After surgery to remove a tumor, there may still be some residual cancer cells in the body, hidden in the blood or lymphatic system. The postoperative “adjuvant therapy” can remove as many of these “remnants” as possible to consolidate the results of surgery and prevent recurrence and metastasis.
I need adjuvant therapy.
Do I need adjuvant therapy?
Do I need adjuvant therapy?
Not all postoperative patients need adjuvant therapy. The surgeon needs to consider the pathology report and the surgical record.
Postoperative adjuvant therapy is needed for the following conditions:
- Postoperative pathology suggests lymph node metastasis or invasion of the esophageal epithelium, with a higher risk of recurrence, and radiotherapy may be beneficial.
- Adjuvant radiotherapy is needed for patients who have “missed” surgery. This means that the esophagus was not cut long enough and the lymph nodes were not completely removed because of the location of the tumor and its relationship to the surrounding blood vessels and other important structures.
When can I start adjuvant therapy?
If you are eligible for adjuvant therapy as described above, then treatment is usually started about 4 weeks after surgery.
If you are not recovering well after surgery, you can delay the start of adjuvant therapy, but try to do so within 2 to 3 months after surgery.
What tests and preparations do I need to do before adjuvant radiotherapy?
After surgery, the excised cancerous tissue is sent to the pathology department for biopsy, and the final pathology report is the basis for whether you want to have adjuvant therapy or not. In other words, pathological examination is mandatory before adjuvant therapy.
If you are recovering well from surgery and are considering adjuvant radiotherapy, you can complete your pre-radiotherapy exams, including imaging, blood work, liver and kidney function, coagulation, and electrocardiogram, within 4 weeks after surgery.
These tests are designed to “benchmark” your heart function, hematopoietic function, liver and kidney function, and so on. Only when they meet the appropriate criteria can chemotherapy be started.
What can I and my family do before and during treatment?
Many people often have more concerns and fears when they learn that they will also need radiation or chemotherapy after surgery. I hope that you can be positive about your condition and not get carried away, or equate post-operative adjuvant therapy with “not getting clean”.
Family members need to help your loved one with his/her problems and seek his/her cooperation and understanding.
During treatment, you and your family should visit the hospital weekly as requested by your doctor, inform your supervising physician if you are unwell, and follow your doctor’s instructions for laboratory tests and medications. The general requirement is that you need to be hospitalized on the day of chemotherapy; after chemotherapy is completed, you can have radiation therapy as an outpatient.
Co-written by: Dr. Rong Yu, Peking University Cancer Hospital Dr. Jing You