I had the cancer cut out already, why do I still need chemo and/or radiation?

This is an excellent question that I get asked very often. Yes, the cancer has been cut out completely. Perhaps you were told of “negative margins” which means that the surgeon scooped it out very well, almost like scooping out a large piece of oatmeal with a random lump in the center, in such a way that there is a lot of normal oatmeal around so the lump is not touching the edges of scooped out part.

Why do I need more treatments, like chemotherapy and/or radiation?

The answer has to do with something called “microscopic disease.” Every solid cancer consists of a “large piece” and “microscopic cells”. When the surgeon cuts out the cancer, he/she takes out the large piece but microscopic cells often remain. These cells can be all over the body. They cannot be seen on scans because they are too small.

Sometimes, these cells can grow and multiply and cause cancer to “recur” and/or spread or “metastasize”. This is why someone who had a seemingly small cancer cut out years prior, can show up later with stage IV cancer.

As an Oncologist, I know how much we always want to prevent such a thing from happening.

This is why other treatments, called “adjuvant therapies” may be recommended after an early stage (stages I, II, and III) cancer has been cut out. “Adjuvant” comes from the latin word “adjuvare” which means “to help or assist.”

Adjuvant therapies may include chemotherapy, hormone-blocking medications, and radiation. It may be recommended in some, but not necessarily all, solid cancer cases. Examples include breast, colon, and lung cancer. In some cases, adjuvant therapy is not known to add much else, and may not be recommended. Each case is unique so one needs to have a detailed discussion with their oncologist.

Have you had any other thoughts about adjuvant therapies? Do leave a comment. If you found this helpful, please share freely with your family and friends. Subscribe to my blog, to be the first to read my posts about cancer, blood disorders, parenting, and books.

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Author of "Self navigate for health" available as eBook on Amazon and paperback on Lulu. Hematology-oncology physician writing about medical self-advocacy or "self-navigation", cancer, blood disorders, and books

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