Neoadjuvant Therapy
What is Neoadjuvant Therapy
“Neoadjuvant” therapy refers to any treatment that is given for cancer. Before the main treatment, with the goal of making the main treatment more likely to be successful.
As surgery is the main treatment for many cancers, neoadjuvant therapy for cancer is any treatment administered prior to surgery. It is usually in the form of
- systemic (drug) therapy, or
- local therapy (radiation)
Cancer Stages
Early stage cancer treatment involves a combination of local and systemic therapies, which can be delivered in a variety of possible sequences.
Cancer treatment often involves surgical resection to remove the affected tissue to reduce the risk of recurrence. However, cancer can still recur.
Cancer management has evolved from primarily surgical therapy, to a multidisciplinary approach including
- surgery,
- radiation therapy and
- systemic therapy.
This shift is based on an increased understanding of invasive malignancy as a “systemic” disease, and on the improved outcomes with the addition of adjuvant systemic therapy to local regional therapy.
System Therapy for Cancer Treatment
Systemic therapy refers to cancer treatment that targets the entire body, and when given for non-metastatic invasive cancer is primarily intended to reduce the risk of distant recurrence.
Systemic therapy for cancer began as a postoperative or after a surgical resection was undertaken. Systemic therapy is typically chemotherapy
Adjuvant systemic therapy can reduce recurrence and improve survival rates by killing cells that may have escaped the primary tumour bed via lymphatics and blood vessels.
Research has shown that systemic therapy before surgery (neoadjuvant) might improve outcomes because it destroys undetectable microscopic circulating cells.
Local Neoadjuvant Cancer Treatment
Treat cancer cells in the affected area only and include:
- Surgery and
- Radiotherapy.
Cancer Surgery
Surgery involves removing any visible cancer in the affected areas.
Radiotherapy
Radiotherapy kills cancer cells in the area it is aimed at, and is similar to the x-rays that are used when you have a chest X-ray. Prof Samra will refer you to our radiation oncologist colleagues should you fit the criteria.
Systemic Neoadjuvant Cancer Treatment
Using drugs that can reach all parts of the body
Systemic therapies are drugs which spread throughout the body to treat any microscopic cancer cells, wherever they may be, and include
- chemotherapy,
- hormonal therapy,
- targeted drugs, and
- immunotherapy.
What is Adjuvant Chemotherapy?
In many cancers, the primary, definitive treatment is surgery to remove the cancer.
Additional systemic treatment, such as chemotherapy or hormone therapy, is used either before or after the primary therapy.
Extra treatment in addition to surgery, given after primary therapy is referred to as adjuvant therapy (postop) whereas extra treatment given before primary therapy is referred to as neoadjuvant therapy (preop).
Systemic therapy given for non-metastatic invasive cancer whether administered pre or post op, is intended primarily to reduce the risk of distant recurrence.
Chemotherapy For Cancer
What Is Chemotherapy?
Chemotherapy is the application of special cytotoxic drugs designed to either kill cancer cells or slow cancer cell growth and this will be administered under the management and advice from your Medical oncologist which Prof Samra will consistently communicate with for the management and care for the best outcome.
Some cancers can be treated or cured by chemotherapy alone, in other cases, Chemotherapy may not be able to control cancer but may be used to relieve symptoms such as pain and help you lead a normal life.
Chemotherapy, in particular, is used in the treatment of various cancers where the cancer has spread outside the local area to the lymph nodes, bones, or other areas (metastasis).
Neoadjuvant Chemotherapy
More recently researches showed superior outcomes when chemotherapy and other treatments were given before some cancer surgery or radiotherapy. This is called neoadjuvant therapy.
There are a number of reasons why neoadjuvant chemotherapy may be offered to you and this should be discussed with your Medical Oncologist.
Why Might Neoadjuvant Chemotherapy be Recommended for Me?
With neoadjuvant chemotherapy, you are likely to be given the same chemotherapy drugs that you would be given if you have chemotherapy after your surgery.
There are some benefits in having neoadjuvant chemotherapy, but it is not for everyone. You may want to consider your options carefully and seek further advice from your medical oncologist.
Neoadjuvant chemotherapy may be recommended:
- To enable safe and successful cancer surgery by reducing the size of your cancer (tumour), along with any other cancer cells that may be present elsewhere in the body, by killing those cancers cells prior to surgery,
- To delay surgery or radiotherapy and give you time to consider your options
