Understanding Maintenance Therapy

Approved by the Cancer.Net Editorial Board, 05/2019

Maintenance therapy is the treatment of cancer with medication, typically following an initial round of treatment. Maintenance treatment may include chemotherapy, hormonal therapy, or targeted therapy.

Maintenance therapy is used for the following reasons:

  • To prevent or delay the cancer’s return if the cancer is in complete remission after the initial treatment. “Complete remission” means that the doctors cannot find cancer and you have no symptoms.

  • To slow the growth of advanced cancer after the initial treatment. This can help shrink the cancer, which is called a partial remission. In this situation, maintenance therapy is not used to cure the cancer, but it can lengthen a person’s life.

You can have maintenance therapy for a long time in either of these situations.

Is maintenance therapy new?

No, but doctors use it more today than in the past. Maintenance therapy is more common now for many types of cancer because:

  • The number of effective drugs for most types of cancer has increased. Some of these drugs are not used for initial treatment, but they are effective as a part of maintenance therapy.

  • New cancer drugs often have fewer side effects than older ones. This means that people may be able to take them longer.

  • Maintenance therapy can help lengthen the lives of people with certain types of cancer. But some studies have shown that maintenance therapy does not work for all types of cancer. Some drugs are also more effective than others.

Maintenance therapy often uses traditional chemotherapy drugs. However, it typically involves a single drug rather than a combination, so there are usually fewer side effects. But doctors give lower doses than when you first have treatment. You might also get targeted therapy, hormonal therapy, or other drugs. For example, doctors give hormones as maintenance therapy for some types of breast cancer. Maintenance therapy may include a drug from the first treatment plan. Or it may include another drug or drug combination.

During cancer remission

Maintenance therapy may be used to lower the chance of the cancer coming back. For example, it may be considered after treatment for some types of leukemia and lymphoma. Talk with your doctor about if or how maintenance therapy is used for the type of cancer you have.

For advanced cancer

Maintenance therapy may help control advanced cancer that has improved but is not gone after initial treatments. In these situations, it can help people live longer. Maintenance therapy is now commonly used after initial treatment for several cancers, such as advanced lung cancer, colorectal cancer, and some types of lymphoma.

How long does maintenance therapy last?

It may last weeks, months, or years, depending on:

  • The type of cancer

  • The drugs used

  • How well it works

  • How long you can tolerate any side effects

Benefits and drawbacks

Maintenance therapy may keep cancer from coming back or slow down its growth. But it can also come with disadvantages, including:

  • More side effects

  • Higher treatment cost

  • More doctor visits

If maintenance therapy is an option for you, talk with your doctor about benefits and drawbacks.

Maintenance therapy as a cancer survivor

Some people feel safer taking maintenance therapy. But others feel they are not a cancer survivor if they are still getting treatment. Either way, maintenance therapy is an important part of many people's treatment and recovery plans. Learn more about survivorship.

Questions to ask your health care team

Consider asking the following questions:

  • Is maintenance therapy an option for me?

  • What type of maintenance therapy do you recommend?

  • What are the potential benefits and risks of this treatment?

  • How often would I get it? For how long?

  • Will my insurance pay for it?

  • When is watchful waiting a better option? (Doctors call watchful waiting “active surveillance.” It means watching for signs that cancer is coming back. You only start treatment if symptoms develop.)

  • What clinical trials are available for me, and how do I find out more about them?

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