Mitotane is a medication a doctor may prescribe to treat cancers of the adrenal gland or Cushing's disease. The medication is an anti-neoplastic agent with the capability of suppressing the growth of abnormal cells to limit tumor growth. It may be part of a surgery and chemotherapy regimen, or it can be taken alone to treat an inoperable tumor. Patients can only receive this medication by prescription, as it can be dangerous if the patient does not receive adequate monitoring while taking the drug.
This medication comes in the form of oral tablets. Some patients may need to enter the hospital while taking mitotane so they can be monitored by health care providers. For outpatient treatment, the patient will regularly need to see a doctor for testing and evaluation. The doctor will check for harmful side effects and monitor the tumor's response to the drug on each visit. It is important for patients to take the tablets consistently and to keep taking them even if they start to feel better.
While on mitotane, patients experience a decline in normal steroid production, and can be at risk of dangerously low cortisone levels. To compensate for this, a doctor may prescribe steroids to keep the patient's hormones in balance. This will require periodic blood testing to determine the patient's steroid levels and adjust supplemental medications as necessary. Stable hormone levels are important for general health and will help the patient recover more quickly from the cancer.
Patients taking mitotane can experience side effects like drowsiness, stomachache, rapid heart rate, pain, fever, and rashes. It is important to discuss side effects with a doctor, as some of them can be dangerous and may be a sign of a serious underlying medical issue. Patients with adrenocortical carcinoma, the most common reason to prescribe this medication, can also be at risk of complications caused by the cancer itself, especially if it does not respond to the medication.
Before a doctor can prescribe mitotane or any chemotherapy medication, the patient will need a careful workup. This includes medical imaging to learn more about the cancer, meetings with surgeons to discuss options for surgical treatment, and testing to check on hormone levels and other issues of potential concern, such as liver or kidney disease. If there are contraindications for a given treatment plan, the doctor will need to adjust it to meet the patient's needs without causing complications.
