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How We Treat Adrenocortical Carcinoma

  • At a Glance

    • Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) offers a multidisciplinary team of experts in genitourinary oncology to provide the best care possible.
    • There are different types of treatment for patients with adrenocortical carcinoma: surgery, interventional radiology, radiation, and chemotherapy.
    • The stage of adrenocortical carcinoma will determine the appropriate treatment for you.
    • Clinical trials are an important part of cancer treatment and research – trials are available to adrenocortical carcinoma patients.

    At DF/BWCC, our Genitourinary Cancer Treatment Center focuses on treatment of, and research on, common and rare cancers, including adrenocortical carcinoma. When treated at DF/BWCC, you can feel confident about your care team; our experts in urology, medical oncology, and radiation work closely with you to develop the best personalized treatment plan and answer all questions throughout the process.

    Our Approach to Treatment

    At DF/BWCC, we take a personalized and multidisciplinary approach to treatment. Our team of expert surgical, medical, and radiation oncologists, radiologists, pathologists, researchers, nurses, nutritionists, and social workers cares for each patient with dedication and compassion.

    In addition, our team includes world-renowned endocrinologists and endocrine surgeons at Brigham and Women's Hospital, combining the leading minds in adrenocortical carcinoma treatment. This level of deep expertise is what makes our teams so special.

    DF/BWCC also offers a shared care approach to treatment by collaborating with referring physicians. This ensures shared patients access to care across the entire continuum of services they need in the most appropriate and convenient location. Through a shared care approach, patients gain Dana-Farber expertise while receiving their treatment closer to home.

    Beginning with your first appointment, our team will walk you through the entire treatment process, making sure you know what to expect and where to find helpful resources, such as counseling and support services, nutrition advice, or palliative care. We create a unique, personalized plan for every patient and consider all aspects of your health when making our recommendations.

    For Referring Physicians

    Because primary care physicians and community specialists are integral parts of every patient's care team, we are committed to collaborating with you in the care of your patient.

    If you are a referring physician and have a patient with suspected or confirmed adrenocortical carcinoma, we look forward to working with you. In many cases, we are able to consult with patients and referring physicians and enable patients to receive care close to home.

    Find out more about how to refer a patient to Dana-Farber/Brigham and Women Cancer Center.

    Types of Treatment

    There are several types of treatment for patients with adrenocortical carcinoma. Some treatments are standard, while others are being tested in clinical trials. Four types of standard treatment are currently used:

    • Surgery removes the adrenal gland and is often used to treat adrenocortical carcinoma. This is known as adrenalectomy. Sometimes surgery is done to remove the nearby lymph nodes and other tissue where the cancer has spread.
    • Radiation therapy 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. Intensity-modulated external radiation therapy is used to treat adrenocortical carcinoma to uniquely shape the radiation to the target, while limiting dose to the normal tissues.
    • Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. 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 (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
    • 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. Interventional radiology may be used when the cancer is indolent, as well as to manage metastatic cancer for significant periods of time.

    Treatment Options by Stage

    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. Treatment may also include participating in a clinical trial of a new treatment. We may also consider adjuvant treatment following surgery, such as chemotherapy or radiation to decrease the chance of recurrence.

    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:

    • 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
    • A clinical trial of chemotherapy, biologic therapy, or targeted therapy
    • Interventional radiology

    Recurrent Adrenocortical Carcinoma

    Treatment of recurrent adrenocortical carcinoma may include the following as therapy to relieve symptoms and maintain the quality of life:

    • Surgery
    • Radiation therapy
    • A clinical trial of chemotherapy or biologic therapy
    • Interventional radiology

    Clinical Trials

    A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. Clinical trials are an important part of the cancer research process. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Below are two treatments that are being studied in clinical trials; however, clinical trials and therapies being studied are always evolving.

    • 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.
    • Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.

    Learn more about clinical trials at DF/BWCC.

    Recovery

    The prognosis (chance of recovery) and treatment options depend on the following:

    • The stage of the cancer (the size of the tumor and whether it is in the adrenal gland only or has spread to other places in the body).
    • Whether the tumor can be completely removed in surgery.
    • Whether the cancer has been treated in the past.
    • Your general health.
    • The grade of tumor cells (how different they look from normal cells under a microscope).
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