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Cancer – Definitive Treatments and Neoadjuvant Therapy

February 1, 2021
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"Now the other three is neoadjuvant, adjuvant and definitive. Definitive treatment is the curative measure that you are taking to cure it. So usually definitive therapy is going to be surgery where you're taking the cancer out if it's really early or small. Or you'll have a definitive radiation treatment where sometimes they can put the radiation very vocally or precisely, maybe on a lung lesion, a small lung lesion and definitively treat it with radiation or what's called SBRT. So that's the definitive measure. And that's the thing that you're doing to cure the cancer and remove it from the body. Sometimes to reach the definitive treatment, you have to bring the cancer smaller, or make it smaller, so that that can be achieved. And that's what we call neoadjuvant therapy. And so what neoadjuvant means is you're providing either chemotherapy or radiation or both together, and you're hoping to make the cancer to place where the studies show that if you do that and then take it out, the chance of recurrence is less.

So in rectal cancer, for example, oftentimes we'll do neoadjuvant where we do chemo and radiation up front, see the rectal tumor shrink. There was some lymph nodes. You want to see those get smaller, and then you have optimized it now for the definitive surgery to take it out. That's neoadjuvant therapy, same with lung cancer, or sometimes if a cancer has just a few metastasis or it spread just into the liver, like a colon cancer or into the lung, then you'll give neoadjuvant chemo hoping to shrink it all down and then do definitive resection, which is a soft curative measure to try to take it out."

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