Treatments for adrenal gland cancer
If you have adrenal gland cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for adrenal gland cancer, your healthcare team will consider:
- the stage
- the grade
- whether the tumour makes and releases hormones (functional) or not (non-functional)
- whether the tumour can be completely removed with surgery (is resectable) or can’t be removed with surgery (is unresectable)
You may be offered one or more of the following treatments for adrenal gland cancer.
Depending on the size of the tumour and where the cancer has spread, you may have one of the following types of surgery.
Adrenalectomy is a surgery to remove the whole adrenal gland. It is done if the cancer is only in an adrenal gland.
En bloc resection removes the tumour and surrounding tissues as a single piece. It may be done for adrenocortical carcinoma (ACC) that has spread to nearby tissues.
Debulking means removing as much of the cancer as possible. It helps to reduce the symptoms of high hormone levels and symptoms caused by growth of the tumour. Debulking may be used for unresectable or metastatic adrenal gland cancer.
Surgery for metastasis may be used to remove adrenal gland cancer that has spread (metastasized) to other organs such as the liver, kidney, spleen, pancreas and lymph nodes.
Side effects of surgery will depend mainly on the type and site of surgery and your overall health. Surgery for adrenal gland cancer may cause pain, decreased urinary output, changes in blood pressure and low blood sugar. These side effects can usually be controlled.
Find out more about surgery.
You may be given supportive drugs before surgery to control symptoms caused by too much production of certain hormones. Supportive drugs are used to lower the amount of hormones made or to block the actions of these hormones. The supportive drugs used depend on which hormone is overproduced.
After surgery to remove an adrenal gland, your levels of adrenal gland hormones may be low. You may receive supportive drugs to replace adrenal gland hormones until the levels of the adrenal gland hormones return to normal. This is called hormone replacement therapy. It can be given for a short time or permanently.
Side effects of supportive drugs will depend mainly on the type and dose of the drug.
Chemotherapy is often used as the main treatment if the cancer cannot be removed with surgery. It may be given after surgery to destroy cancer cells left behind or treat adrenal gland cancer that comes back. It is also used to reduce symptoms caused by too much production of certain hormones in advanced adrenal gland cancer.
Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Some common side effects of chemotherapy drugs used for adrenal gland cancer are low levels of adrenal gland hormones, nausea and vomiting, diarrhea, loss of appetite, and high or low blood pressure.
Find out more about chemotherapy.
External beam radiation therapy may be given after surgery for ACC to reduce the risk of the cancer coming back. It may also be given if adrenal gland cancer has spread to the bone or brain.
Targeted radiation therapy with radioactive metaiodobenzylguanidine (MIBG) may be used to treat cancerous pheochromocytomas. MIBG attaches to the cancer cells. This allows the radioactive material to be delivered directly to the cancer cells. This treatment may not be available at all treatment centres.
Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy used for adrenal gland cancer are fatigue, nausea, loss of appetite, diarrhea and skin problems.
Find out more about radiation therapy.
If you can’t have or don’t want cancer treatment
You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first few years after treatment has finished. These visits allow your healthcare team to follow your progress and recovery from treatment.
A few clinical trials in Canada are open to people with adrenal gland cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.
Questions to ask about treatment
To make the decisions that are right for you, ask your healthcare team questions about treatment.