Adjuvant therapy

Overview

After undergoing cancer treatment, healthcare providers may suggest adjuvant therapy, also known as helper therapy, to target residual cancer cells that were not eliminated during the primary treatment. This additional treatment, which includes various common cancer therapies, aims to decrease the risk of cancer recurrence. While adjuvant therapy may extend the duration of cancer treatment, it significantly lowers the likelihood of the cancer reappearing. Breast, colon, and lung cancers are commonly addressed with adjuvant therapy by healthcare professionals.

Reasons for undergoing the procedure

Adjuvant therapy is a common approach for the treatment of various cancers, including breast cancer, colorectal (colon) cancer, and non-small cell lung cancer. Healthcare providers tailor adjuvant therapies based on cancer type, surgical procedures, and the likelihood of cancer recurrence. The following outlines the adjuvant therapies for specific cancers:

• Breast cancer: Adjuvant therapies for breast cancer vary based on the type and stage of cancer, as well as the surgical procedure performed. Options include:
  • Radiation therapy: Recommended after lumpectomy or mastectomy to reduce the risk of cancer in the remaining breast or nearby lymph nodes.
  • Chemotherapy: Administered post-surgery to eliminate any remaining cancer cells and reduce the chance of cancer recurrence.
  • Immunotherapy: Suggested for stage II or stage III triple-negative breast cancer, often combined with chemotherapy as neoadjuvant therapy.
  • Hormone therapy: Utilized for hormone-sensitive tumors, especially in cases of early-stage estrogen receptor-positive (ER-positive) cancer.
  • Targeted therapy: Recommended for HER2-positive breast cancer to block cancer growth and spread.
• Male breast cancer: For males with breast cancer, treatment recommendations, including radiation therapy, chemotherapy, and hormone therapy, align with those for females.
• Colorectal (colon) cancer: For stage II or stage III colorectal cancer, surgery is the primary treatment, with adjuvant chemotherapy and/or radiation recommended based on the extent of cancer spread.
• Rectal cancer: Treatment depends on pre-surgery interventions. Adjuvant chemoradiation may be suggested if chemotherapy and/or radiation were not administered initially. For stage II or stage III rectal cancer, adjuvant chemotherapy might be recommended.
• Lung cancer: Immunotherapy has gained FDA approval as adjuvant therapy for non-small cell lung cancer (NSCLC), administered after chemotherapy in certain cases.
• Small cell lung cancer: Typically treated with chemotherapy and radiation; adjuvant chemotherapy and radiation may be recommended post-surgery in early stages.
• Cancer stages and adjuvant therapies: Healthcare providers categorize cancers into stages based on size, location, growth, and spread. Adjuvant therapy is commonly advised for earlier-stage cancers, ranging from localized tumors to those with minimal spread to lymph nodes or other tissues.

In summary, adjuvant therapies play a crucial role in managing various cancers, and treatment recommendations are tailored to specific cancer types and stages.

Risk

Adjuvant therapy, akin to cancer treatment, comes with a spectrum of risks and benefits. Its primary advantage is the potential to diminish the likelihood of cancer recurrence. Conversely, almost all adjuvant therapies carry side effects, some of which may be unfamiliar and pose additional uncertainties in the treatment process. It’s crucial to recognize that the duration of adjuvant therapy, spanning months or even years, is a significant consideration. While not inherently a risk, it emphasizes the long-term commitment required for such treatment. Individuals contemplating their options must carefully weigh these potential benefits and risks to make informed decisions about their course of adjuvant therapy.

Procedure

Healthcare providers base recommendations for adjuvant therapy on various factors related to the type and stage of cancer, as well as the effectiveness of the initial treatment. If you were diagnosed and treated for cancer at an early stage, studies indicate that adjuvant therapy can be beneficial in reducing the likelihood of cancer recurrence. Additionally, if your cancer was diagnosed and treated at a later stage, where there is a higher probability of residual cancer cells even after completing treatment, adjuvant therapy may be recommended. The presence of cancer cells in the lymph nodes, discovered by your healthcare provider, also increases the risk of recurrence, making adjuvant therapy a consideration.

It’s important to note that the recommendation for adjuvant therapy does not necessarily mean you currently have visible cancer. The microscopic nature of these cells makes them undetectable through imaging tests like magnetic resonance imaging (MRI) or computed tomography (CT) scans. The primary goal of adjuvant therapy is to target and eliminate any potential residual microscopic cancer cells, aiming to minimize the risk of cancer recurrence and enhance the overall effectiveness of the treatment you received initially.

Outcome

The key benefit of effective adjuvant treatment is its potential to reduce the risk of cancer recurrence. Patients may need to undergo adjuvant therapy for several months or even years after their initial treatment. While it is not a direct risk, individuals should consider this factor when evaluating their treatment options.