Removing an adrenal tumor can help restore normal hormone levels to the body, but NYU Langone doctors may need to prescribe medication before, during, or after an operation to reduce dangerous side effects of elevated hormone levels, such as high blood pressure. They may also recommend chemotherapy to destroy rare, cancerous adrenal tumors known as adrenocortical carcinomas.
Physicians sometimes prescribe medication before or after surgery to reduce levels of excess hormones in the body. For example, if a pheochromocytoma—a tumor that usually develops in the center, or medulla, of the adrenal gland—is producing large amounts of stress hormones and is causing high blood pressure, your doctor may prescribe medications called alpha-blockers to lower blood pressure prior to surgery. Your doctor may also prescribe medications called beta-blockers to help lower your heart rate, which can be raised by elevated levels of stress hormones.
Immediately after surgery, hormone levels may still be in flux. For example, your body may require elevated levels of cortisol after a cortisol-producing tumor has been removed. Doctors may prescribe cortisol for several weeks while the remaining adrenal gland works to become more active.
Doctors may treat adrenocortical carcinomas, which are rare, with chemotherapy drugs that destroy cancer cells throughout the body. For example, the drug mitotane, which is taken by mouth several times a day, may reduce the risk of the cancer coming back. If surgery is not possible because of poor overall health or another condition such as heart disease, mitotane can be used to reduce elevated levels of sex hormones caused by tumors.
Because mitotane destroys both cancerous cells and healthy adrenal tissue, you may need to take steroid medications on an ongoing basis to help regulate or replace hormones such as cortisol and aldosterone.
If an adrenocortical carcinoma has spread, doctors may prescribe chemotherapy drugs such as doxorubicin, cisplatin, or etoposide, which are given through a vein with intravenous (IV) infusion. These drugs are usually given a few days a week every three or four weeks.
The most common side effects of the chemotherapy drugs used to treat adrenal tumors are nausea, vomiting, and diarrhea. Our doctors can help you manage them by changing the dosages of the drugs, prescribing additional medications, or referring you to support services available at NYU Langone.
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