The drugs used in chemotherapy attack and kill cells that divide quickly, including cancer cells and some normal cells. In general, chemotherapy is not very effective for adrenal cancer, and if at all possible, surgery should be considered the treatment of choice. However, chemotherapy may be used when adrenal cancer has become widespread in the body.
Mitotane is the most commonly used drug for this purpose. Mitotane works by blocking production of hormones by the adrenal glands. It also destroys cancer cells and healthy adrenal tissue. Decreased production of adrenal hormones can cause fatigue and weakness. If this side effect occurs, you will most likely be given medication to increase your adrenal hormone levels. Mitotane may also alter levels of other hormones, such as thyroid and testosterone. If this occurs, you will need to take drugs to replace these hormones as well.
Mitotane may be given after surgery to help destroy any remaining cancer cells that were not removed during surgery. This is called adjuvant therapy, and may help prevent or delay the return of adrenal cancer.
Mitotane is especially effective in people whose adrenal cancer has caused excessive production of adrenal hormones.
The most common side effects that may occur with mitotane include nausea, vomiting, diarrhea, rash, confusion, and sleepiness. You should be monitored closely while taking mitotane.
Mitotane is generally given three to four times a day in pill form.
Other chemotherapy medications used to treat adrenal cancer include:
Various combinations of these drugs may be used. They may also be given along with mitotane. When cancer has spread or may have spread beyond the adrenal gland, a combination of cisplatin, doxorubicin, and etoposide may be used.