Dr. Wakelee on Explaining Adjuvant Therapy to Patients

Heather Wakelee, MD, assistant professor, Department of Medicine, Division of Oncology, Stanford University, Stanford Clinical Cancer Center, explains the methods she uses to discuss adjuvant therapy with patients after they receive surgery for lung cancer.

Many factors can influence the effectiveness of adjuvant therapy. Depending on the stage the patients may already be cured from the surgery alone. On average the surgery cure rate is 30-40% for stage III cancer and up to 60-70% for stage I, with many different variables coming into play. Adjuvant therapy provides an additional 5-10% improvement in survival; it is not a guarantee, but does offer significant improvement.

The level of the discussion depends greatly on the sophistication of the patient. Analogies can be a useful tool in some cases, Wakelee commonly uses gambling or two groups of 100 patients, one group will receive adjuvant therapy and the other will not.