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Radiation therapy uses high-energy x-rays (or particles) to kill cancer cells. Radiation therapy is generally not used as the main initial treatment for adrenal cancer. Rather, it is usually offered to patients as:

• Adjuvant therapy: Radiation may be used after surgery to help keep the tumor from coming back.

• Local control of 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.

Types of radiation therapy

External beam radiation therapy (EBRT) focuses radiation on the cancer from a machine outside the body. It is like getting an x-ray and is not painful. 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, although the setup time - getting you into place for treatment - usually takes longer to make sure that the radiation is aimed accurately at the cancer. Before treatment starts, the radiation team will take measurements to find the correct angles for aiming the radiation beams and the proper dose of radiation. This planning session, called simulation, usually includes getting imaging tests such as CT or MRI scans.

Brachytherapy (internal radiation therapy) uses small pellets of radioactive material placed next to or directly into the cancer. This type of radiation is not often used to treat adrenal cortical cancer.

Radiofrequency ablation 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, using local anesthesia (numbing medicine) where the probe is inserted. You may be given medicine to help you relax. Some people with adrenal cancer might not be healthy enough for surgery. Others may have a tumor that cannot be surgically removed, either due to size or where it is. For these patients, radiofrequency ablation may be an option.

Possible radiation side effects

Common side effects of radiation therapy include:

• Nausea and vomiting
• Diarrhea (if an area of the abdomen is treated)
• Skin changes in the area being treated, which can range from redness to blistering and peeling
• Hair loss in the area being treated
• Fatigue
• Low blood counts