Chemotherapy is used as a form of adrenal cancer treatment, but it is not known for curing adrenal cancer. There are no chemotherapy drugs that have been proven to kill adrenal cancer cells. Chemotherapy is used on adrenal cancer patients as a way to control and minimize hormonal symptoms experienced by tumors in the adrenal glands. Tumors in the adrenal glands cause an excess of hormones to be produced and released into the body. These hormones can cause facial and back hair on women and an increase in breast size among men. They can also cause one's blood pressure to rise to dangerous levels and produce too much adrenaline resulting in severe headaches.

Mitotane is the most commonly used chemotherapy drug used to minimize symptoms in adrenal cancer patients. The drug helps maintain normal amounts of hormones to be released by the adrenal glands. Other than controlling hormonal symptoms, mitotane is used to reduce the chances of cancer coming back after it has been removed from the adrenal glands. Chemotherapy drugs taken to reduce the risk of cancer reemerging is referred to as adjuvant therapy. Research is still being performed to figure out how effective adjuvant therapy is in treating adrenal cancer. Mitotane is also used to kill cancer cells that have spread from the adrenal glands to other areas of the body. The drug is taken in pill form and it enters the blood stream. Entering the blood stream allows mitotane to travel throughout the body to areas infected with cancer cells.

Mitotane, similarly to other chemotherapy drugs, is not free of it's own side effects. The most common side effects from mitotane includes nausea, vomiting, sleepiness, diarrhea and rashes. Lower doses of mitotane can still be effective while causing less side effects. Side effects from chemotherapy drugs should wear off within a few weeks of discontinued usage. If side effects from treatment are severe, doctors may be able to suggest or prescribe another non-chemotherapy drug that can help reduce the symptoms caused by chemotherapy. Currently, new chemotherapy drugs and methods of treatment are being explored during clinical trials. New chemotherapy drugs that are more effective in curing adrenal cancer could reduce the number of surgeries needed to physically remove cancer cells from the adrenal glands.