What is Adjuvant Chemotherapy?
Chemotherapy is a treatment for many types of cancer. It is a systemic treatment in which the drug is used to attack the rapidly dividing cancer cells. Adjuvant chemotherapy is a chemo session given after primary treatment, usually surgery. It is given to lessen the chance of cancer coming back.
Sometimes even in a successful surgery where all the signs of cancer are removed, there are chances of some microscopic bits remaining undetected with current methods. These cancer cells circulate in the bloodstream or the lymphatic system. If not treated, there are chances of these cells reaching the distant organs to form new tumors.
The main goal of adjuvant therapy is to lower the chances of return of cancer and also to improve the outcome of first-line treatment.
It is well known that chemotherapy drugs also destroy the healthy cells in the body. But, it surely does lower the risk of cancer cells spreading to distant organs.
When is Adjuvant Chemotherapy Recommended?
A doctor recommends Adjuvant chemotherapy if:
- If the cancer is of a particular type or carries a type of biomarker that respond well to chemotherapy drugs
- If a person carries a specific genetic mutation that carries a high risk of cancer recurrence
- If during surgery, cancer cells were detected in the lymph nodes
- If cancer is not positive for hormone receptor that makes the hormone therapy ineffective
- In cancer that has reached its last stages
Adjuvant chemotherapy is used to treat breast cancer, lung cancer and colon cancer.
A research review noted that adjuvant chemotherapy is standard care and beneficial for people with stage 3 colon adenocarcinoma.(1)
What is Neoadjuvant Chemotherapy?
Neoadjuvant chemotherapy is a chemotherapy session given before the main treatment. The goal is to improve the likelihood of the main treatment, usually surgery or radiation therapy.
Neoadjuvant therapy is recommended in the following situations:
- The primary tumor is large and is pressing on the vital organs, making the surgery complicated and risky. The neoadjuvant chemotherapy can make the tumor shrink and make the surgery less risky.
- Sometimes there are chances that the cancer cells have broken away from the primary tumor. There are chances of complications after surgery that may delay adjuvant chemo. This time starting with chemo may prevent tumors from developing in distant organs.
- In breast cancer, sometimes shrinking the tumor before surgery can allow breast-conserving surgery over mastectomy.
The response to neoadjuvant therapy can be a guide to decide about adjuvant therapy.
Research showed that in some types of cancer, neoadjuvant therapy is linked with favorable survival.(2)
Side Effects of Adjuvant Chemotherapy
There are many potential side effects of chemotherapy. These side effects vary a bit from one chemo drug to another.
Chemotherapy drugs work by attacking the fast-growing cancer cells as well as the healthy cells. The side effects occur due to the damage to the healthy cells. The effects are:
- Nausea, vomiting
- Fatigue
- Bruising and bleeding
- Hair loss
- Infection
- Mouth sores and dry mouth
- Weight loss
- Anemia
- Diarrhea and constipation
- Urine and bladder conditions
- Change in sexual desire
- Mood changes
- Loss of concentration and focus
- Numbness and tingling
Nobody has all the side effects as everyone reacts differently to chemo.
There are a few chemo drugs that cause long term side effects, such as:
- Early menopause
- Nerve damage
- Heart, lung and kidney damage
Other Types of Adjuvant Therapies Used To Treat Cancer
In addition to chemotherapy, other adjuvant treatments for cancer includes:
Hormone Therapy: It is used in hormone receptor-positive cancers
Immunotherapy: This therapy helps recognize and fight cancer cells
Radiation Therapy: This therapy targets a particular tumor or organ
Targeted Therapy: It is an option for cancers that carry specific mutations or abnormalities
Adjuvant chemotherapy is chemo given after primary treatment and neoadjuvant is given before starting the main treatment. The goal of the treatment is to lower the risk of cancer spread or return.
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