The short answer
Treatment may involve specialist preparation, surgery, medicines, radionuclide therapy, radiation, and systemic options, but the right discussion depends on location, hormone secretion, inherited risk, spread, symptoms, and resectability.
Treatment categories may include specialist preparation, surgery, medicines, radionuclide therapy, radiation, and systemic options.
The plan depends on location, hormone secretion, inherited risk, spread, symptoms, and resectability.
Blood pressure control is part of the cancer treatment, not a side issue, because the hormones these tumors release can spike it dangerously.
NCI describes drug therapy, with alpha-blockers and beta-blockers, often given for one to three weeks before surgery. Rushing that step is risky.
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The full explanation.
The short answer
Pheochromocytoma and paraganglioma are rare tumors. They come from the same type of tissue. Pheochromocytomas grow in the adrenal glands, which sit above your kidneys. Paragangliomas grow outside these glands, often near blood vessels and nerves. Both can pump out extra adrenaline and noradrenaline. This is why these tumors need careful handling before, during, and after treatment, not just careful removal.
Why these tumors are different from most cancers
Most cancer treatment plans focus on removing or shrinking a tumor. These tumors add another layer. The hormones they release can cause dangerously high blood pressure. This can happen suddenly. It can be hard to manage. Common symptoms include headaches and heavy sweating. A fast or irregular heartbeat is common too. So are shakiness and a pale look to your skin. Very high blood pressure can lead to serious problems. These include irregular heartbeat, heart attack, stroke, or death. This is why doctors treat blood pressure control as part of the cancer treatment itself. It is not a side issue.
Surgery: the main treatment
Surgery is the standard treatment. It usually means removing the affected adrenal gland, called an adrenalectomy. Or it means removing the paraganglioma itself. Before surgery, you will likely take medicines first. These stabilize your blood pressure and heart rate. This preparation typically lasts one to three weeks. Skipping or rushing this step raises the risk of a dangerous blood pressure spike during surgery.
Medicines used before surgery
Alpha-blockers relax your blood vessels. Beta-blockers help normalize your heart rate. Your team gives these before surgery, in that order. This helps prevent a hormone surge from spiking your blood pressure once the tumor is handled during the operation. Take these exactly as prescribed. Tell your team right away if you feel dizzy, especially when standing up. That can be a sign your dose needs adjusting.
Options for advanced or spread disease
If the tumor has spread beyond its original site, other treatments come into play. Radiation therapy can help control tumors that have spread. One targeted radioactive form is called MIBG. Chemotherapy combinations are used too. So are targeted therapies called tyrosine kinase inhibitors. These block specific growth signals cancer cells use. Ablation and embolization are other tools for specific situations. Ablation destroys tumor tissue directly. Embolization cuts off its blood supply. Which combination fits you depends on where the disease has spread and how it is behaving.
What can trigger a blood pressure crisis
Several things can trigger a sudden hormone surge and blood pressure spike. These include physical activity, emotional stress, childbirth, and surgery. Certain foods high in a substance called tyramine can trigger one too. Ask your team for a specific list of foods and situations to avoid. This list is personal to your tumor and your medicines. It is not a one-size-fits-all rule.
Which symptoms cannot wait
Call 911 or go to an emergency department for a sudden severe headache, chest pain, a pounding or irregular heartbeat, or blood pressure readings far above what your team told you to expect. These can signal a hormone surge or a blood pressure crisis, which can damage the heart or brain within the hour. Follow any emergency instructions your team has given you, but do not hold off on the ambulance to see whether the symptoms pass on their own.
What to expect after surgery
Blood pressure and hormone levels are usually checked closely after surgery, since your body needs time to adjust once the tumor is no longer releasing extra hormones. Follow-up includes repeat blood or urine tests to check hormone levels and confirm the tumor has not returned or spread, since these tumors can come back years later in some people.
What to ask your care team
- What medicines do I need before surgery, and how will you know I'm ready?
- What blood pressure readings or symptoms mean I should call you right away?
- Are there foods or activities I need to avoid because of my specific tumor?
- How often will I need follow-up testing after treatment, and for how long?
Sources
Words to know
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Common questions
What is the difference between the two tumors?
They come from the same type of tissue. Pheochromocytomas grow in the adrenal glands, which sit above your kidneys. Paragangliomas grow outside these glands, often near blood vessels and nerves. Both can pump out extra adrenaline and noradrenaline.
Why is blood pressure treated as part of the cancer care?
Because the hormones these tumors release can cause dangerously high blood pressure, sometimes suddenly and hard to manage. Common symptoms include headaches, heavy sweating, a fast or irregular heartbeat, shakiness and pale skin. Very high blood pressure can lead to irregular heartbeat, heart attack, stroke or death, so control of it is part of the treatment rather than a side issue.
What happens before surgery?
Surgery is the standard treatment, usually removing the affected adrenal gland, called an adrenalectomy, or removing the paraganglioma itself. Before it you will likely take medicines to stabilize blood pressure and heart rate, typically for one to three weeks. Alpha-blockers relax the blood vessels and beta-blockers help normalize heart rate, given in that order. Skipping or rushing this step raises the risk of a dangerous blood pressure spike during surgery.
What if the disease has spread?
Other treatments come into play. Radiation therapy can help control tumors that have spread, including a targeted radioactive form called MIBG. Chemotherapy combinations and targeted therapies called tyrosine kinase inhibitors are used too, and ablation or embolization suit specific situations. Ablation destroys tumor tissue directly, while embolization cuts off its blood supply.
What can trigger a blood pressure crisis?
Physical activity, emotional stress, childbirth and surgery can each trigger a sudden hormone surge, and so can certain foods high in a substance called tyramine. Ask your team for a specific list of foods and situations to avoid, because that list is personal to your tumor and your medicines rather than one-size-fits-all.
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Sources last checked: 2026-07-22 what this meansLast updated: 2026-08-19Next planned review: 2027-01-22
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How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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