National Comprehensive Cancer Guideline first-line therapies are considered the "gold standard" when first treating a cancer patient with a particular cancer type or stage, such as a stage II, invasive intraductal breast cancer diagnosis. In other words, it is the treatment most oncologists would select when first treating the patient.

First-line treatment regimens are often a combination of therapies, such as surgery first, chemotherapy second, and radiation therapy third, given in succession. Regrettably, first-line therapy often fails to kill all living cancer cells during this initial treatment cycle; later reappearing at the original tumor as little as six months or even several years after completing the first-line therapy -- cancer can also appear at a distant site with treatment now considered palliative rather than curative; sadly, depriving the patient the potential for being cancer free forever.

• Malignant tumors go far beyond visible/perceptible "boundaries" ("microscopic spread").
• Excessive tumor margin remaining after first-line line surgery, fails to eliminate all microscopic spread.
• Clinical studies confirm cancer biopsies often facilitate potentially lethal microscopic spread – the patient should seek administration of a small amount of intravenous chemotherapy -- 10 to 20 mg of cisplatin several hours before the biopsy.
• Microscopic spread must be eliminated before any first-line surgery is undertaken, to prevent cancer recurrence.
• Cancer recurrence has the potential to be avoided when a different sequence of treatment events is undertaken before commencing any first-line treatment.
• Invoking an entirely different first-line therapy sequence can prevent cancer remission for the majority of patients and possibly full eradication of cancer for others!

Cancer recurrence can be prevented if very-short course of radiation is given immediately preceding the patient undergoing their first-line treatment, regardless of the treatment sequence.

Why?
It's well accepted that short-course radiation can significantly reduce or even obviate lethal cancer tumor cells in surrounding tumor margins and regional lymphatic areas when combined with a chemo-sensitizing cytostatic agent. This combination of chemotherapy and radiation is called cytoreduction ("CCRT"), or more commonly "neoadjuvant" However, neoadjuvant was never expected or intended to eliminate the tumor in its entirety, rather:

• Clear microscopic cancer spread within surrounding tumor tissue margins.
• Reduce overall tumor mass providing the opportunity for more manageable and less invasive eventual tumor removal.
• Facilitate tumor retraction from adjacent critical structures (e.g., blood vessels, nerves, bone, organs, etc.) facilitating eventual tumor removal with a less invasive and a more conservative surgical approach.
• Enhance overall organ/tissue preservation.
• Implementation of neoadjuvant must be precisely timed with 1st-line surgery, to ensure the peak benefits are fully implemented while still facilitating patient recovery.

The prophylactic use of a low-dose chemo agent immediately preceding and immediately following 1st line surgery, has shown to provide the greatest protection for lethal cancerous cells spreading during an initial biopsy or tumor surgery; it can also help overlap the gap between the 1st line surgery and any subsequent invasive treatment(s).

In all instances this is best achieved when CCRT is administered immediately following full recovery of the patient (usually 4 to 6 weeks after surgery) when a small dose of radiation and low-dose chemotherapy is given within same cancer "fields" and identically as given previously; with the primary intent to eliminate the potential for lethal "surgical seeding" and/or any remaining localized malignant cells.

This proprietary neoadjuvant protocol has been the mainstay of our treatment approach for over 40 years of practice and enabled us to achieve remission for tens of hundreds of past patients, with many remaining cancer-free for over 10 to 20 years!