Understanding Maintenance Therapy

Approved by the Cancer.Net Editorial Board, 08/2015

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

Maintenance therapy is used for the following reasons:

  • To avoid or slow the cancer’s return if the cancer is in complete remission after initial treatment. Being in “complete remission” means doctors cannot find cancer and you have no symptoms. Maintenance therapy can help keep the cancer from coming back.
  • To slow the growth of advanced cancer after initial treatment.  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. They use it for many different types of cancer. Maintenance therapy is more common today for several reasons. These include:

  • New cancer drugs often have fewer side effects than older ones. This means that patients may be able to take them longer.
  • New research has found that maintenance therapy helps lengthen the lives of patients with certain types of cancer.  However, maintenance therapy does not work for all types of cancer.

Maintenance therapy often uses traditional chemotherapy drugs. But doctors give lower doses than when you first have treatment. You might also get vaccines, hormone 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.

Maintenance therapy during cancer remission

Maintenance therapy may be used to keep the cancer from coming back. For example, maintenance therapy may be considered after treatment for some types of leukemia and early-stage breast cancer. Talk with your doctor about if or how maintenance therapy is used for the type of cancer you have.

Maintenance therapy for advanced cancer

Maintenance therapy may help control advanced cancer that has improved but is not gone after initial therapy. In these situations, it can help patients live longer. Pemetrexed (Alimta) is the first drug the U.S. Food and Drug Administration approved for advanced lung cancer maintenance therapy. Even though many patients lived longer, researchers are not sure maintenance therapy reduces cancer symptoms or improves quality of life.

How long does maintenance therapy last?

It may last weeks, months, or years. That depends on factors such as:

  • Cancer type
  • Drugs used
  • How well it works
  • How long you can tolerate any side effects

Doctors usually give maintenance therapy less often than regular chemotherapy. You might also get a lower dose.

Benefits and risks of maintenance therapy

Maintenance therapy may keep cancer from coming back. It may also slow down cancer growth. But it does have possible disadvantages. These include:

  • More side effects
  • Higher treatment cost
  • More doctor visits
  • Limited information on if it helps you live longer, or how much longer

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

Maintenance therapy as a cancer survivor

More people are now using maintenance therapy. If you do, you might wonder when you become a “cancer survivor.” You might feel safer if you take maintenance therapy. But you might not feel like a survivor if you still get treatment.

No matter what you think about the stages of cancer treatment, maintenance therapy is an important part of many people's treatment and recovery plans. Learn more about survivorship.

Questions to ask your doctor

Consider asking your doctor the following questions:

  • Is maintenance therapy an option for me?
  • What type 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 open to me?

More Information

What is Chemotherapy?

How Cancer is Treated

Financial Considerations

Coping with Fear of Recurrence

Dealing with Cancer Recurrence