Adjuvant chemotherapy refers to chemotherapy that people receive after another cancer treatment, such as surgery. Neoadjuvant chemotherapy is when a person has chemotherapy as their main treatment before other options.
Both adjuvant and neoadjuvant therapies may encompass chemotherapy, radiation therapy, hormone therapy, and others.
Neoadjuvant therapy occurs prior to someone’s primary cancer treatment. Adjuvant therapy occurs after. For example, an individual may have surgery to remove a tumor, followed by adjuvant chemotherapy.
Read more to learn about adjuvant and neoadjuvant therapies, their uses, benefits, and side effects.
Types of neoadjuvant therapy include:
- radiation therapy
- hormone therapy
Treatments doctors use for adjuvant therapy include:
- radiation therapy
- targeted therapy
- hormone therapy
- biological therapy
Doctors may use adjuvant therapies in people with early stage cancer who have had surgery as their primary treatment. For example, they
There is considerable overlap in adjuvant and neoadjuvant treatment options. The primary difference is their timing in the overall treatment schedule.
Doctors plan a treatment schedule depending on the individual and the type and stage of cancer. For example, they may use neoadjuvant therapy to
In some cases, doctors prefer neoadjuvant therapy because it allows them to see how the cancer responds to treatment right away. They can then make adjustments for future treatment protocols. It may also give people extra time to seek genetic testing or plan reconstructive surgery prior to more aggressive treatment methods.
Doctors may prescribe both neoadjuvant and adjuvant therapies.
Doctors use these additional therapies to ensure all cancer cells are targeted, including those that do not show up on scans and those that have spread to distant parts of the body.
With breast cancer, neoadjuvant chemotherapy often
When treating breast or prostate cancer, doctors may use endocrine or
Conditions that impact someone’s recommendation for adjuvant or neoadjuvant therapy may include:
- the cancer type and stage
- the goal of treatment, such as slowing tumor growth or easing symptoms
- how far the cancer has progressed
- the general health of the individual
Both therapies offer various benefits to people living with cancer.
Neoadjuvant therapies can:
shrink tumors, making their surgical removal more straightforward
- make inoperable tumors operable
- reduce the need for mastectomies
- kill any cells that have spread
Adjuvant therapy can improve a person’s long-term outcomes. For people with cancer that has spread, it can reduce the likelihood of recurrence.
Despite the benefits that neoadjuvant and adjuvant therapies can offer those living with cancer, individuals must consider the potential side effects for the following:
- Chemotherapy: Common side effects
includenausea, fatigue, infections, anemia, and hair loss.
- General radiation: Early, short-term side effects
includefatigue, skin irritation, and hair loss.
- Hormone therapy: Side effects can
includehot flashes, fatigue, memory problems, and decreased sexual desire.
When deciding on a course of treatment, both the doctor and individual must carefully consider if the expected benefits outweigh any potential risk of side effects.
Some examples of chemotherapy drugs that doctors use for adjuvant and neoadjuvant therapies include:
- anthracyclines, including doxorubicin (Adriamycin) and epirubicin (Ellence)
- 5-fluorouracil (5-FU) or capecitabine (Xeloda)
- taxanes, including paclitaxel (Taxol) and docetaxel (Taxotere)
- carboplatin (Paraplatin)
Neoadjuvant and adjuvant therapies can include chemotherapy, radiation, and hormone therapy.
If doctors deliver the therapy before the primary treatment, they refer to this as neoadjuvant therapy. This therapy aims to shrink tumors and kill any cancer cells that have spread from the primary site.
Adjuvant therapy follows the primary treatment and helps reduce the risk of cancer recurring.