Neoadjuvant therapy is usually the first-stage treatment method to reduce tumor size before the main treatment method planned surgically. Chemotherapy, radiation therapy and hormone therapies are the main approaches that make up neoadjuvant therapy. Neoadjuvant therapy is among the types of induction therapy. Induction therapy covers the beginning of the treatment plan and constitutes the first of the chemotherapy stages.
What is Neoadjuvant Therapy?
Neoadjuvant therapy, which may consist of chemotherapy, radiation and hormone treatments, is required before the main treatment phase in order to achieve success in the main treatment. known as applied therapy. Adjuvant literally means helper. Adjuvant chemotherapy is administered to cancer cells that survive the primary treatment approach. Neoadjuvant therapy, on the other hand, differs from adjuvant therapy as it is administered as an extra before primary therapy. However, both treatment methods have similar characteristics. Although neoadjuvant chemotherapy is a frequently preferred method, it includes drug therapy applied to shrink the tumor structure before moving on to other treatment options such as surgery. It can also be preferred in cases where very large tumors cause pressure on vital organs and cause loss of function. Preferring more than one method together instead of a single method in cancer treatment is generally the basis of the approach to conditions such as breast, colon or lung cancer. Adjuvant or neoadjuvant treatment choices generally increase the chance of recovery in most types of cancer. One of the most important advantages of neoadjuvant treatment is that it can reach cancer cells in the circulation, distant tissues and organs, which are overlooked by imaging techniques during the diagnosis process. If cancer cells that are overlooked at the time of diagnosis are not treated, there is a risk of cancer recurrence and cancer treatment failure. In such cases, neoadjuvant therapy is a very valuable approach for cancer treatment to be successful. Neoadjuvant chemotherapy makes it easier to target cancer cells and increases the likelihood that treatment will be successful. In some cases, neoadjuvant radiation therapy may also be preferred to shrink the tumor before surgery. Induction chemotherapy is often combined with neoadjuvant chemotherapy. It is a confusing concept. If the main treatment approach in cancer treatment planning is only chemotherapy, this is called induction chemotherapy. Neoadjuvant therapy, on the other hand, is the application of a different treatment method before the actual treatment. The preoperative treatment method is usually chemotherapy.
In Which Situations Is Neoadjuvant Therapy Applied?
The main proven benefits of neoadjuvant chemotherapy are to ensure the removal of tumors that cannot be removed by surgical operations and to make inoperable tumors operable. to make it come. While neoadjuvant chemotherapy is a potentially beneficial approach, it has not been proven to increase life expectancy or provide definitive treatment. While the response to neoadjuvant chemotherapy is positive in some cancer types, neoadjuvant chemotherapy may not reduce the likelihood of cancer recurrence in some cancers. Indications for neoadjuvant chemotherapy are not extensive. The main reasons for the systemic neoadjuvant treatment approach before definitive cancer treatment are as follows.
- Preventing the spread of overlooked or very small cancer cells (micrometastases) in the diagnosis of cancer and completing the treatment at the earliest opportunity are the main reasons for choosing neoadjuvant treatment.
- If complications develop after cancer treatment that may prevent the application of additional treatment methods, recovery becomes difficult and the process prolongs. Neoadjuvant therapy gave more reliable results in this sense.
- The systemic effects of the disease on the body can be observed more accurately in the long term with neoadjuvant therapy.
- The ability to shrink large tumors in some cancer types improves the course of cancer. Neoadjuvant therapy, which facilitates surgery by shrinking the tumor, is a promising approach in some cancers that cannot be treated with surgery.
How is Neoadjuvant Therapy Applied?
Neoadjuvant chemotherapy There are multiple forms of application. Neoadjuvant chemotherapy can be administered orally (by mouth), intravenously (through a vein), and by injection. The reason for the change in application methods can be explained by various factors. The most important of these factors are the type and stage of the cancer and the type of drug that the specialist doctor deems appropriate. Stop. Neoadjuvant chemotherapy is a procedure that can be applied in the doctor's outpatient clinic, in the hospital or at home, depending on the type of cancer and treatment planning. Radiation therapy (radiotherapy) can be used if the disease does not regress after completion of neoadjuvant chemotherapy or in cancer types that progress despite chemotherapy. After surgical removal of the tumor, adjuvant radiotherapy is planned at the most appropriate time according to the patient's symptoms and the course of the cancer. Hormone therapies or neoadjuvant endocrine therapies may be preferred in patients who do not show characteristics suitable for chemotherapy, but the chance of success in these treatments is very low compared to chemotherapy. If there is neoadjuvant chemotherapy in the specific plan, it is recommended to apply chemotherapy without losing time so that the surgical operation can be performed quickly. Neoadjuvant treatments are usually administered intermittently with some rest period added following each treatment period. For example, chemotherapy in breast cancer usually lasts for 3-6 months. The number of cures can be increased or decreased according to the characteristics of the patient, the characteristics of the cancer, its progression, and the response to treatment. When the response to treatment is good, the amount of cure is usually reduced and the duration of treatment is shortened. The response to neoadjuvant therapy is evaluated by following the tumor size, shrinking or enlarging the tumor in the images obtained by imaging techniques, and examining the parts taken from the tumor under the microscope.
What are the Side Effects of Neoadjuvant Therapy?
In neoadjuvant chemotherapy Although the possible side effects vary from person to person, the main side effects are seen in almost every patient and disappear after chemotherapy treatment is completed. There are a number of medications available to prescribe for the management of milder side effects such as nausea and vomiting. With these drugs, side effects are alleviated and an increased likelihood of benefit from chemotherapy is expected. Possible side effects can be listed as follows.
- Nausea and vomiting
- Hair loss
- Changes in nails, skin and teeth
- Losses in appetite
- Weight loss, weight changes, deterioration of fat, muscle and protein balance i
- Change in bowel habits such as constipation or diarrhea
- Soreness of the mouth, tongue and gums
- Restlessness, weakness and depressed mood.
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