Adrenocortical Carcinoma Care for Patients Worldwide

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Adrenocortical Carcinoma Care for Patients Worldwide

  • Category

    Cancer

  • Published By

    GetWellGo Team

  • Updated on

    26-Aug-2025

Adrenocortical carcinoma care

The ACC is a highly malignant adrenocortical cancer originating in the outer portion (cortex) of the adrenal glands that make cortisol, aldosterone, and androgens. Due to the rapid growth in the treatment of this type of cancer, it is important to take an approach involving oncology, endocrinology, surgical intervention and supportive services.

Here is the general idea of adrenocortical carcinoma treatment:

Diagnosis & Evaluation

  • Medical history and physical: Examining evidence of hormone excess (Cushing’s syndrome, virilization, and high blood pressure).
  • Hormonal assays: Cortisol, aldosterone and androgens, estrogen levels.
  • Imaging: CT scan, MRI, PET scan of tumor location and spread.
  • Biopsy: Confirmation is often by surgery, though ordinarily considered not safe owing to possibility of spreading the tumor.

Treatment Options

Surgery (First line of Treatment)

  • It is treated mainly with adrenalectomy (surgical removal of the adrenal gland).
  • Objective: complete excision with no margins as the probability of recurrence is higher with incomplete surgery.

Medications

  • Mitotane (adrenolytic drug): Only used in ACC; reduces adrenal hormones and controls the tumor development.
  • Other drugs: Chemotherapy combinations (e.g. Etoposide, doxorubicin, cisplatin with mitotane).

Radiation Therapy

  • Not the first-line, but can be applied after the surgery (adjuvant therapy) or as symptomatic treatment in case of the tumor spread.

Hormone Control

  • Medications to treat excess cortisol, androgens, or aldosterone (e.g. metyrapone, ketoconazole, spironolactone).

Supportive and Palliative Care

  • Symptom control: Hypertension, diabetes, muscle aches, mood level.
  • Nutritional support: To address the side effects and strength.
  • Psychological support: Counselling, support groups, stress management.
  • Palliative care: To make quality of life better in advanced cases.

Advanced and Q&A Experimental Options

  • Targeted therapy: immunotherapy: remains under research, clinical trials may be a possibility.
  • Genetic testing: In case of Li- Fraumeni syndrome, Lynch syndrome or other inherited risks.

Adrenocortical carcinoma treatment in India

The treatment of adrenocortical carcinoma (ACC) has to be considered on the basis of the tumor stage, the occurrence of metastasizing, and the overproduction of hormones. As ACC is rare and aggressive, the treatment can usually only be done at specialized cancer centers with a multidisciplinary team (oncologists, endocrinologists, and surgeons).

Below you will find a systematic description of the treatment of ACC:

Surgery (Primary Means of Treatment)

  • Adrenalectomy (adrenal gland along with the tumor) is the main treatment.
  • Intent: To eliminate it with clear borders because, incomplete surgery augments the risk of recurrence.
  • In severe stages, the affected organs/ tissues (kidney, liver, or lymph nodes) may also be removed by the surgeons.

Medical Therapy

  • Mitotane (special medication of ACC)
  • Unique to cancers of the adrenal.
  • Kills adrenal cells, inhibits excessive production of hormoness and reduces the rate of tumor development.
  • Mostly applied as an adjuvant treatment process following surgery or where surgery is not possible.

Systemic Chemotherapy (advanced or metastatic ACC)

  • The most frequently used regimen: EDP-M (Etoposide + Doxorubicin + Cisplatin + Mitotane).
  • Coincombinations may be employed when EDP-M is intolerated.

Radiation Therapy

  • Is not the first-line treatment.
  • A lymph node dissection may be performed in the postoperative phase (to reduce the risk of recurring) or in palliative treatment (relief of pain or symptom control in advanced disease).

Hormone Management

  • ACC tends to overproduce the hormones (cortisol, aldosterone, androgens, estrogens).
  • Medications that control the symptoms:
  • Metyrapone or Ketoconazole- prevents production of cortisol
  • Spironolactone - prevents raised blood pressure as a result of aldosterone.

Newer Therapies

  • Targeted therapy: Research is continuing and there is yet no standard drug.
  • Immunotherapy: The immune checkpoint inhibitors (e.g., pembrolizumab) are under clinical trial.
  • Clinical Trials: people are usually advised to go under clinical trials because of lack of standard remedies.

Palliative Care

  • Effectiveness: pain, fatigue, endocrine balance.
  • Adequate nutrition and counselling.
  • Palliative care regarding patients with advanced and inoperable disease or with the metastatic disease.

Adrenocortical Carcinoma

  • The likelihood of recurrence in ACC is rather high, and therefore it is important to conduct a long-term observation:
  • Routine scanning (CT, MRI, PET).
  • Hormonal tests to recheck recurrence.
  • Follow-up visits within an interval of 3-6 months and later once a year.

Adrenocortical carcinoma symptoms

ACC symptoms will vary depending on whether the tumor functions (releases excess hormones) or non- functions (does not release hormones).

A categorization of it is as follows:

Functioning Tumors which Produce Hormones

  • These lead to symptoms as they over secrete the hormones.

Cushing syndrome

  • Increased consumption of food (face, neck, trunk)
  • The expression is a moon- juin vaguely Round face
  • Purple stretch marks on skin (striae)
  • Weakness of the muscles, in particular arms/legs
  • Hyperglycemia / diabetes
  • Hypertension
  • Poor bruising, thin skin
  • Mood alterations (depression, anxiety and irritability)

Excess androgen (in women)

  • Uncontrollable growth of hair (hirsutism:face, chest, back)
  • Growing of voice
  • Infrequent or missed menstrual delays
  • Acne, oily skin
  • Male-pattern baldness

The overproduction of Estrogen (more typical of men)

  • Deflation (flattening) of the breasts (gynecomastia)
  • Erectile dysfunction
  • Decreased libido

Aldosterone excess (Conn s syndrome)

  • Hypertension (mostly drug resistant)
  • Low potassium levels => muscle cramps, and palpitations or weakness

Adrenocortical carcinoma surgery

Surgical treatment of adrenocortical carcinoma (ACC) remains the main modality or the most effective with early and non-extensive dissemination of the disease. Since ACC is an aggressive tumour, surgical treatment has to be facile and definitive.

The objective of surgery

  • Total resection of the tumor and diseased adrenal gland (adrenalectomy).
  • Avoid residual tumor (clear margins).
  • Avoid spillage of tumors that may enhance its recurrence.

Categories of surgery

Standard Approach, Open Adrenalectomy

  • Better with big tumors (>6 cm) or cases suspected of cancer.
  • Involves an abdominal or side abdominal incision
  • Enables surgeon to excise tumor and surrounding organs/tissues if necessary (kidney, a portion of liver, pancreas, lymph nodes).
  • Provides increased visibility and reduces the chances of a tumor rupture.

Laparoscopic Adrenalectomy

  • Minor and small incision, quick recovery.
  • Is improperly considered in the case of suspected or confirmed ACC as:
  • There is increased risk of incomplete removal.
  • Risk of the spread of tumor within abdomen.
  • Only small incidentally found tumors of little suspicion of being cancerous can be used.

Best hospitals for adrenocortical carcinoma care

  • Artemis Hospital, Gurgaon
  • Medanta-The Medicity, Gurgaon
  • Fortis Memorial Research Institute, Gurgaon
  • Max Hospital, Saket

Adrenocortical carcinoma oncologists in India

  • Dr. Mukesh Patekar
  • Dr. Parveen Yadav
  • Dr. Gagan Gautam
  • Dr. Ashok Kumar Vaid
  • Dr. Ankur Bahl
  • Dr. Harit Chaturvedi

Affordable adrenocortical carcinoma care in India by GetWellGo

GetWellGo is the kind of medical tourism facilitator that assists international patients to get quality and cost-effective cancer care in India. They provide:

  • Have access to high profile hospitals and who are oncologists
  • Transparent comparative cost information of treatment
  • Special care, such as visa support, accommodation and language support
  • Entry to exit support-including consultation to post-treatment follow-up

Why Choose GetWellGo for Adrenocortical carcinoma treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

  • Complete transparency
  • Fair costs.
  • 24 hour availability.
  • Medical E-visas
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  • Assistance in selecting India's top hospitals for Adrenocortical Carcinoma treatment.
  • Expert oncologists with a strong track record of success
  • Assistance during and after the course of treatment.
  • Language Support
  • Travel and Accommodation Services
  • Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
  • Local SIM Cards
  • Currency Exchange
  • Arranging Patient’s local food

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