Chemotherapy given before surgery to remove cancer is called neoadjuvant treatment. An oncologist might recommend this based of the size of the tumor -- it being very large. The idea is to shrink the tumor and then have surgery to remove the cancer.

Having chemotherapy administered while the tumor is still there can show what drugs are working and what drugs have no effect on the tumor. Chemotherapy when started immediately, not after surgery with healing time needed, gives the patient systematic treatment right away. This could be beneficial and is why physicians might recommend this form of treatment. The truth is they don't know if it is better or not.

Of course, every case of breast cancer is different. We all need to make tough decisions regarding our treatment plan. The facts are that currently there is no evidence that survival is improved with neoadjuvant verses adjuvant (after surgery) chemotherapy in women with locally advanced breast cancer.

The clinical trials that are done help physicians understand what treatments are more effective. Results from a Phase II clinical trial was published in the Journal of Clinical Oncology. It stated that neoadjuvant treatment with Taxotere, Navelbine, and Herceptin resulted in a complete disappearance of detectable cancer in 39 percent of women with locally advanced HER2 positive breast cancer.

The study showed that after two years followup, on the thirty one women with locally advanced breast cancer involved in the study, the overall survival was 97 percent and cancer free survival was 84 percent.

So, the message here is that, even though the study group was small, the results showed a good response to this treatment plan.

Results of two studies, sponsored by the Adjuvant Breast Cancer (ABC) Trials Collaborative Group, conclude that adding chemotherapy to the estrogen-blocking drug tamoxifen improves survival for those with early-stage breast cancer. The same studies reveal preventing the secretion of estrogen from the ovaries does not offer much benefit for most women.

Researchers studied 1991 patients, ages 28 to 81. All had received five years worth of treatment with tamoxifen therapy with or without standard chemotherapy. Some premenopausal women were also treated with ovarian removal (ablation) or suppression, a technique used to stop the glands from secreting hormones.

While early results, appearing in the Journal of the National Cancer Institute, fell short of statistical significance, chemotherapy still reduced the overall risk of death by 17 percent, mostly for women younger than 50 and especially for premenopausal women not treated with ovarian ablation or suppression.

Stage IIIB breast cancer describes invasive breast cancer in which a tumor of any size has spread to the breast skin, chest wall, or internal mammary lymph nodes. It also includes inflammatory breast cancer, a very uncommon but very serious, aggressive type of breast cancer.

Patients diagnosed with Stage IIIB breast cancer usually will receive chemotherapy before surgery and then possibly radiation, hormonal therapy, and more chemotherapy after surgery.

Those who receive a complete disappearance of all detectable cancer from receiving the chemotherapy before surgery have a better survival rate than those who have evidence of cancer after the neoadjuvant treatments. Researchers want to try and improve survival for those who have not had a complete response to the treatments before surgery.

Researchers from Italy conducted a trial to evaluate the effects of additional chemotherapy after surgery to see if this will give these patients a better chance at cancer free survival.

The participants were followed for over six years:

• Cancer free survival was 92 percent among patients who had a complete response from neoadjuvant treatment.
• Patients that still had detectable cancer after neoadjuvant treatment had only a 53 percent cancer free survival.
• Those patients that did not have a complete response after neoadjuvant therapy but went on to have more chemotherapy after surgery had 100 percent cancer free survival.

The researchers added that the trial was small but it appears that additional chemotherapy added after surgery could provide a significant survival benefit.

In September of 1998, the FDA approved Herceptin to treat breast cancer after it had become metastatic. Yesterday the FDA approved Herceptin's use for women diagnosed with breast cancer just after surgery. The drug is already widely prescribed for adjuvant therapy even without the FDA's approval, a practice called off-label use. Off-label use means that a prescription drug is being prescribed for a purpose not listed on the product's label. This is a common and acceptable practice by doctors and the Food and Drug Administration.

Clinical trials were conducted that showed women who received Herceptin (trastuzumab) given along with chemotherapy had fewer relapses than those who only received chemotherapy. Twenty to thirty percent of women diagnosed with breast cancer have this genetic alteration of the HER2 gene and could benefit by being treated with Herceptin.

In previous studies there has not shown to be an increase in survival when adding chemotherapy after surgery for gastric cancer compared with surgery alone. Most U.S. patients that are diagnosed with cancer of the stomach or lower esophagus have locally advanced disease that is hard to cure.

The MAGIC trial represents a landmark study in gastric cancer, as it is the first trial to demonstrate a survival benefit for pre- and postoperative chemotherapy. Researchers studied 503 patients with cancer of the stomach, esphagogastric junction or lower esophagus. One arm of the trial received three preoperative and three postoperative cycles of chemotherapy, the other arm of the study had only surgery.

The trial concluded that the chemotherapy group had smaller resectable tumors with negative margins, fewer patients had advanced nodal disease and the five year survival rate increased by 13 percent. It was noted that this is a significant advance for the treatment of this disease.

Lung cancer remains the leading cause of cancer-related death in the United States. Non-small cell lung cancer (NSCLC) comprises the majority of lung cancers.

According to the results presented at the 2006 annual meeting of the European Society for Medical Oncology, the combination consisting of Platinol (cisplatin) plus Navelbine (vinorelbine) improves survival among non-small cell lung cancer patients whose cancer has been surgically removed.

Early stage lung cancer is usually treated with surgery, chemotherapy or radiation therapy. The use of adjuvant chemotherapy has not shown in the past to have improved survival.

This study included data from almost two thousand patients with early stage lung cancer. Patients were treated with either adjuvant Platinol/Navelbine or no chemotherapy at all. The study showed that at five years 55 percent of patients who were treated with the chemotherapy combination were alive compared to only 46 percent who received no further treatment after surgery.

The researchers concluded that adjuvant chemotherapy consisting of Platinol/Navelbine improves survival at five years among patients with NSCLC who were able to have their cancer completely removed by surgery.

I have made on-line visits to Wikipedia many times -- mostly for information on cancer. And what I've found are endless resources, thoroughly-covered topics, and material that is easy to read and easy to understand. Wikipedia, a free on-line encyclopedia -- where readers can participate in editing and changing content -- offers information on just about any topic you can imagine. And here are seven stops you might make in pursuit of cancer-related material.

Prostate cancer that has spread to the lymph nodes is more likely to be controlled if radiation is given along with hormonal therapy. A study was done and published in the Journal of Urology. The study showed that among the prostate cancer patients that had initially received hormonal therapy faired better than those that didn't use hormonal therapy along with or before radiation.

It is important to discuss adjuvant hormonal therapy with your doctor if you have been diagnosed with prostate cancer. If hormonal therapy given right after diagnoses gives a better benefit than just radiation alone and causes less distant recurrences then I would go for it.

The National Institute of Health and Clinical Excellence (NICE) cleared the way for Herceptin to be prescribed on the National Health Service for women with aggressive HER2 breast cancer following surgery. Herceptin will be paid for by the state health insurance. NICE Chief Executive said that Herceptin is "clinically and cost effective".

Herceptin was recently only used for breast cancer patients with metastatic disease unless the patients had participated in a clinical trial. It has shown now to reduce the risk of recurrence in HER2 positive breast cancer when given as adjuvant therapy.

The challenge is to make sure that all newly diagnosed patients, wherever they live, have access to the HER2 test so they can get Herceptin without delay.

If you have been diagnosed with stage I, stage II or stage III breast cancer you might be eligible to participate in a trial that uses bisphosphonates as adjuvant therapy along with standard treatments.

When breast cancer metastasizes it often spreads first to the bone. Bisphosphonates have been shown to slow the progression of cancer in the bone. This trial will test to see if bisphosphonates when used as adjuvant therapy may delay or prevent bone metastasis from happening altogether.

This phase III trial will compare two newer and stronger bisphosphonates with a bisphosphonate called clodronate that has been shown to interrupt bone metastasis in early stage breast cancer.

Bone metastasis can lead to fractures, spinal cord compression and it can be very painful. If we can halt the spread of breast cancer to the bone with an additional adjuvant therapy it can save many lives.