Neoadjuvant chemotherapy is chemotherapy given before surgery. Its aims are to shrink the tumour, make surgery easier or more effective, treat cancer cells that may have spread unseen and show how well the cancer responds to treatment. It is commonly used in breast, stomach, esophageal, rectal, ovarian, pancreatic and some other cancers.
Why Give Chemotherapy First?
Shrink the tumour
Smaller tumours may be easier and safer to remove.
Allow organ-preserving surgery
For example, breast-conserving surgery instead of mastectomy, or sphincter-saving surgery in rectal cancer.
Treat hidden spread
Early treatment may target microscopic cancer cells elsewhere in the body.
Test response
How the tumour responds helps guide further treatment and predict outcomes.
Select patients for surgery
In aggressive cancers, it helps identify those who will benefit from surgery.
Cancers Where It Is Commonly Used
- Breast cancer
- Stomach and esophageal cancer
- Rectal cancer, often with radiation
- Ovarian cancer
- Pancreatic cancer in selected cases
- Bladder cancer
- Some sarcomas and head and neck cancers
What Happens During Treatment?
- Chemotherapy is given in cycles over weeks to months
- Regular blood tests and scans check response
- Side effects are monitored and managed
- The surgical team stays involved in planning
Timing of Surgery
Surgery is usually scheduled a few weeks after chemotherapy ends to allow recovery of blood counts and general health.
Common Side Effects
- Tiredness
- Nausea
- Hair loss with some drugs
- Low blood counts and infection risk
- Mouth sores
- Numbness in hands and feet with certain drugs
What If the Tumour Does Not Shrink?
Your team may change the treatment plan, proceed with surgery earlier or consider other options. Not responding does not always mean surgery is impossible.
Key Takeaways
- Neoadjuvant chemotherapy is given before surgery.
- It can shrink tumours and treat hidden spread.
- It may allow less extensive surgery.
- Response helps guide future treatment.
- Surgery follows after a recovery period.
Final Thoughts
Starting with chemotherapy can feel like delaying surgery, but it is often a carefully planned step that improves outcomes. Your team will explain why it suits your case. For multidisciplinary surgical planning, you can consult Dr. Varadharajan, a surgical oncologist in Chennai.
