Adrenal Cancer: Chemotherapy
What is chemotherapy?
Chemotherapy (chemo) uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly.
Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects.
When might chemotherapy be used for adrenal cancer?
Chemotherapy may be used to treat adrenal cancer that has spread too much and can’t be removed with surgery. In this case, it can’t cure the cancer. But it can keep it under control.
Chemotherapy may also be given after surgery. It helps destroy any cancer cells that were not removed during surgery. This can help prevent or delay adrenal cancer from coming back.
What types of medicines are used to treat adrenal cancer?
Mitotane is the medicine used most often for adrenal cancer. It stops the adrenal glands from making hormones. It also destroys cancer cells and healthy adrenal tissue.
When you have fewer adrenal hormones, you may feel very tired and weak. If this happens, you will likely be given medicine to raise your adrenal hormone levels. Mitotane may also change other hormone levels, such as thyroid hormones and testosterone. If this happens, you will need medicines to replace these hormones as well. Medicines to control hormone levels are also used to ease symptoms caused by hormone imbalances. You may need to take them even after treatment is done.
Mitotane works very well when adrenal cancer has caused too many adrenal hormones to be made. It may not shrink the tumor. But it can help stop more hormones from being made. This can help ease symptoms.
How is chemotherapy given for adrenal cancer?
Mitotane is generally given 3 to 4 times a day in pill form. You can take it at home. But be sure you know exactly how much, when, and how to take it.
Other chemotherapy medicines may be used with mitotane to treat advanced adrenal cancer. These medicines are given through an IV (intravenous) line into your bloodstream. They include:
Streptozocin plus mitotane
A combination of cisplatin, doxorubicin, and etoposide plus mitotane
Other chemotherapy medicines that are used less often for adrenal cancer include:
These medicines are also given by IV. Different combinations of these medicines may be used. They may also be given with mitotane.
What are common side effects of chemotherapy?
Chemotherapy side effects depend mostly on the type of medicines you are taking. The most common side effects of mitotane include:
Rash or changes in skin color
You should be watched closely while taking mitotane.
Chemotherapy affects normal cells as well as cancer cells. You may have a higher risk of infection because of low white blood cell counts.
If you have any symptoms of infection during chemo, tell your doctor or nurse right away. This is very important if you have a fever. If your blood-clotting cell (platelet) counts are down, you may bruise and bleed more easily from a cut or injury. You may feel more tired if you have a low red blood cell count.
Most side effects go away over time when treatment is stopped. There are medicines that can help reduce the side effects. They can help you recover from chemotherapy more quickly.
Working with your healthcare provider
It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.
Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections. Make sure you know what number to call if you have questions. Is there a different number for evenings and weekends?
It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.
May 11, 2018
Gersten, Todd, MD,Image reviewed by StayWell art team.,LoCicero, Richard, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS