Introduction:

Adjuvant therapy refers to the additional treatment after the primary treatment. In case of cancer treatment adjuvant therapy is used as second line of treatment after primary treatment like surgery or radiation. Surgery/Radiation is used to remove all the detectable disease. Even after the successful surgery some patients may be statistically prone to relapse of the disease cancer; in such cases adjuvant therapy may be useful in reducing the chances of cancer relapse.

Treatments Used as Adjuvant Therapy:

Chemotherapy:

In chemotherapy drugs are used to kill the cancer cells. Chemotherapy helps in killing all the cancer cells present in the entire body.

Hormone Therapy:

Some of the cancer like breast, uterine and prostate cancer is hormone sensitive. This type of cancer can be treated by stopping hormone production in the body of the patient or by blocking the effect of hormones on cancer cells.

Radiation Therapy:

Adjuvant Radiation therapy are given on the area in and around the original cancer site to reduce the risk of cancer recur in that area. High-energy radiations like X-ray are used in radiation therapy to kill the cancer cells.

Immunotherapy:

In adjuvant immunotherapy treatment are can stimulate the patient's own defence mechanism to fight off remaining cancer cells.

Targeted Therapy:

Therapy which targets the specific abnormalities seen in cancer cells to treat them or kill them are known as target therapy.

Factors Effecting Adjuvant therapy:

Effectiveness of Adjuvant Therapy depends on many factors such as

1. Type of Cancer:

Adjuvant therapy may be effective in treating breast cancer but may not be effective in treating other type of cancer.

2. Stage of the Cancer:

Adjuvant therapy will not be beneficial in early stage of cancer as possibility of the recurring of the cancer is very less. But in case of treating late stage of cancer where the cancer cells are spread to the near lymph nodes then automatically chances of recurring of the cancer increases so patient may benefit from adjuvant therapy.

3. Number of Lymph Nodes Involved:

The greater the number of lymph nodes involved, greater is the chances of cancer cells left behind in the body of the patient after surgery. In such cases adjuvant therapy can be used to stop the growth of cancer cells.

4. Hormone sensitivity:

If the cancer is not sensitive to the level of hormones then the adjuvant hormone therapy may not be effective.

Applications:

1. Interferon α-2b as adjuvant therapy increased the disease free survival rate and reduced the risk of recurrence in patients with malignant melanoma.
2. Adjuvant chemotherapy with fluorouracil is effective in preventing the metastatic spread of the locally advanced colorectal cancer.
3. Adjuvant chemotherapy using drugs such as, docetaxel, paclitaxel, cyclophosphamide, fluorouracil, methotrexate, epirubicin doxorubicin decreases the recurrence of metastatic node-positive breast cancer in patients
4. Comination adjuvant chemotherapy where more than one drug is used to treat the patient to decrease the chances of cancer recurrence. For example combination of doxorubicin and cyclophosphamide or doxorubicin and cyclophosphamide followed by docetaxel are effective in treating patient with breast cancer.

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