Knowledge centre

Treatment explanations

What common treatment modalities involve, how they are monitored and which side effects should prompt urgent contact.

Oncology · 5 min read

Neoadjuvant versus adjuvant therapy

Neoadjuvant therapy is given before surgery to shrink the tumour and test its biology in vivo. Adjuvant therapy is given afterwards to reduce the risk of recurrence from residual disease.

Neoadjuvant treatment can convert an inoperable tumour to a resectable one and allows the response to be observed directly, which carries prognostic information.

Adjuvant treatment targets micrometastatic disease that imaging cannot detect. Because that disease is invisible, benefit is expressed statistically as a reduction in recurrence risk.

Sequencing is a frequent point of legitimate disagreement between specialists and one of the most common reasons patients request a multidisciplinary review.

Oncology · 6 min read

Immunotherapy: mechanism and immune-related adverse events

Checkpoint inhibitors release the brakes on T cells. The same mechanism can cause inflammation in healthy tissue, producing colitis, pneumonitis, hepatitis, thyroiditis or hypophysitis.

PD-1, PD-L1 and CTLA-4 inhibitors work by blocking inhibitory signalling so that cytotoxic T cells can recognise tumour cells.

Immune-related adverse events can appear weeks to months after a dose and sometimes after treatment has finished. New persistent diarrhoea, breathlessness, jaundice or profound fatigue should be reported to your oncology team the same day.

Management usually involves corticosteroids and, in resistant cases, further immunosuppression. Early reporting materially improves outcomes.

These articles are general education reviewed by our clinical editorial team. They are not tailored to your circumstances and do not constitute medical advice, diagnosis or a recommendation to start, stop or change any treatment.