This information represents the views of the doctors and nurses serving on the American Cancer Society's Cancer Information Database Editorial Board. These views are based on their interpretation of studies published in medical journals, as well as their own professional experience.
The treatment information in this document is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor.
Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options.
After the cancer is diagnosed and staged, your doctor will talk to you about your treatment choices. Take time and think about all of the choices. In choosing a treatment plan, factors to think about include your overall health and the stage of the cancer. You might also want to check with another doctor for a second opinion. This can give you more information and help you feel good about the choice you make. Another reason to look for a second opinion is that these cancers are rare. Only large cancer centers will have much experience in treating them.
The main methods of treatment for cancer are surgery, radiation therapy, chemotherapy, and the use of other drugs.
Surgery
To remove most adrenal cortical tumors, the surgeon will make an incision through the front of the abdomen. If the cancer has grown into the kidney, it will be removed as well. If it has grown into the muscle and fat around the gland, these tissues will also be removed. If the liver is involved, part of that organ will be removed. If the cancer has grown into the large vein that carries blood from the lower part of the body to the heart (the inferior vena cava), an extensive operation will need to be done. The goal of surgery is to get out as much of the cancer as possible, no matter where it is found.
Radiation Therapy
This treatment uses high-energy radiation to kill cancer cells. But radiation therapy is not often used for adrenal cancer because the x-rays do not easily kill this type of cancer.
Chemotherapy
Chemotherapy (most often called chemo) refers to the use of drugs to kill cancer cells. Usually the drugs are given into a vein or by mouth. Once the drugs enter the bloodstream, they reach throughout the body. Chemo is not very good treatment for adrenal cancer. It is only used to treat adrenal cancer that has become widespread.
Chemo can have some side effects. These side effects will depend on the type of drugs given, the amount taken, and how long the treatment lasts. Side effects could include the following:
- nausea and vomiting
- loss of appetite
- hair loss (hair grows back after treatment)
- hand and foot rashes
- mouth sores
- increased chance of infection (from low white blood cell counts)
- bleeding or bruising easily (from a shortage of blood platelets)
- tiredness (from low red blood cell counts)
If you have side effects, your doctor or nurse can suggest steps to ease them. For example, there are drugs to help control and prevent nausea and vomiting. The good news is that most side effects will go away when your treatment ends.
Other Drugs to Treat Adrenal Cancer
A drug called mitotane is most often used to treat people with adrenal cancer. Mitotane blocks the gland from making hormones and also destroys cancer cells. Studies have shown that starting mitotane treatment when all of the cancer is thought to be gone may delay the return of the cancer. For some patients whose cancer was not completely removed by surgery or whose cancer has come back, this drug will shrink the cancer. Even when it doesn抰 shrink the tumor, it can help relieve symptoms. About 8 out of 10 patients are helped by mitotane. On average, the response lasts about one year, or sometimes longer.
Unlike chemo drugs, mitotane does not cause low blood counts. But it can cause major side effects. The most common are nausea, vomiting, diarrhea, rashes and sleepiness. Sometimes lower doses of the drug can be used with fewer side effects. There are also some other drugs that may work for some people.
Adrenal Cancer Survival Rates
Because the number of cases of adrenal cancer is so small, the survival rates are only estimates. Also, the cancer itself has certain features that make it more or less likely to grow fast and spread. While the numbers below provide an overall picture, keep in mind that every person抯 situation is unique and the statistics can抰 predict exactly what will happen in your case. Talk with your cancer care team if you have questions about your personal chances of a cure, or how long you might survive your cancer. They know your situation best.
The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is found. Of course, many people live much longer than 5 years. These rates are also based on people first treated more than 5 years ago. Improved treatments often mean better survival rates for patients now.
Approximate Survival Rates for Adrenal Cortical Cancer
| Stage | Survival Rate |
| I | 50% to 60% |
| II | 50% to 60% |
| III | 20% |
| IV | Less than 10% |
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