Materiały źródłowe

• #1 Adrenal Carcinoma Treatment & Management: Approach Considerations, Surgical Resection, Chemotherapy

  https://emedicine.medscape.com/article/276264-treatment

  Because adrenocortical carcinomas (ACs) are so rare, clinical series are small and there has been only limited prospective evaluation of treatment strategies. Therefore, significant controversy over therapy exists, and very few, if any, universally accepted treatment standards have been determined. Current practices are strongly influenced by expert consensus opinion from a few medical centers that specialize in ACs. […] When feasible, total resection remains the modality of choice for the definitive treatment of AC. It also remains the only potentially curative therapy. […] Medical care in patients with AC, which can be supportive or adjuvant to surgical resection, encompasses the following: Treatment of endocrine excess syndromes, Use of mitotane or several multiagent chemotherapy regimens, Treatment and prevention of potential complications, Strategies for palliative and terminal care issues, including symptom relief and management.

• #1 Adrenal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adrenal-cancer/diagnosis-treatment/drc-20446405

  Treatment for adrenal cancer often includes surgery to remove the adrenal gland. Other treatments also might be used in some situations. Those treatments include radiation therapy and medicines, such as chemotherapy and immunotherapy. […] Surgery for adrenal cancer typically involves removing the entire adrenal gland. This procedure is called an adrenalectomy. The surgery is done for several reasons, including to: […] Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. Radiation therapy sometimes is used after adrenal cancer surgery to kill any cells that might be left behind. It also can help ease pain and other symptoms of cancer that has spread to other parts of the body, such as the bones. […] Chemotherapy treats cancer with strong medicines. For adrenal cancers that can’t entirely be removed with surgery or those that come back after surgery, chemotherapy may help keep the cancer from growing and spreading.

• #1 Treatment of adrenocortical carcinoma – UpToDate

  https://www.uptodate.com/contents/treatment-of-adrenocortical-carcinoma

  Treatment of adrenocortical carcinoma […] Complete surgical resection is the only potentially curative treatment for adrenocortical carcinoma (ACC). For patients with potentially resectable stage I to III disease who are surgical candidates, we recommend complete surgical resection as initial therapy. […] Before proceeding to a surgical excision, all patients must undergo a complete hormonal assessment to determine the secretory activity of the tumor. It is particularly important to identify those with cortisol-producing tumors. These patients, even those with mild hypercortisolism, have some degree of hypothalamic-pituitary-adrenal (HPA) axis suppression and require glucocorticoid coverage to prevent postoperative adrenal insufficiency.

• #1 Adrenal Cancer Treatment | Endocrine Oncology Program | University of Michigan Rogel Cancer Center

  https://www.rogelcancercenter.org/adrenal-cancer/learn-about-adrenal-cancer/treatment

  If an adrenal nodule is found, the team wants as much information as possible to develop an individualized treatment plan. […] Surgery is the treatment of choice if possible. […] If patients are able to undergo surgery, it is extremely important that your surgery is performed by a surgeon experienced in the treatment of adrenal cancer, as the covering of the tumor must not be penetrated during surgery and a wide margin of normal tissue around the tumor should be included to ensure complete resection and minimize the chance for local recurrence. […] Based on experience and research done at the University of Michigan, we generally do not recommend removing adrenal cancer using a laparoscopic approach as it often leads to early recurrence in the abdominal cavity due to microscopic tumor spillage.

• #1 Adrenal Carcinoma Treatment & Management: Approach Considerations, Surgical Resection, Chemotherapy

  https://emedicine.medscape.com/article/276264-treatment

  When feasible, total resection remains the treatment of choice for the definitive management of AC. It also is still the only potentially curative therapy. […] Recurrent local and metastatic tumors are common in AC, even in patients who undergo a successful complete resection. In such settings, the only effective treatment is attempted reoperation. […] Mitotane remains the major chemotherapeutic option for the management of AC because it is a relatively specific adrenocortical cytotoxin. It is used as primary therapy, as adjuvant therapy, and as therapy in recurrent or relapsing disease. […] Adjuvant therapy with mitotane remains controversial. […] Based on data so far, adjuvant therapy can be recommended for patients with high risk for recurrence based on positive margins, ruptured capsule, large size of the primary tumor, or high mitotic rate. Adjuvant mitotane therapy can be considered after resection of AC.

• #1 Chemotherapy for Adrenal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/adrenal-cancer/treating/chemotherapy.html

  Certain types of drugs are given to treat cancer. These drugs, known as chemotherapy, are typically given into a vein or by mouth (in pill form). Because chemo enters the bloodstream and can reach throughout the body, it is commonly given to patients whose cancer has spread (metastasized) to organs beyond the adrenal gland or after surgery to prevent the cancer from coming back. […] Mitotane is the drug most often used for people with adrenal cancer. It blocks hormone production by the adrenal gland and destroys both cancer and healthy cells in the adrenal gland. […] Mitotane can be given after surgery, after all the visible cancer has been removed. This is meant to kill any cells that were left behind but were too small to see. Giving the drug this way is intended to prevent or delay the cancer’s return.

• #1 Chemotherapy for Adrenal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/adrenal-cancer/treating/chemotherapy.html

  If the cancer has not been completely removed by surgery or has come back, mitotane may be used to shrink the cancer in some patients. […] Mitotane is particularly helpful for people with adrenal cancers who have problems caused by excessive hormone production. Even when it doesn’t shrink the tumor, mitotane can reduce abnormal hormone production and relieve symptoms. Most patients with excess hormone production are helped by mitotane. […] This drug is a pill taken 3 to 4 times a day. Like other types of chemo, treatment with mitotane needs to be supervised closely by a doctor. […] Drugs are sometimes combined with mitotane to treat advanced adrenal cancer. The chemo drugs used most often in combination with mitotane are: Carboplatin or Cisplatin, Etoposide (VP-16), Doxorubicin (Adriamycin).

• #1 Adrenocortical Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq

  Radiation therapy (approximately 5070 Gy over a period of 4 weeks) may be given to patients with localized but unresectable tumors (under clinical evaluation). […] Chemotherapy with mitotane in doses as high as 10 to 12 g/day to achieve a blood level of 14 to 20 mg/L should be considered for patients unable to undergo complete resection (under clinical evaluation). […] The role of mitotane as adjuvant therapy after complete tumor resection is still unclear but should be discussed with the patient. […] Treatment options for stage IV ACC include: […] Chemotherapy with mitotane. […] Chemotherapy with mitotane plus streptozotocin or mitotane plus etoposide, doxorubicin, and cisplatin, as evidenced by the NCT00924144 phase III clinical trial. […] Radiation therapy to bone metastases.

• #1 Chemotherapy for Adrenal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/adrenal-cancer/treating/chemotherapy.html

  Chemo kills cancer cells but also damages some normal cells, which can cause side effects. These depend on the type, dose, and length of drugs given. Some common side effects of chemo include: Nausea and vomiting, Loss of appetite, Loss of hair, Mouth sores, Diarrhea, Increased risk of infection (due to a shortage of white blood cells), Problems with bleeding or bruising after minor cuts or injuries (due to a shortage of blood platelets), Anemia, fatigue, or shortness or breath (due to low red blood cell counts). […] Be sure to report any side effects you notice during chemo to your cancer care team so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to keep the side effects from getting worse.

• #1 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=34&contentid=19180-1

  Radiation therapy uses high-energy X-rays to kill cancer cells. […] Radiation is rarely the main treatment for adrenal cancer. This type of cancer tends to be hard to kill with radiation. But radiation therapy may be used after surgery to help keep adrenal cancer from coming back later. It may also be used to treat other body parts where the tumor has spread. Its sometimes used to help control pain caused by tumor growth. […] The most common type of radiation for adrenal cancer is external beam radiation therapy (ERBT). A large machine directs the beams at the cancer to kill the cancer cells. […] Radiation treatment is a lot like getting an X-ray. The radiation comes from a large machine. The machine doesn’t touch you during the treatment. Treatments don’t hurt and they’re quick. […] Side effects of radiation can include: upset stomach (nausea) and vomiting, diarrhea, skin irritation (like a bad sunburn) in the treatment area, hair loss in the treated area, loss of appetite, severe tiredness (fatigue), low blood counts.

• #1 Adrenal Cancer: Radiation Therapy | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/adrenal-cancer-radiation-therapy

  Radiation therapy uses high-energy X-rays to kill cancer cells. […] Radiation is rarely the main treatment for adrenal cancer. This type of cancer tends to be hard to kill with radiation. But radiation therapy may be used after surgery to help keep adrenal cancer from coming back later. It may also be used to treat other body parts where the tumor has spread. Its sometimes used to help control pain caused by tumor growth. […] The most common type of radiation for adrenal cancer is external beam radiation therapy (ERBT). A large machine directs the beams at the cancer to kill the cancer cells. Radiation is often given once a day, 5 days a week (Monday through Friday), for a certain number of weeks. […] Before you start treatment, imaging scans will be done to know exactly where the cancer is. This is called a simulation scan. This is done so the radiation beams can be focused there.

• #1 Adrenal Cancer: Radiation Therapy

  https://krames.forthealthcare.com/wellness/Stress/34,19180-1

  Radiation treatment is a lot like getting an X-ray. The radiation comes from a large machine. The machine doesn’t touch you during the treatment. Treatments don’t hurt and they’re quick. […] Before you start treatment, imaging scans will be done to know exactly where the cancer is. This is called a simulation scan. This is done so the radiation beams can be focused there. […] Talk with your healthcare provider about what short- and long-term side effects you can expect and what can be done to prevent or manage them. […] Side effects of radiation can include: Upset stomach (nausea) and vomiting, Diarrhea, Skin irritation (like a bad sunburn) in the treatment area, Hair loss in the treated area, Loss of appetite, Severe tiredness (fatigue), Low blood counts. […] Often these side effects start a few weeks into treatment. They go away over time after treatment is over. Many side effects can be helped with certain medicines.

• #1 Adrenocortical Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq

  Surgical removal of localized metastases, particularly for tumors that are functioning. […] Temporary palliation of disseminated ACC can sometimes be achieved with the chemotherapeutic agent mitotane. […] Many patients with functioning tumors who receive treatment experience reduced hormone production. […] In patients with increased hormone production, antisteroidogenic drugs, such as ketoconazole and metyrapone, and steroid receptor antagonists, such as spironolactone and mifepristone, should be considered. […] Deciding to treat patients with recurrent adrenocortical carcinoma (ACC), and what treatment to use, depends on many factors, including previous treatment, site of recurrence, and individual patient considerations. […] Local recurrence and selected sites of metastatic disease can sometimes be palliated by surgery or radiation therapy. […] Although recurrent ACC is not considered curable, palliation of hormonal symptoms and occasional 5-year survivals can be achieved.

• #1 Adrenal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adrenal-cancer/diagnosis-treatment/drc-20446405

  Mitotane (Lysodren) is an older medicine that has been used to treat advanced adrenal cancer. It also has shown promise in keeping adrenal cancer from coming back after surgery. Mitotane may be used after surgery for people who are at high risk of the cancer coming back. Research into mitotane for this purpose is ongoing. […] For adrenal cancer, immunotherapy may be used when the cancer has spread to other parts of the body or in situations where surgery isn’t possible.

• #1 The Immunotherapy Landscape in Adrenocortical Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8199088/

  Adrenocortical carcinoma is a rare and life-threatening cancer originating from the adrenal glands. […] Although aggressive surgical interventions may cure this cancer when detected at early stages, treatments for advanced or metastatic disease are limited and often unable to shrink or control the growth of this tumor. […] Research into new treatments is needed for adrenal cortical carcinoma and other rare cancers. […] Among these novel and innovative treatments are immunotherapies. […] This article focuses on the various immunotherapies that have been, currently are, or will be tested in clinical trials for the treatment of adrenocortical carcinoma. […] Immunotherapies, inclusive of a broad array of immune-activating and immune-modulating antineoplastic agents, have demonstrated clinical benefit in a wide range of solid and hematologic malignancies. […] Multiple clinical trials evaluating immunotherapies for the treatment of ACC have been conducted, and many more are ongoing or planned. […] Immunotherapies that have been evaluated in clinical trials for ACC include the immune checkpoint inhibitors pembrolizumab, nivolumab, and avelumab. […] Other immunotherapies that have been evaluated include the monoclonal antibodies figitumumab and cixutumumab directed against the ACC-expressed insulin-like growth factor 1 (IGF-1) receptor, the recombinant cytotoxin interleukin-13-pseudomonas exotoxin A, and autologous tumor lysate dendritic cell vaccine. […] Clinical trials are ongoing to evaluate whether this clinical activity may be augmented through combinations with other immune-acting agents or targeted therapies.

• #1 How We Treat Adrenocortical Carcinoma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/adrenocortical-carcinoma/treatment

  Treatment of recurrent adrenocortical carcinoma may include the following as therapy to relieve symptoms and maintain the quality of life: […] A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. […] Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. […] Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.

• #1 Treatment for Adrenal Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/adrenal-tumors/treatment

  There are many treatment options for adrenal cortical carcinomas, including medications, radiation therapy, surgery, and chemotherapy. We can combine treatments if the cancer has metastasized, or spread, beyond the adrenal glands. […] If you have a tumor that has spread or come after being first treated, or if youre too sick to undergo surgery, we may recommend a procedure called tumor ablation. This allows us to use heat or cold to kill cancer cells, relieving some of your symptoms and improving your quality of life.

• #1 Treating Adrenal Cancer | Adrenal Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/adrenal-cancer/treating.html

  If you’ve been diagnosed with adrenal cancer, your care team will discuss treatment with you. […] The main types of treatment for adrenal cancer are: Surgery for Adrenal Cancer, Radiation Therapy for Adrenal Cancer, Chemotherapy for Adrenal Cancer, Immunotherapy for Adrenal Cancer, Hormone Therapy for Adrenal Cancer. […] Depending on the type and stage of your cancer, you might need more than one type of treatment. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors havent mentioned.

• #1 Treatments for adrenocortical carcinoma (ACC) | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/adrenal-gland/treatment/adrenocortical-carcinoma-acc

  The following are treatment options for adrenocortical carcinoma (ACC). Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. […] Treatment decisions depend mainly on whether the cancer can be completely removed with surgery (is resectable) or cant be completely removed with surgery (is unresectable). […] Surgery is the main treatment for resectable ACC. You may also be offered surgery for unresectable or recurrent ACC. […] An adrenalectomy is a surgery to remove the adrenal gland. It’s done if the cancer is only in the adrenal gland. […] Debulking means removing as much of the cancer as possible. This surgery may be used for unresectable or recurrent ACC. […] Different types of supportive therapy drugs may be offered as treatment for ACC.

• #1 Adrenocortical Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq

  Treatment options for stage I ACC include: […] Complete surgical removal of the tumor is the treatment of choice for patients with stage I ACC. […] Adjuvant mitotane (under clinical evaluation). Adjuvant mitotane has shown some progression-free or disease-free survival advantage, but no overall survival advantage. […] Treatment options for stage II ACC include: […] Complete surgical removal of the tumor is the treatment of choice for patients with stage II ACC. […] Adjuvant mitotane (under clinical evaluation). Adjuvant mitotane has shown some progression-free or disease-free survival advantage, no overall survival advantage. […] Treatment options for stage III ACC include: […] Complete surgical removal of the tumor, with or without regional lymph node dissection, is the treatment of choice for patients with stage III ACC.

• #1 Adrenocortical Carcinoma Treatment – NCI

  https://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq

  Patients may want to think about taking part in a clinical trial. […] Treatment of stage I adrenocortical carcinoma may include: Surgery (adrenalectomy). Nearby lymph nodes may also be removed if they are larger than normal. […] Treatment of stage II adrenocortical carcinoma may include: Surgery (adrenalectomy). Nearby lymph nodes may also be removed if they are larger than normal. […] Treatment of stage III adrenocortical carcinoma may include: Surgery (adrenalectomy). Nearby lymph nodes may also be removed if they are larger than normal. […] Treatment of stage IV adrenocortical carcinoma may include the following as palliative therapy to relieve symptoms and improve the quality of life: Chemotherapy or combination chemotherapy, Radiation therapy to bones or other sites where cancer has spread, Surgery to remove cancer that has spread to tissues near the adrenal cortex. […] Treatment of recurrent adrenocortical carcinoma may include the following as palliative therapy to relieve symptoms and improve the quality of life: Surgery, Radiation therapy, A clinical trial of chemotherapy or immunotherapy.

• #1 Adrenal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546580/

  For this reason, adjuvant therapy after surgery is common and includes the use of mitotane and tumoral irradiation. […] Treatment of advanced ACC must be considered palliative. This treatment includes improving the quality of life (QOL) through necessary interventions (e.g., pain control, prevention of fractures caused by bony metastasis and adequate control of hormonal symptoms) as well as minimizing side effects from antineoplastic therapies. […] The drug of choice for adjuvant treatment is mitotane, which exerts hormonal effects by reducing adrenal steroids production by blocking steroidogenic enzymes, as the 11b-hydroxylase enzyme, (officially named cytochrome P450 11B1 -CYP11B1-) and cholesterol side-chain cleavage by inhibiting CYP11A1 (which appears to be one of the covalently bound mitotane targets) in the adrenal cortex.

• #1 Adrenal Carcinoma Treatment & Management: Approach Considerations, Surgical Resection, Chemotherapy

  https://emedicine.medscape.com/article/276264-treatment

  Some experts recommend that the use of radiation therapy be restricted to palliation of local disease, such as symptomatic metastases to the bone and local luminal obstructive disease. […] Ambulatory follow-up should be performed every month for the first 2 years after treatment because repeat resection of locally recurring disease and resection of metastatic lung disease can substantially improve long-term survival.

• #1 Support for Adrenal Tumors | NYU Langone Health

  https://nyulangone.org/conditions/adrenal-tumors/support

  Support for Adrenal Tumors […] NYU Langone doctors are closely involved in the follow-up care for people with adrenal tumors. Our endocrinologists help ensure that your hormone levels are stable after treatment by monitoring you with blood and urine tests and imaging scans. […] […] You may need to see your doctor every six months to a year after your initial treatment. If you are taking the chemotherapy drug mitotane, you may need to be seen more often to ensure that your hormone levels are normal. Mitotane can destroy healthy adrenal tissue as well as cancerous tissue, so hormone levels may be low. […] Our doctors provide regular follow-up care after treatment for adrenal tumors to monitor hormone levels and other symptoms. […] NYU Langone offers a variety of support services to help you manage adrenal tumors during and after treatment.

• #1 Support for Adrenal Tumors | NYU Langone Health

  https://nyulangone.org/conditions/adrenal-tumors/support

  After an evaluation by our doctors at Rusk Rehabilitation, physical therapists can help you get out of the hospital bed and start moving after adrenal surgery, so you can return home quickly. Our doctors also prescribe medications for postoperative pain and discomfort, which can affect your mobility. […] Our doctors encourage good nutrition for your overall health as a part follow-up care for an adrenal tumor. Registered oncology dietitians at NYU Langones Perlmutter Cancer Center provide nutrition education and counseling. […] Support groups and one-on-one counseling sessions with a psycho-oncologist, a healthcare provider who is trained to address the psychological needs of people with cancer, are available at the Perlmutter Cancer Center. […] Counseling can often help alleviate any anxiety or depression you may experience after your diagnosis or during the treatment process. Social workers at Perlmutter Cancer Center are also available to help you address any financial challenges or issues regarding insurance reimbursement during treatment.

• #1 Systemic therapy for adrenocortical carcinoma: a review – Hallanger-Johnson – AME Medical Journal

  https://amj.amegroups.org/article/view/5384/html

  The First International Randomized Trial in Locally Advanced and Metastatic Adrenocortical Carcinoma Treatment (FIRM-ACT) compared mitotane plus etoposide, doxorubicin, and cisplatin every 4 weeks or mitotane plus streptozocin every 3 weeks. Overall survival was not different, but EDP plus mitotane demonstrated improved response rate (23.2% vs. 9.2%). This data lead to EDP plus mitotane as the systemic therapy of choice. […] Systemic therapies for ACC remain focused on mitotane, a treatment we have utilized for more than 5 decades to treat this disease. Unfortunately, although we now understand much more than ever in the pathogenesis of ACC, we have not yet identified the perfect therapy for this aggressive disease.

• #1 The Immunotherapy Landscape in Adrenocortical Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8199088/

  As immunotherapies are among the most rapidly developing fields in oncology, there has been a great interest in their potential application in the treatment of ACC. […] Two clinical trials using the PD-1 inhibitor pembrolizumab as monotherapy in ACC have been reported. […] A second study, reported by Habra et al., investigated pembrolizumab in patients with rare malignancies. […] Nivolumab monotherapy was tested in a phase II trial reported by Carneiro et al. […] Avelumab has been evaluated in a phase 1b clinical trial in patients with metastatic ACC who had progressed after first-line platinum-based therapy. […] Although the described trials of immunotherapies in ACC have yet to deliver on the potential promise of these agents, it is an active area of research in this difficult-to-treat disease. […] Current and planned clinical trials evaluating immunotherapy are outlined in Table 3. […] Effective therapies for this disease are sorely needed. […] Cancer immunotherapies such as immune checkpoint inhibitors alone or in combination with targeted therapies may have benefits in ACC; however, to date, the clinical utility of these agents in unselected populations of patients with ACC has proven limited.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/How-is-Adrenal-Cancer-Treated.aspx

  Following a diagnosis of adrenal cancer, there are several treatment options that may be used. Each of these techniques has unique advantages and disadvantages that will make it preferable for some cases and not others. […] The treatment of adrenal cancer typically involves a multidisciplinary team a may include surgeons, endocrinologists, radiation oncologists, medical oncologists, nurses, psychologists, social workers, and other health professionals. […] The most common treatment for adrenal cancer is adrenalectomy or surgical removal of the adrenal gland. In this procedure, the cancer is removed as much as possible, including areas where the cancer has spread to such as nearby lymph nodes. […] If the cancer has metastasized to other areas of the body, such as the liver, surgical removal of these secondary tumors may also be needed.

• #2 Adrenal Cancer: Symptoms, Prognosis & Treatment

  https://my.clevelandclinic.org/health/diseases/25236-adrenal-cancer

  Adrenal cancer can be difficult to cure, but its possible with early detection and treatment. Treatments could include surgery, radiation therapy and chemotherapy. […] Surgical removal (adrenalectomy) is the main curative treatment for adrenal cancer. […] Possible treatments include: Surgery, Radiation therapy, Chemotherapy, Other medications. […] If the tumor is in your adrenal gland or has only spread to very nearby tissues or lymph nodes, then your provider will likely recommend surgery. […] Sometimes, providers recommend chemotherapy or radiation therapy after surgery to kill any remaining cancer cells and reduce the risk of recurrence (return). […] Radiation therapy uses high-energy X-ray beams to kill cancer cells. […] Chemotherapy uses drugs to kill cancer cells. […] Healthcare providers may use other medications to treat adrenal gland cancer.

• #2 Adrenal Cancer Treatment | Endocrine Oncology Program | University of Michigan Rogel Cancer Center

  https://www.rogelcancercenter.org/adrenal-cancer/learn-about-adrenal-cancer/treatment

  An open approach allows the surgeon to remove a rim of normal tissue around the tumor more easily to help decrease rates of local recurrence and spread within the abdomen and has been found to improve survival in patients with adrenal cancers which have not already spread outside the adrenal gland. […] Unfortunately, even with pathologically documented complete resection of ACC, up to two-thirds of patients have recurrence of tumor at a locoregional or distant site, or both. […] If a recurrence is found where the original tumor previously was and there is no evidence of tumor elsewhere in the body, re-operation is associated with increased length of survival when compared to patients treated with mitotane and/or chemotherapy alone. […] Treatment may include one or more of the following: external beam radiation therapy, mitotane, chemotherapy.

• #2 Adrenal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adrenal-cancer/diagnosis-treatment/drc-20446405

  Mitotane (Lysodren) is an older medicine that has been used to treat advanced adrenal cancer. It also has shown promise in keeping adrenal cancer from coming back after surgery. Mitotane may be used after surgery for people who are at high risk of the cancer coming back. Research into mitotane for this purpose is ongoing. […] For adrenal cancer, immunotherapy may be used when the cancer has spread to other parts of the body or in situations where surgery isn’t possible.

• #2 Chemotherapy for Adrenal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/adrenal-cancer/treating/chemotherapy.html

  If the cancer has not been completely removed by surgery or has come back, mitotane may be used to shrink the cancer in some patients. […] Mitotane is particularly helpful for people with adrenal cancers who have problems caused by excessive hormone production. Even when it doesn’t shrink the tumor, mitotane can reduce abnormal hormone production and relieve symptoms. Most patients with excess hormone production are helped by mitotane. […] This drug is a pill taken 3 to 4 times a day. Like other types of chemo, treatment with mitotane needs to be supervised closely by a doctor. […] Drugs are sometimes combined with mitotane to treat advanced adrenal cancer. The chemo drugs used most often in combination with mitotane are: Carboplatin or Cisplatin, Etoposide (VP-16), Doxorubicin (Adriamycin).

• #2 Treatment for adrenal cortical cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/adrenal-gland-cancer/adrenal-cortical-cancer/treatment

  The main treatment for adrenal cortical cancer (ACC) is surgery. This gives the best chance of curing ACC. […] Treatment for advanced ACC is usually chemotherapy. […] You usually have chemotherapy if you have ACC that has come back after surgery or has spread to other parts of the body. […] You might have a chemotherapy drug called mitotane (Lysodren) after surgery. This helps to lower the chance of the cancer coming back. […] You usually have chemotherapy for advanced ACC. Your doctor might also suggest debulking surgery. This is an operation to remove as much of the cancer as possible. […] These treatments wont cure ACC. But they can help to control the growth of the cancer and relieve your symptoms. […] Doctors aim to remove as much of the cancer as possible, rather than removing the cancer completely. […] Your doctor may suggest you have other treatments. You might have them on their own or in combination with mitotane.

• #2 Medication for Adrenal Tumors | NYU Langone Health

  https://nyulangone.org/conditions/adrenal-tumors/treatments/medication-for-adrenal-tumors

  Because mitotane destroys both cancerous cells and healthy adrenal tissue, you may need to take steroid medications on an ongoing basis to help regulate or replace hormones such as cortisol and aldosterone. […] If an adrenocortical carcinoma has spread, doctors may prescribe chemotherapy drugs such as doxorubicin, cisplatin, or etoposide, which are given through a vein with intravenous (IV) infusion. […] The most common side effects of the chemotherapy drugs used to treat adrenal tumors are nausea, vomiting, and diarrhea. Our doctors can help you manage them by changing the dosages of the drugs, prescribing additional medications, or referring you to support services available at NYU Langone.

• #2 Adrenocortical Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq

  Radiation therapy (approximately 5070 Gy over a period of 4 weeks) may be given to patients with localized but unresectable tumors (under clinical evaluation). […] Chemotherapy with mitotane in doses as high as 10 to 12 g/day to achieve a blood level of 14 to 20 mg/L should be considered for patients unable to undergo complete resection (under clinical evaluation). […] The role of mitotane as adjuvant therapy after complete tumor resection is still unclear but should be discussed with the patient. […] Treatment options for stage IV ACC include: […] Chemotherapy with mitotane. […] Chemotherapy with mitotane plus streptozotocin or mitotane plus etoposide, doxorubicin, and cisplatin, as evidenced by the NCT00924144 phase III clinical trial. […] Radiation therapy to bone metastases.

• #2 Systemic therapy for adrenocortical carcinoma: a review – Hallanger-Johnson – AME Medical Journal

  https://amj.amegroups.org/article/view/5384/html

  The First International Randomized Trial in Locally Advanced and Metastatic Adrenocortical Carcinoma Treatment (FIRM-ACT) compared mitotane plus etoposide, doxorubicin, and cisplatin every 4 weeks or mitotane plus streptozocin every 3 weeks. Overall survival was not different, but EDP plus mitotane demonstrated improved response rate (23.2% vs. 9.2%). This data lead to EDP plus mitotane as the systemic therapy of choice. […] Systemic therapies for ACC remain focused on mitotane, a treatment we have utilized for more than 5 decades to treat this disease. Unfortunately, although we now understand much more than ever in the pathogenesis of ACC, we have not yet identified the perfect therapy for this aggressive disease.

• #2 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=34&contentid=19180-1

  Radiation therapy uses high-energy X-rays to kill cancer cells. […] Radiation is rarely the main treatment for adrenal cancer. This type of cancer tends to be hard to kill with radiation. But radiation therapy may be used after surgery to help keep adrenal cancer from coming back later. It may also be used to treat other body parts where the tumor has spread. Its sometimes used to help control pain caused by tumor growth. […] The most common type of radiation for adrenal cancer is external beam radiation therapy (ERBT). A large machine directs the beams at the cancer to kill the cancer cells. […] Radiation treatment is a lot like getting an X-ray. The radiation comes from a large machine. The machine doesn’t touch you during the treatment. Treatments don’t hurt and they’re quick. […] Side effects of radiation can include: upset stomach (nausea) and vomiting, diarrhea, skin irritation (like a bad sunburn) in the treatment area, hair loss in the treated area, loss of appetite, severe tiredness (fatigue), low blood counts.

• #2 Adrenal Cancer: Radiation Therapy

  https://healthlibrary.uwmedicine.org/BreatheEasy/34,19180-1

  Radiation therapy uses high-energy X-rays to kill cancer cells. […] Radiation is rarely the main treatment for adrenal cancer. This type of cancer tends to be hard to kill with radiation. But radiation therapy may be used after surgery to help keep adrenal cancer from coming back later. It may also be used to treat other body parts where the tumor has spread. Its sometimes used to help control pain caused by tumor growth. […] You’ll work with a radiation oncologist to make your radiation treatment plan. This is a doctor who specializes in both cancer and radiation. This healthcare provider decides: The goal of radiation therapy, The type of radiation that’s best for you, The radiation dose, How long treatment should last. […] The most common type of radiation for adrenal cancer is external beam radiation therapy (ERBT). A large machine directs the beams at the cancer to kill the cancer cells. Radiation is often given once a day, 5 days a week (Monday through Friday), for a certain number of weeks. The treatment is done by a radiation therapist. You’ll likely get it as an outpatient. This means you go in, get treatment, and go home the same day.

• #2 Adrenal Cancer: Radiation Therapy | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/adrenal-cancer-radiation-therapy

  Radiation therapy uses high-energy X-rays to kill cancer cells. […] Radiation is rarely the main treatment for adrenal cancer. This type of cancer tends to be hard to kill with radiation. But radiation therapy may be used after surgery to help keep adrenal cancer from coming back later. It may also be used to treat other body parts where the tumor has spread. Its sometimes used to help control pain caused by tumor growth. […] The most common type of radiation for adrenal cancer is external beam radiation therapy (ERBT). A large machine directs the beams at the cancer to kill the cancer cells. Radiation is often given once a day, 5 days a week (Monday through Friday), for a certain number of weeks. […] Before you start treatment, imaging scans will be done to know exactly where the cancer is. This is called a simulation scan. This is done so the radiation beams can be focused there.

• #2 Adrenal Cancer: Radiation Therapy | UMass Memorial Health

  https://www.ummhealth.org/health-library/adrenal-cancer-radiation-therapy

  Before you start treatment, imaging scans will be done to know exactly where the cancer is. This is called a simulation scan. This is done so the radiation beams can be focused there. […] Talk with your healthcare provider about what short- and long-term side effects you can expect and what can be done to prevent or manage them.

• #2 Adrenal Cancer: Radiation Therapy | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/adrenal-cancer-radiation-therapy

  Talk with your healthcare provider about what short- and long-term side effects you can expect and what can be done to prevent or manage them. […] Side effects of radiation can include: Upset stomach (nausea) and vomiting, diarrhea, skin irritation (like a bad sunburn) in the treatment area, hair loss in the treated area, loss of appetite, severe tiredness (fatigue), low blood counts.

• #2 Adrenal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546580/

  Mitotane has been shown to significantly improve recurrence-free survival (RFS) in some studies and not others. […] The combination of cancer burden and hormonal excesses occur in almost 50% of adrenocortical carcinoma patients. Agents to treat Cushing syndrome such as ketoconazole, metyrapone, and mifepristone are often used, with the hope of reducing the morbidity of cortisol excess. […] The success of hormonal control is contingent on a synchronized approach to reducing hormonal production, counteracting the effects of hormonal overproduction, and reducing disease burden via surgery or systemic chemotherapy. […] In metastatic disease, different parameters merit consideration: the tumoral volume, the number of metastatic organs, and the progression rates. Debulking surgery only benefits in ACC patients with a limited number of tumoral organs (less than or equal to 2), resectable tumoral mass, with a light progression and when severe hormone excess that is not manageable medically. However, most patients require medical therapy. […] Mitotane remains the only medication approved by the European Medicine Executive Agency (EMEA) and the U.S Food and Drug Administration (FDA) for the treatment of metastatic ACC.

• #2 Nonsurgical and Surgical Therapies | GW Cancer Center

  https://cancercenter.gwu.edu/specialties/adrenal-carcinoma/nonsurgical-surgical-therapies

  Once diagnosed, there may be different treatment options for adrenal cancer. The specific treatment choice is determined by age, medical history, and the stage of cancer. The GW Cancer Center will provide you information to help you decide which treatment pathway is right for you. […] Chemotherapy: Powerful drugs taken by mouth or delivered into the veins can be very effective in killing cancer cells, particularly if they have spread beyond the adrenal gland. […] Immunotherapy: These are treatments that help the bodys immune system work harder in fighting cancer cells. Immunotherapy is a relatively new, safe alternative with minimal side effects. […] Medication: There are drugs that can help correct the levels of hormones created by adrenal tumors. They help relieve symptoms associated with adrenal cancer.

• #2 The Immunotherapy Landscape in Adrenocortical Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8199088/

  As immunotherapies are among the most rapidly developing fields in oncology, there has been a great interest in their potential application in the treatment of ACC. […] Two clinical trials using the PD-1 inhibitor pembrolizumab as monotherapy in ACC have been reported. […] A second study, reported by Habra et al., investigated pembrolizumab in patients with rare malignancies. […] Nivolumab monotherapy was tested in a phase II trial reported by Carneiro et al. […] Avelumab has been evaluated in a phase 1b clinical trial in patients with metastatic ACC who had progressed after first-line platinum-based therapy. […] Although the described trials of immunotherapies in ACC have yet to deliver on the potential promise of these agents, it is an active area of research in this difficult-to-treat disease. […] Current and planned clinical trials evaluating immunotherapy are outlined in Table 3. […] Effective therapies for this disease are sorely needed. […] Cancer immunotherapies such as immune checkpoint inhibitors alone or in combination with targeted therapies may have benefits in ACC; however, to date, the clinical utility of these agents in unselected populations of patients with ACC has proven limited.

• #2 Drug Treatments for Adrenal Tumors | Roswell Park Comprehensive Cancer Center – Buffalo, NY

  https://www.roswellpark.org/cancer/adrenal/treatment/medical-treatments

  Some patients with adrenal tumors or adrenal cancer may need systemic therapy, which uses anti-cancer drugs that circulate throughout the body. […] Your cancer care team will select the specific drugs or combination of drugs that are best for your cancer. Systemic therapy for adrenal cancer may include one of more of these types of drugs: […] Chemotherapy. These drugs find and kill cancer fast-growing cancer cells by interrupting the process the cells use to multiply. […] Targeted therapy. Targeted therapy drugs seek cancer cells by targeting specific characteristics or features of the cancer cells. The drugs then stop the action of certain molecules that allow the cancer cells to grow or survive. […] Theranostics. This approach uses radiopharmaceuticals, drugs that carry radiation. […] Immunotherapy. Cancer cells are able to grow in the body because they have learned how to hide themselves from the bodys immune system. Immunotherapy uses drugs to stimulate the bodys immune system and/or reveal the cancer cells, so that your immune system can fight the cancer.

• #2

  https://winshipcancer.emory.edu/cancer-types-and-treatments/adrenal-cancer/

  With more clinical trials than any other cancer center in the state including Phase I trials, which feature the newest therapies you’ll have access to the most advanced and innovative treatments and adrenal cancer resources. […] Our patients benefit from the advantages of Winship’s prestigious status as an NCI-designated Comprehensive Cancer Center: data shows that cancer centers designated by the National Cancer Institute have better patient survival rates than centers without NCI designation. We also focus on lowering the chances of cancer returning and on delivering treatments with fewer side effects.

• #2 How We Treat Adrenocortical Carcinoma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/adrenocortical-carcinoma/treatment

  Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. […] Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. […] Interventional radiology (IR), also known as image-guided treatment, uses technology such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) to perform minimally-invasive procedures to diagnose and treat cancer, as well as provide relief from symptoms. […] The treatment approach may vary based on the stage of adrenocortical carcinoma. […] If you are diagnosed with stage I, II, or III adrenocortical carcinoma, treatment may involve surgery to remove the adrenal gland. […] If you are diagnosed with stage IV adrenocortical carcinoma, treatment may include the following as palliative therapy to relieve symptoms and improve the quality of life:

• #2 Adrenocortical Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq

  Surgical removal of localized metastases, particularly for tumors that are functioning. […] Temporary palliation of disseminated ACC can sometimes be achieved with the chemotherapeutic agent mitotane. […] Many patients with functioning tumors who receive treatment experience reduced hormone production. […] In patients with increased hormone production, antisteroidogenic drugs, such as ketoconazole and metyrapone, and steroid receptor antagonists, such as spironolactone and mifepristone, should be considered. […] Deciding to treat patients with recurrent adrenocortical carcinoma (ACC), and what treatment to use, depends on many factors, including previous treatment, site of recurrence, and individual patient considerations. […] Local recurrence and selected sites of metastatic disease can sometimes be palliated by surgery or radiation therapy. […] Although recurrent ACC is not considered curable, palliation of hormonal symptoms and occasional 5-year survivals can be achieved.

• #2 Support for Adrenal Tumors | NYU Langone Health

  https://nyulangone.org/conditions/adrenal-tumors/support

  After an evaluation by our doctors at Rusk Rehabilitation, physical therapists can help you get out of the hospital bed and start moving after adrenal surgery, so you can return home quickly. Our doctors also prescribe medications for postoperative pain and discomfort, which can affect your mobility. […] Our doctors encourage good nutrition for your overall health as a part follow-up care for an adrenal tumor. Registered oncology dietitians at NYU Langones Perlmutter Cancer Center provide nutrition education and counseling. […] Support groups and one-on-one counseling sessions with a psycho-oncologist, a healthcare provider who is trained to address the psychological needs of people with cancer, are available at the Perlmutter Cancer Center. […] Counseling can often help alleviate any anxiety or depression you may experience after your diagnosis or during the treatment process. Social workers at Perlmutter Cancer Center are also available to help you address any financial challenges or issues regarding insurance reimbursement during treatment.

• #2 Support for Adrenal Tumors | NYU Langone Health

  https://nyulangone.org/conditions/adrenal-tumors/support

  Our supportive care team provides ongoing treatment for any discomfort you may experience during or after treatment for an adrenal tumor. Pain management can include integrative therapies, which are available at the Perlmutter Cancer Center. These include massage therapy, which can help reduce stress, and acupuncture, which may relieve tumor-related pain and the fatigue associated with chemotherapy or hormonal changes. […] Chemotherapy drugs used to treat a malignant tumor, such as an adrenocortical carcinoma, may cause neuropathy, or nerve damage. Symptoms include numbness, tingling, pain, and weakness in the hands, feet, arms, legs, or other parts of the body. […] After an evaluation by NYU Langones Rusk Rehabilitation specialists, they can prescribe medication to ease the discomfort caused by neuropathy, and can recommend a rehabilitation program to help you maintain your balance, strength, and ability to perform daily activities.

• #3 Treatment for Adrenal Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/adrenal-tumors/treatment

  Endocrinologist Mabel Ryder, surgeon Vivian Strong, and nuclear medicine doctor Jorge Carrasquillo work together as a team to make sure patients with all kinds adrenal tumors get the best care possible. […] When you come to us for adrenal tumor treatment, you are coming to a cancer center ranked #1 in the nation for Urology Cancer Care this year by U.S. News World Report. Here at MSK, you will have a team of experts caring for you. Experts from endocrinology, nuclear medicine, surgery, medical oncology, and interventional radiology collaborate on a personalized treatment plan that takes into account all of your needs. […] Treatment will depend on the type of adrenal tumor you have and where its located. Your doctor may recommend one or several of the following: surgery, hormone therapy, chemotherapy, radionuclide therapy (injection of a radioactive substance into the tumor), or other therapies.

• #3 Adrenal Carcinoma Treatment & Management: Approach Considerations, Surgical Resection, Chemotherapy

  https://emedicine.medscape.com/article/276264-treatment

  When feasible, total resection remains the treatment of choice for the definitive management of AC. It also is still the only potentially curative therapy. […] Recurrent local and metastatic tumors are common in AC, even in patients who undergo a successful complete resection. In such settings, the only effective treatment is attempted reoperation. […] Mitotane remains the major chemotherapeutic option for the management of AC because it is a relatively specific adrenocortical cytotoxin. It is used as primary therapy, as adjuvant therapy, and as therapy in recurrent or relapsing disease. […] Adjuvant therapy with mitotane remains controversial. […] Based on data so far, adjuvant therapy can be recommended for patients with high risk for recurrence based on positive margins, ruptured capsule, large size of the primary tumor, or high mitotic rate. Adjuvant mitotane therapy can be considered after resection of AC.

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