Surgery is the treatment of choice for many adrenocortical carcinomas. However, your treatment will depend on your overall health and cancer stage.
Stage I and II: These cancers are generally treated by removing the diseased adrenal gland. Nearby lymph nodes may be removed for examination if they are enlarged. If the cancer is not producing hormones, additional treatment may not be needed. However, follow-up exams are recommended.
Stage III: Surgery is the standard treatment for stage III adrenocortical carcinoma. The goal is to remove the affected adrenal gland. Nearby enlarged lymph nodes are also removed. Nearby organs may be removed as well. Patients with stage III adrenocortical carcinoma are at risk for recurrent cancer.
Stage IV: Sometimes the cancer has spread and is not likely to be cured. Still, surgery may be recommended to remove as much of the tumor as possible. This can reduce symptoms and enhance the person's quality of life. Radiation therapy and chemotherapy may also help manage symptoms.
Recurrent adrenocortical cancer: This is usually treated like stage IV disease, but the approach depends on several factors. These include the patient's history with adrenocortical cancer and the site of the recurrence.
For stages III and IV and recurrent adrenocortical cancer, combination chemotherapy that includes a drug called mitotane may help cancer growth and decrease symptoms related to hormone over production.
When treatments are no longer helping, care will focus on controlling pain and improving well-being.