Adrenal Cancer

Back
Download Section as PDF

Radiation Therapy for Adrenal Cancer

Radiation therapy uses high-energy x-rays or particles to kill cancer cells.

For more information on neuroblastoma, see Radiation Therapy for Neuroblastoma.

On this page
[show] [hide]

When radiation therapy is used for adrenal cancer

Radiation therapy is generally not used as the main first treatment for adrenocortical carcinoma or malignant pheochromocytoma. Rather, it is usually offered to patients:

  • After surgery as adjuvant therapy. Radiation may be used after surgery to help keep the tumor from coming back.
  • To treat metastasis. If the cancer has spread to other organs, such as the brain, lung, liver, or bone, radiation therapy to those areas may improve symptoms like pain.

Researchers are studying markers that might help predict which adrenal cancers are most likely to come back after surgery. In these cases, radiation and other treatments may have a benefit. However, most of these tests are still being studied.

Types of radiation therapy

Four types of radiation treatments might be used for adrenal cancers:

  • External beam radiation therapy
  • Stereotactic radiosurgery (SRS) or stereotactic body radiation therapy (SBRT)
  • Radiofrequency ablation
  • Radionuclide therapy

This is the most common type of radiation therapy. It is much like getting an x-ray, but the radiation is stronger. The procedure is painless but might cause side effects after the treatment is completed.

Treatments are often given once or twice a day, 5 days a week for several weeks. The actual treatment time only lasts a few minutes. However, the setup time, getting you into place for treatment and making sure the radiation is aimed at the cancer, usually takes longer.

Before treatment starts, the radiation oncology team will take measurements to find the correct angles and doses for the radiation beams. This planning session, called simulation, usually includes imaging tests such as CT or MRI scans.

This uses a very thin beam of radiation to focus on the exact area of the tumor from many angles. It lets doctors give a large dose of radiation to a small tumor area in fewer sessions than typical EBRT. This is typically done with a radiation source on the end of a computer-controlled arm which rotates around you as you lie on a table.

This might have a benefit for people with spread to limited areas outside the adrenal gland, such as the brain, lung, or liver.

This uses high-energy radio waves to heat and destroy the tumor cells. A thin, needle-like probe is put through the skin and moved until the tip is in the tumor. Placement of the probe is guided by CT scans. This is usually done as an outpatient procedure, meaning you can go home on the same day. The care team uses local anesthesia (numbing medicine) where the probe is inserted. You may also be given medicine to help you relax.

For people who have a tumor that cannot be safely removed with surgery, radiofrequency ablation may help control tumor growth. It may also be used to treat small areas of spread outside the adrenal gland, such as those in the liver.

This is a radioactive medication given through the bloodstream. The radioactive drug finds cancer cells and delivers the radiation, destroying the cancer cells. Some radionuclide medications include:

  • 131I MIBG
  • 68Ga DOTA-TATE
  • 68Ga DOTATOC
  • 68Ga DOTANOC
  • 90Y DOTATOC
  • 177Lu DOTATATE

This type of treatment can work for some tumors of the adrenal medulla, such as pheochromocytomas and neuroblastoma. These treatments might be used if a tumor has spread beyond the adrenal gland or is not responding to other treatments.

Possible radiation side effects

Radiation can cause side effects. These side effects depend on the dose of radiation, where the radiation is given, and how the radiation is given.

  • Short-term side effects happen during or shortly after treatment.
  • Long-term side effects can last for months or years after treatment.
  • Late effects can take months or years to develop after treatment.

Almost all side effects can be treated with medicines, and many go away over time after treatment ends. If you're having any side effects from radiation, discuss what you can do to get relief from these symptoms or prevent them with your cancer care team.

Short-term side effects of radiation

  • Nausea and vomiting
  • Diarrhea (if an area of the abdomen is treated)
  • Skin changes in the area being treated, which can range from a mild sunburn-like rash to blisters and more severe skin reactions
  • Hair loss in the area being treated
  • Fatigue
  • Low blood counts

Long-term or late effects of radiation

Long-term and late effects of radiation therapy depend on where it was given. Some of these effects can last many years after treatment. Long-term or late effects of radiation can include:

  • Impacts on sexual health: Women who receive radiation to the abdomen and pelvis may experience changes in their ovarian health. This could impact menses, fertility, and overall sexual function.
  • Second cancers: Because radiation works by breaking DNA, it can also increase the risk of a second cancer many years later.

For more information on long-term and late effects of cancer treatment, see After Treatment for Adrenal Cancer.

More information about radiation therapy

To learn more about how radiation is used to treat cancer, see Radiation Therapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

side by side logos for 黑料大湿Posts Cancer Society and 黑料大湿Posts Society of Clinical Oncology

Developed by the 黑料大湿Posts Cancer Society medical and editorial content team with medical review and contribution by the 黑料大湿Posts Society of Clinical Oncology (ASCO).

Asban A, Patel AJ, Reddy S, Wang T, Balantine CJ, Chen H. Chapter 68: Cancer of the Endocrine System. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.

Fassnacht M, Assie G, Baudin E, et al. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(11):1476-1490.

Mayo-Smith WW, Dupuy DE. Adrenal neoplasms: CT-guided radiofrequency ablation--preliminary results. Radiology. 2004;231(1):225-230.

National Cancer Institute. Adrenocortical Carcinoma Treatment (PDQ). Accessed at https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq on June 23, 2026.

National Cancer Institute. Childhood Adrenocortical Carcinoma Treatment (PDQ). Accessed at https://www.cancer.gov/types/adrenocortical/hp/child-adrenocortical-treatment-pdq on June 23, 2026.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors Version 1.2026 – April 21, 2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf on June 23, 2026.

Polat B, Fassnacht M, Pfreundner L, et al. Radiotherapy in adrenocortical carcinoma. Cancer. 2009;115(13):2816-2823.

van Hulsteijn LT, Niemeijer ND, Dekkers OM, Corssmit EP. (131)I-MIBG therapy for malignant paraganglioma and phaeochromocytoma: systematic review and meta-analysis. Clin Endocrinol (Oxf). 2014;80(4):487-501.

Wood BJ, Abraham J, Hvizda JL, Alexander HR, Fojo T. Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases. Cancer. 2003;97(3):554-560.

Young WF. Management of malignant (metastatic) paraganglioma and pheochromocytoma. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/management-of-malignant-metastatic-paraganglioma-and-pheochromocytoma on June 23, 2026.

Last Revised: October 5, 2026

黑料大湿Posts Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.

黑料大湿Posts Cancer Society Emails

Sign up to stay up-to-date with news, valuable information, and ways to get involved with the 黑料大湿Posts Cancer Society.

Sign Up for Email