more likely to spread to these areas:

  • Lung cancer: Brain, bones and adrenal glands
  • Prostate cancer: Bones and liver
  • Pancreatic cancer: Abdomen and liver
  • Esophageal cancer: Brain, lungs, bones, liver and adrenal glands
  • Colorectal cancer: Liver, brain, lungs and the peritoneum (the lining of the abdomen and some organs inside it)
  • Breast cancer: Bones, liver, lungs and brain
  • Stomach cancer: Liver and the peritoneum

Adenocarcinomas may be more likely to spread if the cancer cells are high-grade (also called poorly differentiated), which means they look different from normal cells under a microscope. High-grade cancers are aggressive and more likely to grow and become metastatic than low-grade cancers.

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