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Difference between Adjuvant and Neoadjuvant Therapy
After a malignant tumour has been removed surgically, any further treatment is considered adjuvant therapy. Before a malignant tumour is removed surgically, neoadjuvant therapy may be used.
What is Adjuvant Therapy?
Any treatment administered after a malignant tumour has been removed surgically is considered adjuvant therapy. This might be anything from pain medication to radiation or chemotherapy.
Why and how it's employed − This treatment is given to terminally sick patients in an effort to prolong their lives and lessen the likelihood of a cancer recurrence. Opioid painkillers can be administered to terminally sick patients even after a tumour has been surgically removed if they are still experiencing agony.
Adjuvant treatment can be helpful for a patient. The most notable benefit is its potential to reduce the risk of cancer returning and to eradicate any leftover malignant cells. It also helps terminally ill people have a better quality of life and lessen their pain and suffering.
Disadvantages − Especially with chemotherapy, the treatment might leave the patient feeling drained and ill. Some individuals with breast cancer, for instance, have chronic issues with tiredness, cognitive difficulties, and hot flashes after undergoing adjuvant therapy.
Examples − Women with specific types of breast cancer are given aromatase inhibitor medication as adjuvant treatment. In addition, women with breast cancer frequently undergo adjuvant therapy, which frequently includes targeted therapies like those used to inhibit human epidermal growth factor receptor 2 (HER2). Colon cancer treatment often include surgery followed by oral or intravenous chemotherapy.
What is Neoadjuvant Therapy?
Neoadjuvant therapy is given before any surgery is done on a cancerous tumor, and may take the form of radiation therapy or chemotherapy.
What it is used for − Generally, the idea behindneoadjuvant therapy is that it helps tumors to shrink and become easier to surgically extract. It can result in down-staging of the particular cancer, making it easier to treat; this was found to be the case in a study done on breast cancer patients.
Advantages − Neoadjuvant therapy gives researchers an opportunity to study cancer cells in vivo. If the therapy is effective, it can make a big difference because it can shrink previously unresectable tumors making them small enough to then surgically remove.
Disadvantages − The main disadvantage of neoadjuvant therapy is the concern regarding delay in surgical resection, with the fear that the stage of cancer may change, making the situation worse. The chemotherapy and radiation used during the therapy may also result in the patient becoming too weak for later surgical removal of their tumor.
Examples − Neoadjuvant chemoradiation has been used to help decrease the size of tumors in the case of pancreatic cancer. It is also found to be a good strategy for non-metastatic breast cancer in studies done on mice, with fewer metastases forming when neoadjuvant therapy was done versus when it was not.
Differences: Adjuvant and Neoadjuvant Therapy
The following table highlights the major differences between Adjuvant and Neoadjuvant Therapy −
Characteristics |
Adjuvant therapy |
Neoadjuvant therapy |
|---|---|---|
Definition |
After a tumour has been surgically removed, the patient may have adjuvant therapy. |
Pre-tumor treatment, or neoadjuvant therapy, is administered before the tumour is surgically excised. |
Advantages |
Some of the benefits of adjuvant therapy include its ability to eliminate any lingering cancer cells and reduce the likelihood of a recurrence. |
Neoadjuvant treatment reduces the size of tumours prior to surgery, making surgical removal more feasible. |
Disadvantages |
The adverse consequences of adjuvant therapy might further weaken the individual being treated. |
One potential drawback of neoadjuvant treatment is that it may prolong the time before the tumour is surgically removed, increasing the risk of the cancer spreading. |
Gives early insight into treatment plan |
Patients' responses to a given regimen of chemotherapy or radiation therapy cannot be predicted in advance using adjuvant therapies. |
Neoadjuvant therapies provide information on how a patient responds to chemotherapy or radiation before surgery, so that adjustments may be made in post- operative care. |
Conclusion
Adjuvant treatment is typically advised when malignancies are caused by inherited gene alterations. If the cancer is due to genetic alterations, neoadjuvant treatment is not suggested.
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