Understanding Adrenal Cancer: Unveiling Anna 'Chickadee' Cardwell's Demise

Anna “Chickadee” Cardwell, a well-known Reality TV personality from TLC’s “Here Comes Honey Boo Boo”, passed away on Sunday, according to an Instagram post revealed by June Shannon, her mother.

Shannon declared on her Instagram channel, “It is with great sadness that we announce that @annamarie35 is no longer among us. She died peacefully at my residence last night at 11:12 p.m.”

Cardwell, aged 29, was previously diagnosed with stage 4 adrenal carcinoma in January 2023 after complaining of persistent stomachaches. Subsequent medical investigations disclosed that the cancer had affected her liver, kidney, and lungs. She embarked on her chemotherapy journey in March. In an encouraging Instagram post in May, Cardwell stated that she was going through her third chemo cycle and that there were positive signs.

However, it seems her health dramatically declined. In a heartfelt appeal shared on Instagram two days before Cardwell’s passing, Shannon asked her followers to keep her family in their prayers.

Left to mourn her loss are her two daughters, Kaitlyn and Kylee, her mother and half-sisters Alanna “Honey Boo Boo” Thompson, Lauryn “Pumpkin” Efird, and Jessica “Chubbs” Shannon.

Adrenal cancers are extremely uncommon. Though precise statistics are uncertain, it's speculated that only around 200 cases are detected each year.

Adrenal cancers or carcinomas can affect people of all ages, however, the average diagnosis age is approximately 46 years.

The origin of adrenal cancer is in the adrenal glands, small glands located above the kidneys. In an explanation by Kedar Kirtane, MD, an assistant member in the department of head and neck-endocrine oncology at Moffitt Cancer Center, “The adrenal glands are responsible for generating hormones that control various functions of the body comprising metabolism, blood pressure, and stress response."

The tumors usually evolve in the cortex of the adrenal gland. The two main sorts are adenomas (benign or non-cancerous tumors) and carcinomas (malignant or cancerous tumors). The unique kind of cancer that arises in the cortex of the adrenal gland is referred to as adrenal cortical carcinoma.

The cause of adrenal cancer is still a mystery and thus offers no clear prevention methods. Certain lifestyle risk factors such as obesity, smoking, or a sedentary lifestyle have been linked to an increased risk of different types of cancer, yet their relationship with adrenal cancer remains unclear.

However, “there are a handful of rare inherited cancer syndromes that could increase the likelihood of developing adrenal cancer,” informed Melanie Goldfarb, MD, an endocrine surgeon and director of the Center for Endocrine Tumors and Disorders at Saint John’s Cancer Institute at Providence Saint John's Health Center.

The associated symptoms of adrenal cancer can be varied—some might be related to the hormones produced by the tumor, others may occur due to the tumor pressing against other organs.

“The tumors can grow significantly large—some are the size of a cantaloupe when they are diagnosed,” said Amanda M. Laird, MD, the leader of the Section of Endocrine Surgery at the Rutgers Cancer Institute. “Due to their location, people may not show symptoms until their tumors have grown considerably large."

When an adrenal cancer tumor typically produces an excess of specific hormones—cortisol, aldosterone, testosterone, or estrogen—, the symptoms change depending on which hormone is affected, and whether it’s causing an increase in that hormone in males or females.

Discovery of adrenal cancer is usually inadvertent, through imaging tests performed for unrelated reasons, or when symptoms due to hormonal abnormalities or a growing tumor are reported.

Like others, early detection is critical for more successful treatment in cases of adrenal cancer. “The patients with the best prognosis are generally those diagnosed incidentally when we discover a mass on the adrenal gland through imaging scans done for another reason and we abruptly remove it,” said Goldfarb.

Such initial treatment might involve a surgical procedure to remove the tumor or, if necessary, the whole affected adrenal gland, as noted by Brian Lane, MD, PhD, the director of urologic oncology at Corewell Health.

If in the later stages, there is remaining cancer post-surgery or if the cancer has metastasized to other body parts, radiotherapy or chemotherapy could be applied, but they are "typically not quite effective,” Lane acknowledged.