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Adjuvant therapy: Treatment to keep cancer from returning
How effective is adjuvant therapy?
Because none of these treatments is completely harmless, it's important to determine the risks of adjuvant therapy versus the benefits. The following factors can help you and your doctor determine whether adjuvant therapy is appropriate for you and, if so, which type:
- Type of cancer. Treating certain types of cancer with adjuvant therapy can be very beneficial. Examples include breast cancer and colon cancer. For some other types of cancer, there might not be a benefit.
- Stage of cancer. A cancer's stage refers to the extent of the cancer. If the cancer is at a very early stage — before it has had time to spread — then the chance of cancer recurring after surgery may be very small. Adjuvant therapy may offer little benefit in this case. If cancer is at a later stage — if it is a larger tumor or if the cancer has spread to nearby lymph nodes — then the chance that cancer will reappear sometime in the future is much greater. Adjuvant therapy may be more beneficial in this case.
- Number of lymph nodes involved. The more lymph nodes involved, the greater the chance that cancer cells will be left behind after local therapy, such as surgery.
- Hormone receptivity. Hormone therapy won't be effective if your tumor is not hormonally sensitive.
- Other cancer-specific changes. Certain cancers may have specific changes within their cells that indicate the likelihood that your cancer will return. If tests show your cancer is unlikely to recur, adjuvant therapy may offer little benefit. If tests show your cancer has a greater chance of recurring, you're more likely to benefit from adjuvant therapy. Your doctor may request special testing of your cancer cells to determine if adjuvant therapy would be beneficial.
Receiving adjuvant therapy doesn't guarantee your cancer won't recur. It can, however, help reduce the risk that your cancer will come back.
Is adjuvant therapy for you?
As you're deciding whether adjuvant therapy is right for you, you might want to discuss the following issues with your doctor:
- What procedures are you considering? Find out exactly what will be expected of you during adjuvant therapy. Will you have to see your doctor for injections or will you take pills at home?
- What are the side effects? What side effects are you willing to live with? Which ones will be too much for you to tolerate? Do you plan to work or stay active during treatment? Could side effects interfere with your plans?
- What are the chances you'll stay cancer-free? Understand how likely it is that your cancer will return if you decide against further therapy and how much improvement you might experience if you do undergo additional therapy. Your doctor can estimate how well your treatment will work based on comparisons with data from studies of other people with your same type of cancer, at the same stage and given the same treatment.
- How is your overall health? People who are otherwise healthy may experience fewer side effects during adjuvant therapy and are more likely to benefit from the therapy. People with severe health problems may be more likely to experience side effects during adjuvant therapy and may be less likely to benefit from the therapy.
- What is your preference? Some people want to do everything possible to reduce the chance that their cancer will return, no matter the side effects. Others choose not to tolerate extra side effects if there is likely to be little benefit. Discuss your preferences with your doctor.
Together you and your doctor can weigh these factors and decide whether the benefits of adjuvant therapy outweigh the risks for you.
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References
- Dictionary of cancer terms: Adjuvant therapy. National Cancer Institute. http://www.cancer.gov/dictionary/?CdrID=45587. Accessed April 12, 2012.
- Types of treatment. Cancer.Net. http://www.cancer.net/patient/All+About+Cancer/Treating+Cancer/Types+of+Treatment. Accessed April 12, 2012.
- Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1709/0.html. Accessed April 12, 2012.
- Adjuvant and neoadjuvant therapy for breast cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Therapy/adjuvant-breast. Accessed April 12, 2012.
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