Chemotherapy Principles

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The goals of chemotherapy

There are 3 possible goals for chemotherapy treatment:

Cure: If possible, chemotherapy is used to cure the cancer, meaning that the cancer disappears and does not return. However, most doctors do not use the word “cure” except as a possibility or intention. When giving treatment that has a chance of curing a person’s cancer, the doctor may describe it as treatment with curative intent. But there are no guarantees, and though cure may be the goal, it doesn’t always work out that way. It often takes many years to know if a person’s cancer is actually cured.

Control: If cure is not possible, the goal may be to control the disease — to shrink any cancerous tumors and/or stop the cancer from growing and spreading. This can help someone with cancer feel better and possibly live longer. In many cases, the cancer does not completely go away but is controlled and managed as a chronic disease, much like heart disease or diabetes. In other cases, the cancer may even seem to have gone away for a while, but it’s expected to come back.

Palliation: When the cancer is at an advanced stage, chemotherapy drugs may be used to relieve symptoms caused by the cancer. When the only goal of a certain treatment is to improve the quality of life but not treat the disease itself, it’s called palliative treatment or palliation.

Chemo that’s given with other treatments

Sometimes, chemotherapy is the only treatment used. In other cases, chemotherapy may be given along with other treatments. It may be used as adjuvant therapy or neoadjuvant therapy.

Adjuvant chemotherapy: After surgery to remove the cancer, there may still be some cancer cells left behind that cannot be seen. When drugs are used to kill those unseen cancer cells, it’s called adjuvant chemotherapy. Adjuvant treatment can also be given after radiation. An example of this would be adjuvant hormone therapy after radiation for prostate cancer.

Neoadjuvant chemotherapy: Chemotherapy can be given before the main cancer treatment (such as surgery or radiation). Giving chemotherapy first can shrink a large cancerous tumor, making it easier to remove with surgery. Shrinking the tumor may also allow it to be treated more easily with radiation. Neoadjuvant chemotherapy also can kill small deposits of cancer cells that cannot be seen on scans or x-rays.

Last Medical Review: 02/07/2013
Last Revised: 02/07/2013