Adjuvant Therapy

Adjuvant therapy is treatment after cancer surgery to destroy tiny cancer cells that surgery misses. It’s also known as helper therapy. Adjuvant therapy may reduce the risk that cancer will come back or spread. It may also help you live longer. People with breast cancer, colorectal cancer, non-small cell lung cancer or melanoma may have adjuvant therapy.

Your surgeon may recommend this treatment even if surgery has removed a tumor. They base their recommendation on factors like:

• Cancer stage: This includes tumor size and whether tests find cancer in your lymph nodes. Large tumors are more likely to spread to nearby tissues. Cancer in nearby lymph nodes increases the chance that cancer cells are somewhere else.
• Cancer grade: Providers check cancer cells under a microscope to see how they compare with healthy cells. Higher-grade cells look very different from healthy cells. They’re more aggressive and more likely to spread.
• Cancer cell features: Providers look for specific genetic mutations, biomarkers and proteins. These are signs that cancer is more likely to come back.

What are adjuvant therapy types?

Adjuvant therapy typically involves systemic therapies, like:

• Chemotherapy: This treatment sends medication throughout your body. Your provider may recommend it if you have breast cancer, colorectal cancer, non-small cell lung cancer or melanoma.
• Hormone therapy: This is adjuvant therapy for breast cancer. It keeps your body from making hormones that help cancer cells grow.
• Immunotherapy: This is a common adjuvant therapy for breast cancer, colorectal cancer, non-small cell lung cancer and melanoma. It helps your immune system find and destroy microscopic cancer cells.
• Targeted therapy: This treatment works by blocking proteins that help cancer cells grow. It’s a treatment for breast cancer, non-small cell lung cancer and melanoma.

Your provider may use radiation therapy as adjuvant therapy for breast cancer and lung cancer. The treatment targets the areas where cancer was first found.

What are common success rates for adjuvant therapy?

Research shows adjuvant therapy may keep cancer from coming back. Success rates differ based on factors like cancer type, stage and the specific medications used in adjuvant therapy.

Researchers continue to study the impact of adjuvant therapy. For example, one study found that half of the people with stage III melanoma were cancer-free seven years after adjuvant therapy. Another recent study found that, in some cases, about 9 out of 10 children who had radiation therapy after surgery to remove a brain tumor were alive five years after treatment. And immunotherapy is an effective adjuvant treatment for non-small cell lung cancer and other cancer types.

Is there anything I can do to make adjuvant therapy easier on me?

Ask your cancer care team about cancer rehabilitation and palliative care. With cancer rehabilitation, specialists help you get ready for adjuvant therapy. For example, some cancer treatments affect your appetite. A nutritionist will suggest ways to get the nutrition you need. A physical therapist may recommend gentle exercise to help you manage fatigue and stress.

Palliative care is holistic treatment and support. Specialists can help you manage treatment side effects. They can also connect you with mental health support, community programs and spiritual support.

When should I call my healthcare provider?

Talk to your cancer care team if you have treatment side effects that are stronger than you expect or you need help managing side effects. There are many things your team can do to ease these effects. Your team will move quickly to help you.

What’s the difference between adjuvant therapy and neoadjuvant therapy?

Both treatments help make cancer surgery more effective. Neoadjuvant therapy is cancer treatment before surgery. The treatment, often chemotherapy, immunotherapy or radiation therapy, may help shrink a tumor so it’s easier to remove. Adjuvant therapy targets microscopic cancer cells that surgery may miss.