Chemotherapy is often used alongside surgery to treat cancer. If your cancer treatment plan includes adjuvant chemotherapy or neoadjuvant chemotherapy, that means you will be receiving both chemotherapy and surgery to treat your cancer.

Chemotherapy is the use of powerful drugs to kill or slow the growth of cancer cells. It is frequently administered before or after surgery to improve results. The different terms indicate the order in which you will get these treatments:

  • Neoadjuvant chemotherapy is delivered before surgery with the goal of shrinking a tumor or stopping the spread of cancer to make surgery less invasive and more effective.
  • Adjuvant chemotherapy is administered after surgery to kill any remaining cancer cells with the goal of reducing the chances of recurrence.

Whether or not your doctor recommends chemotherapy before or after surgery, depends on several factors, including:

  • Cancer type and stage
  • Whether or not the cancer has spread to lymph nodes
  • The goal of treatment, whether it is to rid your body of cancer, slow the cancer’s growth and progression, or ease the symptoms of your cancer
  • How well your body is likely to tolerate multiple treatments

When are Neoadjuvant Chemotherapy and Adjuvant Chemotherapy Used?

Adjuvant chemotherapy and neoadjuvant chemotherapy are frequently used in the treatment of breast, colon, lung, bladder, and prostate cancers. For example, a woman with invasive breast cancer or a very large tumor may undergo neoadjuvant chemotherapy to shrink a tumor before breast surgery so a lumpectomy (surgery to remove only the cancer and surrounding tissue) can be performed instead of a mastectomy (removal of the entire breast). Or, she may receive adjuvant chemotherapy after breast surgery to kill any cancer cells that may have been too small to detect during surgery to keep them from growing and spreading.

Neoadjuvant Chemotherapy

If your cancer treatment plan includes neoadjuvant chemotherapy, you are likely to begin chemotherapy very quickly so that surgery can be performed.

Adjuvant Chemotherapy

If your treatment plan includes adjuvant chemotherapy, you’ll likely begin treatments within 30 days following surgery. The number and frequency of treatments will depend on your type of cancer and how invasive it is. Some adjuvant chemotherapy is administered in a few treatment cycles while others are administered for up to 10 years.

Side Effects of Adjuvant and Neoadjuvant Chemotherapies

The side effects of adjuvant and neoadjuvant chemotherapy are the same as when chemotherapy is the only treatment. Recent advances in chemotherapy drugs have reduced the number and severity of many side effects. 

Learn more about chemotherapy side effects and how to cope with them.