Treatment of Adrenocortical Carcinoma

Stages of Adrenocortical Carcinoma

After adrenocortical carcinoma has been diagnosed, tests are done to find out if cancer cells have spread within the adrenal gland or to other parts of the body. The following tests and procedures may be used in the staging process:
  • CT scan
  • MRI
  • Adrenal Angiography
  • Adrenal Venography
  • Cavagram
  • Ultrasound
  • Adrenalectomy

Metastasis

Cancer spreads in the body through tissues, lymph system or blood. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. The following stages are used for adrenocortical carcinoma:
  • Stage I-– In stage I, the tumor is 5 centimeters or smaller and is found only in the adrenal gland.
  • Stage II— In stage II, the tumor is larger than 5 centimeters and is found only in the adrenal gland.
  • Stage III— In stage III, the tumor can be any size and may have spread to fat or lymph nodes near the adrenal gland.
  • Stage IV— In stage IV, the tumor can be any size and has spread:
    • to fat or organs and to lymph nodes near the adrenal gland; or
    • to other parts of the body. Adrenocortical carcinoma commonly spreads to the lung, liver, bones, and peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen).

Recurrent Adrenocortical Carcinoma

Recurrent adrenocortical carcinoma is cancer that has recurred (come back) after it has been treated. The cancer may come back in the adrenal cortex or in other parts of the body.

Treatment of Adrenocortical Carcinoma

Different types of treatments are available for patients with adrenocortical carcinoma. Some treatments are standard and some are being tested in clinical trials. Three types of standard treatment are used:

Surgery

Surgery to remove the adrenal gland (adrenalectomy) is often used to treat adrenocortical carcinoma. Sometimes the nearby lymph nodes are also removed.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated. Systemic chemotherapy— When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body. Regional chemotherapy— When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas.

Clinical trials

Patients can enter clinical trials before, during, or after starting their cancer treatment. Biologic Therapy is one of the treatments that are being studied in clinical trials.

Biologic therapy

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

Follow-up

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Contact us to request an appointment with one of our medical oncologists to discuss your treatment options or obtain a second opinion.