Chemotherapy, Radiation, Surgery: What's the Difference and Why Combine Them?

Q: How is surgery used in cancer treatment?

Surgery physically removes the tumour and, often, some surrounding tissue or nearby lymph nodes to check for spread. It's most effective for tumours that are localised (haven't spread widely) and accessible.

Q: How does chemotherapy work?

Chemotherapy uses medicines that travel through the bloodstream to reach cancer cells throughout the body, making it useful for cancers that have spread or might have spread beyond what surgery or radiation alone could address.

Q: How does radiation therapy work?

Radiation therapy uses high-energy beams targeted at a specific area to damage and destroy cancer cells in that location, while trying to minimise effect on surrounding healthy tissue.

Q: Why are these treatments often combined?

Combining treatments can address a cancer more thoroughly — for example, surgery to remove a visible tumour, followed by radiation to the local area and/or chemotherapy to address any cells that may have spread elsewhere. The combination and sequence depend on cancer type and stage.

Q: What do “neoadjuvant” and “adjuvant” mean?

Neoadjuvant treatment (usually chemotherapy or radiation) is given before the main treatment, often surgery, to shrink a tumour first. Adjuvant treatment is given after the main treatment to reduce the chance of the cancer returning.

Q: How do doctors decide which combination is right for a specific patient?

This depends on the cancer type, stage, its specific biological characteristics, the patient's overall health, and sometimes genetic or molecular testing of the tumour. This is a highly individualised decision made by the treating oncology team.

Q: Does every cancer need all three types of treatment?

No — some cancers are treated effectively with just one approach (for example, surgery alone for a small, early-stage, localised tumour), while others need a combination. There's no single formula that applies to every diagnosis.