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Chemotherapy is a commonly employed treatment for cancer and uses cytotoxic drugs to destroy cancer cells. Neoadjuvant chemotherapy is a mode of cancer treatment received by patients before undergoing their surgical treatment. The aim of this therapy is to shrink the cancerous tumour using certain combinations of drugs and remove the circulating cancer cells in the blood & to downsize the cancer, thus making it easier to be removed surgically.
Oncologists may also recommend this type of chemotherapy when a tumour is too large for a major operation or is affecting various vital organs. It may also kill cancerous tissue that is not yet visible on imaging tests.
Benefits
Neoadjuvant chemotherapy has these specific benefits:
- Making the surgical removal of tumours easier.
- Making inoperable tumours operable.
- Reducing the need for mastectomies.
Uses
Neoadjuvant therapy is often used for the following:
- Inflammatory breast cancer.
- HER2-positive breast cancer.
- Triple-negative breast cancer.
- High-grade breast cancers.
- Cancers which have spread to the lymph nodes.
- Larger breast cancers.
Drugs Used
Earlier, doctors used to recommend neoadjuvant chemotherapy for the treatment of either inoperable or even advanced cases of breast cancer. In recent times, they have recommended it for a variety of cancers such as colon, lungs, bladder as well as prostate.
Doctors give several types of drugs for neoadjuvant chemotherapy. These are as follows:
- Anthracyclines treat different cancers involving various parts like the bladder, breasts and sarcomas.
- Taxanes target solid tumours in the breast, lungs, and ovaries.
- 5-fluorouracil, administered by injection to treat cancer of the colon, rectum, pancreas, and stomach.
- Carboplatin (Paraplatin) to treat ovarian and lung cancer.
Mode of Administration
There are several ways doctors can administer neoadjuvant chemotherapy. A person may receive it:
- Orally
- Intravenously, through an IV line
- Via injection
Risks
Commonly faced short-term side effects comprise the following:
- Loss of hair
- Fatigue
- Loss of appetite
- Nausea and vomiting
- Constipation or diarrhoea
- Mouth sores
- Changes in the skin and nails
- Increased chances of forming infection
- Nerve damage
- Issues with cognitive function affecting memory and concentration
Long-term Side Effects
Certain chemotherapy drugs for breast cancer can result in long-term side effects, including:
- Infertility: One possible side effect is infertility. Some anti-cancer drugs damage the ovaries causing symptoms of menopause like dryness of the vagina. Menstrual periods may become irregular. In some cases, it may result in Amenorrhea. If ovulation ceases, pregnancy becomes impossible.
- Bone Thinning: Women experiencing menopause early because of chemotherapy sessions may have a higher risk of osteopenia as well as osteoporosis. It's generally advised to undergo regular bone density tests and, accordingly, various treatments to avoid any additional bone loss and decay.
- Heart Damage: Chemotherapy involves a certain risk of weakening the cardiac muscle and causing other associated heart complications. Certain chemotherapy medications are linked with a higher risk of future heart problems.
- Leukaemia: Chemotherapy for breast cancer can trigger secondary cancer, such as cancer of the blood cells (leukaemia), several years after the chemotherapy is completed.