Has your doctor told you or someone you know needs surgery for cancer? When they say that, they probably also tell you about 'treatment before surgery'. This is medically called Neoadjuvant Therapy . When they hear this name, many people get a little nervous, thinking, "I'm going to have surgery, so do I need to get treatment before that?" But this is actually something that can help you a lot and bring you hope. Let's talk about this simply, removing all the fears and doubts you have about it.
What is neoadjuvant therapy?
Simply put, Neoadjuvant Therapy is a treatment method that allows a tumor to shrink, that is, become smaller, before surgery to remove it. Think about it, there is something that is difficult to remove, like a large stone. It is easy to crush it, grind it up, and remove it, right? This is the same. If the tumor is large, it may be difficult for the surgeon to completely remove it. But when the tumor is shrunk with these treatments, the surgery becomes much easier and more successful.
Sometimes these treatments are so successful that the tumor disappears completely and surgery is not needed. Your doctor may also call this ``perioperative therapy`` or ``induction therapy.`` These are all the same thing.
What are these treatments?
This `neoadjuvant` treatment method uses different things. Your doctor will decide what is best for you based on the type and nature of your cancer. Let's look at the main methods.
| Therapy Type | What does it do? |
|---|---|
| Chemotherapy | This works by destroying cancer cells by stopping them from dividing, growing, and causing the tumor to grow. |
| Hormone Therapy | Some types of cancer (e.g. breast, prostate) are stimulated by hormones. This treatment blocks the supply of those hormones. This stops the tumor from growing. |
| Immunotherapy | This stimulates our body's own immune system, allowing it to fight cancer cells. |
| Radiation Therapy | This is done by using radiation, such as powerful X-rays, to destroy cancer cells. |
Sometimes your team may combine these two treatments. For example, chemotherapy and radiation therapy are given together (neoadjuvant chemoradiation). This treatment can last from a few weeks to a few months, or even a year. Surgery is usually done within a month of completing treatment.
What types of cancer is this treatment used for?
Oncologists use this treatment for more than a dozen types of cancer, including:
- Breast Cancer: For some types of breast cancer, chemotherapy, hormone, or immunotherapy is given before surgery.
- Colon Cancer: If the cancer has metastasized to the liver, chemotherapy may be given before surgery.
- Lung Cancer: Chemotherapy is commonly used for some types of lung cancer that have spread.
- Prostate Cancer: This cancer is fueled by the male hormone testosterone. It is controlled with hormone therapy.
- Rectal Cancer: It is also common for these to be given together with radiation therapy and chemotherapy.
What are the advantages of this treatment method?
There are several benefits to this. Knowing these will help you overcome your fear of this treatment.
- Smaller tumors: As we discussed earlier, larger tumors become smaller , making surgery much easier. For example, if a tumor is smaller in a breast cancer case, instead of a mastectomy, which removes the entire breast, a smaller surgery called a lumpectomy can be performed, which removes only the tumor.
- Complete disappearance of some tumors: Sometimes small tumors may completely dissolve and surgery may not be necessary.
- Shorter recovery time: When the surgery is smaller, the amount of incision in your body is smaller. So you can recover faster and return to your normal life.
- The success of treatment can be measured: When treating before surgery, doctors can see how the cancer is responding to the treatment and how quickly the tumor is shrinking. This allows them to make better decisions about future treatment.
- Killing hidden cancer cells: Sometimes, tiny cancer cells that break away from the main tumor, are invisible to the naked eye, and cannot be detected by scans, and can travel to other parts of the body (micrometastases). These hidden cells are also killed by treatments like chemotherapy, which affect the whole body.
- Reduced risk of cancer recurrence: Some studies have found that neoadjuvant treatment reduces the risk of cancer recurring after it has been cured.
Are there no side effects?
As with any cancer treatment, side effects can occur. But what they are depends on the type of treatment you are receiving. Some of the most common are:
- Appetite
- Diarrhea
- Fatigue
- Loss of taste on the tongue (ageusia)
- Nausea and vomiting
But don't be afraid of these side effects. The most important thing is to talk openly about all of this with your doctor. He or she will give you the necessary medications and advice to reduce these side effects. Also, there are special treatments (palliative care) that can help you manage the complications and keep you comfortable during treatment.
What is the difference between Neoadjuvant and Adjuvant Therapy?
You may have also heard of `Adjuvant Therapy`. Both are treatments given as support for cancer surgery. The difference is in the timing of the treatment.
| Characteristic | Neoadjuvant Therapy | Adjuvant Therapy |
|---|---|---|
| Timing | Before surgery | After the surgery |
| Main Goal | Making the cancer smaller and easier to operate on. | Destroying any cancer cells that may remain after surgery. |
If you think of this like a marathon, `Neoadjuvant therapy` is like the `warm-up` before the race. It prepares you well for the race. `Adjuvant therapy` is like the `cool-down` after the race, it eliminates any remaining problems and makes you fully recovered.
Take-Home Message
- Neoadjuvant therapy is a treatment given before cancer surgery. Don't be alarmed when you hear about this.
- This is done to make the tumor smaller, making surgery easier and more successful.
- This treatment may allow for a minor surgery instead of a major surgery, or it may even allow for a cure without surgery.
- Side effects may occur, but your doctor will help you manage them. Talk to him or her about any discomfort.
- See this treatment as a very important and hopeful step in your fight against cancer.
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