This treatment of choice is surgery to remove the tumour. However it is not curative as cancer cells are likely to have spread or a few cells are likely to be left behind after removal and can act as sites for further tumour growth.
The surgery itself is described in the section on 'Surgery'. In cases where adrenal carcinoma has spread to the kidney, it may necessitate removal of the kidney.
Medical therapy is also needed for surgery. The unaffected adrenal gland often starts to atrophy (i.e. it begins to whither) and so itself can produce less adrenal hormones such as cortisol. After surgery therefore, there can be an underproduction of these hormones and so replacement is necessary.
The use of radiotherapy is not yet well established, with some groups indicating success and others reporting no demonstrable improvement.
There is some role of drugs targeting the cancer here, although there is no standard regimen. Several drugs such as 5-fluorouracil (5-FU), a general anti-cancer drug, and suramin, an anti-cancer drug which directly targets the adrenal gland, have been tried. Research in this area should yield the best combination of drugs that can be used.
Unfortunately the survival rate for patients with adrenocortical carcinoma isn't very good. On average 22% patients survive for 5 years after diagnosis. However with research into chemotherapy and improvements in imaging the outlook can only get better with time.