Chemotherapy

Who Needs Chemotherapy?

Chemotherapy may be documented for patients based on the following:

• Type/stage of cancer (e.g., breast, lung, colon, leukemia)
• Aggressiveness of cancer, whether and extent of metastasis
• Before surgery or radiation therapy to eliminate remaining cells
• The primary approach for lymphoma/leukemia that needs systemic therapy
• Palliative - provides symptom management in end-of-life situations
• Tumors/diseases are chemo-sensitive

People should particularly be aware that chemotherapy is so important for:

• Metastatic cancers
• Hematological cancers (blood cancers -  leukemia, lymphoma, myeloma)
• High-grade aggressive tumors

Types of Chemotherapy Procedures

Chemotherapy exists in various ways of administering and in different regimens. Types include the following:

1. Intravenous (IV) Chemotherapy: The most common method: drugs are injected into the blood vessels and vein.
2. Oral Chemotherapy: Mouth administered pills or capsules. These are suitable for people who want to continue treatment at home.  
3. Injection (Intramuscular/Subcutaneous): Chemotherapy is administered in a muscle or under the skin.
4. Intraperitoneal (IP) Chemotherapy: Injects drugs into the abdominal cavity for ovarian cancer.
5. Intrathecal Chemotherapy: Administered in the cerebrospinal fluid for brain or spinal cord involvement.
6. Topical Chemotherapy: Used on the skin, primarily for some skin cancers.

Chemotherapy could be administered in a regimen of cycles with pauses in between cycles, through which the body can recover.

Pre-Chemo Evaluation and Diagnostics

Before undergoing chemotherapy, comprehensive examinations are carried out in order to arrive at the best approach.

• Cancer Staging and Biopsy: The tumour type, stage, as well as features are identified.
• Blood Tests: CBC, liver and kidney functionalities, electrolytes, etc.
• Imaging: CT, PET-CT, and MRI scans to check on the growth and spread of the tumour.
• Heart Function Tests: Echocardiogram or MUGA scan for using some chemo drugs.
• Infection Screening: To avoid complications during treatment.
• Performance Status Assessment: Tests for the patient’s tolerance to chemotherapy.

Patients are also taught about possible side effects and what to expect during treatment.

Selection and Treatment Planning

Personalised plans for chemotherapy are made depending on:

• Type, stage, and biomarkers of cancer (like HER2, BRCA, EGFR)
• General health and organ function
• Treatment goals (curative vs. palliative)
• Patient’s age, choices, and prior treatment.
• Drug sensitivity and resistance profiles

Treatment is done by a multidisciplinary team of medical oncologists, pharmacists, dietitians, and support staff.

Drug dosage, drug combinations, cycle intervals, and supportive therapies are all preset.

Chemotherapy Procedure

This is usually the case whenever a person undergoes chemotherapy treatment:

1. Pre-Medication: Anti-nausea drugs and hydration could be provided to prevent side effects.
2. Drug Administration: 
   • IV through a cannula or PICC line, or chemo port
   • Oral medication with food or fasting as instructed
3. Monitoring: Vital signs and side effects are monitored during and post-infusion.
4. Post-Treatment Care: Follow-up instructions and home care prescriptions are given.

Each session can take from 30 minutes to several hours if the drug and its route of administration are different.

Risks & Potential Complications of Chemotherapy

Although effective, chemotherapy generally has side effects because it affects healthy, fast-growing cells.

Common Side Effects:

• Nausea and vomiting
• Fatigue
• Hair loss
• Mouth sores
• Diarrhea or constipation
• Appetite loss
• Anaemia, infections, and bruising: Low blood cell count

Serious Complications:

• Infections due to low immunity
• Heart, liver or kidney damage (drug-dependent)
• Infertility
• Cognitive effects ("chemo brain")
• Risk of secondary cancers

Supportive care, modification in doses, and injections of growth factors can help alleviate side effects.

What to Expect After Chemotherapy?

The body goes through a process of processing and eliminating the drugs after each chemotherapy session. This is what most of the patients will experience:

• Fatigue or weakness for 1–3 days
• Changes in taste or appetite
• Sensitivity to infections (particularly when the blood count is low)
• Testing the blood for purposes of tracking the cell counts
• The side effects usually come to a peak in 2-5 days and decline

During this period, patients should always remain hydrated, eat healthy meals, and avoid crowds or infections.

Post-Chemo Recovery & Long-Term Care

Chemotherapy recovery not only implies physical healing, but also adaptation of emotions. Key components include:

• Regular Monitoring: Blood tests, tumour markers, and images to know if one is still in remission or has recurrence
• Nutritional Support: Rebuilding strength and immune health
• Psychological Support: Counselling for anxiety, depression, or PTSD
• Rehabilitation: The management of chemo-based fatigue and muscle weakness
• Fertility Counseling: Especially for younger patients
• Lifestyle Adjustments: Exercise, low-stress routine, and habits that enhance immunity

Long-term care also involves testing for late effects such as heart problems or secondary cancers based on the chemotherapy agents used.

Chemotherapy Success Rate in India

The effectiveness of chemotherapy is dependent on the type and stage of cancer. India’s success rates are at a global standard level if the early diagnosis and appropriate treatment procedures are adhered to.

Approximate survival improvements with chemotherapy:

• Breast cancer (early-stage): 90–95%
• Lymphoma (Hodgkin’s): 80–90%
• Colorectal cancer: 60–70% with adjuvant chemo
• Leukemia: 50–80% in children (ALL/AML)

Personalised chemo regimens with genomic tests showcased increased use in Indian hospitals, which enhances the outcomes.

Cost of Chemotherapy in India

The cost of chemotherapy in India can vary widely depending on several factors, including the type of cancer, the specific treatment regimen, and the healthcare facility. On average, a single chemotherapy session may range from USD 1,000 to USD 1,200. However, for a complete treatment cycle that may involve multiple sessions, the total cost can increase. The top Indian hospitals offer advanced facilities at an affordable cost. 

Why Choose India for Chemotherapy?

India provides top-notch chemotherapy treatment at affordable costs than most Western countries. Benefits include:

• Uses global-standard protocols and drug regimens
• Experienced oncologists and chemotherapy nurses
• The affordable generic and branded chemotherapy drugs
• Availability of targeted and immunotherapies
• Day-care chemo lounges in comfortable settings at the best hospitals

Innovation Spotlight: An AI-based dosing calculator and biosimilar drugs are used by hospitals such as Tata Memorial and Apollo Cancer Centres for better results.

Documents Required for Patients Traveling to India for Chemotherapy

For international patients looking for chemotherapy in India, it is necessary to present certain documentation to have a smooth medical journey. These include:

• Valid Passport: Valid for a minimum of six months after the date you travel.
• Medical Visa (M Visa): Granted by the Indian Embassy/Consulate on medical grounds.
• Invitation Letter from Indian Hospital: A formal letter explaining the course of treatment and how long it will last.
• Recent Medical Records: X-rays, MRIs, blood tests, and a referral note by a doctor in the home country.
• Completed Visa Application Form: With passport-size photographs according to specifications.
• Proof of Means: Bank statements dated in the past few months or health insurance.
• Medical Attendant Visa: Needed for a companion or caregiver traveling with the patient.

It is advisable to refer to the Indian consulate or your medical facilitator for the latest information and help in documentation.

Top Chemotherapy Specialists in India

Some of the top Chemotherapy specialists in India include:

1. Dr. Vinod Raina, Fortis Memorial Research Institute, Gurgaon
2. Prof. Dr. Suresh H. Advani, Nanavati Max Super Speciality Hospital, Mumbai
3. Dr. Ashok Vaid, Medanta – The Medicity, Gurgaon
4. Dr. S.V.S.S Prasad, Apollo Cancer Institute, Chennai
5. Dr. Hemant B. Tongaonkar, Nanavati Max Super Speciality Hospital, Mumbai

Best Chemotherapy Hospitals in India

India has many well-known hospitals that provide chemotherapy. Some of these include: 

1. Apollo Cancer Centre, Chennai
2. Fortis Memorial Research Institute, Gurgaon
3. Max Super Specialty Hospital, Saket, Delhi
4. Apollo Hospital, Ahmedabad
5. Dr. Rela Institute and Medical Centre Hospital, Chennai

Frequently Asked Questions (FAQs)

Is chemotherapy painful? 

No, the treatment itself is not painful; however, side effects may occur once the treatment is complete, such as nausea or fatigue. 

How long is a chemotherapy cycle? 

The treatment period lasts anywhere from 30 minutes to several hours, and cycles of chemotherapy typically repeat every 1-3 weeks. 

Will I lose all my hair while on chemotherapy? 

Hair loss is dependent on the type of agents prescribed for chemotherapy. Hair loss is very common, but importantly, reversible with most chemotherapy agents. 

Are patients able to work while on chemotherapy? 

Some patients continue working during and between treatment cycles, depending on their energy levels and type of work. 

Can chemotherapy cure cancer? 

Chemotherapy is curative for some cancers, such as lymphoma, leukemia, and in early-stage breast cancer.