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 says drug therapy, with alpha-blockers and beta-blockers, is often given for one to three weeks before surgery. NCI's clinician guide says beta-blockers must never be started before alpha-blockers.
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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 release 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 that comes on suddenly and can be hard to manage. NCI lists these signs:
- High blood pressure.
- Headache.
- Heavy sweating for no known reason.
- A strong, fast, or irregular heartbeat.
- Being shaky.
- Being extremely pale.
NCI says very high blood pressure can cause serious health problems such as 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 main treatment. For a pheochromocytoma it is usually an adrenalectomy, which is removal of one or both adrenal glands. A paraganglioma is removed by surgery too. NCI says drug therapy is often given for one to three weeks before surgery to control blood pressure and heart rate.
Medicines used before surgery
NCI says alpha-blockers keep blood vessels open and relaxed, which lowers blood pressure. Beta-blockers stop the effect of too much noradrenaline and slow the heart rate. NCI's clinician guide says beta-blockers must never be started before alpha-blockers. Take these exactly as your team prescribes. Tell your team right away if you feel dizzy, especially when standing up.
Options for advanced or spread disease
If the tumor has spread beyond its original site, other treatments come into play. NCI lists radiation therapy, including radioactive MIBG, and chemotherapy combinations. It also lists targeted therapies called tyrosine kinase inhibitors. Ablation and embolization are other tools. Radiofrequency ablation uses radio waves to heat and destroy abnormal cells. Embolization blocks the artery leading to the adrenal gland. Which combination fits you depends on where the disease has spread and how it is behaving.
What can trigger a blood pressure crisis
NCI lists several triggers for symptoms. They are hard physical activity, injury, emotional stress, childbirth, anesthesia, and surgery. Foods high in tyramine, such as red wine, chocolate, and cheese, can trigger them too. Ask your team for a specific list of foods and situations to avoid.
Which symptoms cannot wait
- Call 911 or go to the nearest 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. NCI says very high blood pressure can cause heart attack, stroke or death. NCI does not give an emergency threshold, so 911 is the cautious route. CDC says to call 9-1-1 for chest pain.
- Follow any emergency instructions your team has given you. Do not hold off on the ambulance to see whether the symptoms pass on their own.
- Check with your team right away for headache, heavy sweating, a fast heartbeat or high blood pressure that is not severe. NCI lists these as reasons to check with your doctor.
What to expect after surgery
NCI says people with these tumors need lifelong follow-up. Follow-up includes regular blood and urine tests for catecholamine levels. NCI says levels that are higher than normal can be a sign that the cancer has come back. Ask your team how often you will be tested.
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
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. NCI lists headache, heavy sweating for no known reason, a strong, fast or irregular heartbeat, being shaky and being extremely pale. NCI says very high blood pressure can cause 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. NCI says drug therapy is often given for one to three weeks before surgery to control blood pressure and heart rate. Alpha-blockers keep blood vessels open and relaxed, which lowers blood pressure. Beta-blockers slow the heart rate. NCI's clinician guide says beta-blockers must never be started before alpha-blockers, because that can lead to a life-threatening crisis.
What if the disease has spread?
Other treatments come into play. NCI lists radiation therapy, including a radioactive form called MIBG, and chemotherapy combinations. It also lists targeted therapies called tyrosine kinase inhibitors for metastatic or recurrent disease. Ablation and embolization are other options. Radiofrequency ablation uses radio waves to heat and destroy abnormal cells. Embolization blocks the artery leading to the adrenal gland.
What can trigger a blood pressure crisis?
NCI lists hard physical activity, injury, emotional stress, childbirth, anesthesia and surgery as triggers. It also lists foods high in tyramine, such as red wine, chocolate and cheese. Ask your team for a specific list of foods and situations to avoid.
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Sources last checked: 2026-07-22 what this meansLast updated: 2026-09-29Next planned review: 2027-01-22
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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, and this 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 then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. 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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