Neoadjuvant Chemotherapy for Cancer Treatment in Delhi, India

Overview

Neoadjuvant chemotherapy is a form of chemotherapy aimed at reducing the cancer tissue's size before surgery by administering specific medication, radiation, or hormones. While earlier it was only used for advanced-stage breast cancer.

Today it is used for various other types of cancer such as colon cancer, lung cancer, bladder cancer, and prostate cancer. It provides ease in further treatment and removes any cancerous tissue that may have gone undetected on imaging.

Alternate Name of Neoadjuvant Chemotherapy

Pre-operative Chemotherapy

Route of Administration (Body Location)

Oral, intravenously, or via an injection

Neoadjuvant Chemotherapy Procedure Type

Noninvasive, percutaneous

Preparation for Neoadjuvant Chemotherapy

There is no need to be admitted to the hospital for this procedure.
The doctor conducts a full body assessment, with the following tests being performed.
Tumor evaluation is done by taking a biopsy or histopathological methods to confirm the cancer type and diagnosis.
Imaging - This includes using ultrasounds and magnetic resonance imaging (MRI) to defect the extent of spread and stage of cancer.
Lymph node evaluation - to check for local and distant metastasis or spread of cancer.
There are no dietary limitations in this procedure except that the patient is regularly asked to maintain a healthy balanced diet.

Neoadjuvant Chemotherapy Procedure

During neoadjuvant chemotherapy, anti-cancer medication is administered via the abovementioned routes. This occurs in cycles lasting up to 3-6 months with rest periods in between. The oncologist decides the mode of drug delivery and duration of the procedure based on the location and severity of the cancer.

This could occur in the doctor's office or even at the patient's home. This process is done before moving on to the next major step in treatment, such as surgery to remove the cancerous tissue from one's body.

Some commonly used medication includes - anthracyclines, 5-fluorouracil, taxanes, cyclophosphamides, and carboplatin.

With this treatment, the size of the cancer is aimed to be reduced, but it is believed to give cosmetically better results post-surgery. Other advantages include:

Making inoperable tumors operable.
Reducing the need for mastectomies in case of breast cancer, and ultimately.
Making surgical removal of cancer more manageable.

This differs from adjuvant chemotherapy as the latter is done after the primary treatment modality to destroy the remaining cancer cells.

Recovery After Neoadjuvant Chemotherapy

Surgery is generally planned 3-4 weeks post neoadjuvant chemotherapy to allow for immune and general recovery. Since, after this procedure, the body's immune system becomes weak, one should avoid people with infections and colds. It is also essential to maintain a steady diet and ingest plenty of fluids to allow the drugs to spread through your body.

There is no need to worry if the side effects are not improving, but you must inform the doctor as they may prescribe you a particular medication to deal with them. Recovery may seem like a long and tedious road, but there is always light at the end of the tunnel!

Book an appointment or video consultation and discuss this with our team of doctors today.

Follow-up After Neoadjuvant Chemotherapy

There is regular follow-up during the cycles of therapy. After that, you are expected to meet the doctor to check for regression or progression of the disease and decide the next step in treatment which is usually surgery.

After the treatment, a thorough clinical examination and imaging are conducted to check for the above. Quite commonly, a PET scan is used to assess the outcome of neoadjuvant therapy.

Finally, the doctor must decide the need for adjuvant therapy based on pathological studies in case of remnants of cancer.

The patient must stick to the recommended follow-up routine to keep the disease in check and follow any doctor's advice.

Risks Associated with Neoadjuvant Chemotherapy

A significant risk in this procedure comes because of delaying the surgical removal of cancer as it may grow or spread during this period. This is quite a rare occurrence. Additionally, the following side effects have been reported

Hair loss
Fatigue
Vomiting and Nausea
Sore mouth
Increased risk of infection
Decreased cognitive function

All of these are temporary and go away once the therapy is completed. There are, however, the following serious complications that may occur in the long run -

Frequently Asked Questions

1. What is the main benefit of neoadjuvant chemotherapy?

The main benefit of neoadjuvant chemotherapy is that it can help shrink tumors before surgery, making them easier to remove. This can lead to a better surgical outcome and may allow for breast-conserving surgery instead of a full mastectomy in some cases.

2. Is neoadjuvant chemotherapy successful?

Yes, neoadjuvant chemotherapy has been shown to be successful in treating certain types of cancer, particularly breast cancer. It can lead to significant tumor shrinkage and improve the chances of successful surgical removal, as well as reduce the risk of cancer recurrence.

3. How soon after neoadjuvant chemo do most get surgery?

Typically, surgery is performed about 3-4 weeks after the last dose of neoadjuvant chemotherapy. However, the exact timing may vary depending on the individual patient's response to chemotherapy and the specific treatment plan recommended by the medical team.

4. How long is treatment for neoadjuvant therapy?

The treatment time for neoadjuvant therapy depends on the type and stage of cancer, as well as the drugs being used. Typically, it can range from a few weeks to several months. The treatment plan is usually determined by the healthcare provider.

5. Is neoadjuvant chemotherapy safe?

Yes, neoadjuvant chemotherapy is generally considered safe when administered appropriately and under the supervision of healthcare professionals. Patients are carefully monitored for any adverse reactions, and their treatment plans may be adjusted accordingly.

6. Does neoadjuvant chemo increase metastasis?

No, neoadjuvant chemotherapy does not increase metastasis. In fact, it can potentially reduce the risk of metastasis by shrinking the primary tumor and eliminating any cancer cells that may have spread to nearby lymph nodes before surgery.

7. How long does chemo take to shrink a tumor?

The time it takes for chemotherapy to shrink a tumor depends on various factors, including the type and stage of cancer, the location of the tumor, and the type of chemotherapy used.

8. When is neoadjuvant chemotherapy used?

Neoadjuvant chemotherapy is often used in the treatment of various types of cancer, including breast cancer, lung cancer, bladder cancer, and esophageal cancer. It is typically used to shrink the tumor before surgery.

9. What drug is used in neoadjuvant chemotherapy?

There is no specific drug used in neoadjuvant chemotherapy, as the choice of drugs depends on the type and stage of cancer being treated. Common drugs used in neoadjuvant chemotherapy include taxanes, anthracyclines, platinum compounds, and fluorouracil.

10. How many cycles of neoadjuvant chemotherapy are there?

The number of cycles of neoadjuvant chemotherapy can vary depending on the type and stage of cancer, as well as the patient's overall health. Typically, patients receive two to six cycles of neoadjuvant chemotherapy before undergoing surgery or other additional treatments.