Chemotherapy is a drug therapy that’s used to treat many different types of cancer. Chemicals in chemotherapy drugs target cells that rapidly divide, such as cancer cells. They may also target healthy cells in your body that divide rapidly, such as cells in your hair follicles and gastrointestinal tract.
When chemotherapy is used at the beginning of your cancer treatment and before starting radiation therapy, it’s referred to as induction chemotherapy. The goal of induction chemotherapy is to shrink tumors before beginning radiation therapy.
Consolidation chemotherapy is used to target cancer cells that are still in the body after initial treatment.
Keep reading as we take a look at when induction chemotherapy may be used and how it compares to consolidation therapy and other types of chemotherapy.
An induction therapy is the first treatment for a disease. Induction therapies are also called first-line therapies or primary therapies.
Chemotherapy can be used at different points in your cancer treatment:
- Concurrent chemotherapy radiation therapy is when chemotherapy and radiation therapy are performed together.
- Adjuvant chemotherapy is used after other treatments to shrink remaining cancer cells.
- Consolidation chemotherapy is used after initial treatment to target remaining cancer cells.
- Neoadjuvant chemotherapy is the type used before surgery.
- Induction chemotherapy is the type used before radiation therapy.
The term induction chemotherapy is often used interchangeably with the term neoadjuvant chemotherapy, even among cancer researchers. However, induction chemotherapy should be used when chemotherapy occurs before radiation therapy. The term neoadjuvant chemotherapy should be used to refer to chemotherapy before surgery.
The goal of induction chemotherapy is to reduce tumor size to make it easier for radiation therapy to get rid of cancer cells and to reduce the chances of cancer spreading to distant parts of your body. It’s often used for people with cancers that are at a high risk of spreading.
Induction chemotherapy is used as a first-line treatment for cancer to prepare you for radiation therapy. Consolidation chemotherapy is administered after initial treatment to target cancers cells that may still be in your body.
During consolidation therapy, chemotherapy drugs are administered in higher doses. The combination of chemotherapy drugs administered is often similar as during induction therapy. The duration you undergo consolidation therapy varies widely between people, but it may last 4 to 8 weeks.
The length of induction chemotherapy can vary based on the type and extent of your cancer. When used to treat acute lymphoblastic leukemia, treatment usually lasts about 29 days with a 1-week break.
Side effects are similar between induction and consolidation chemotherapy. The severity of side effects tends to relate to the dose of drugs you’re receiving. If you receive higher doses during consolidation therapy, you may experience more severe side effects.
General side effects of chemotherapy can include:
- anemia
- concentration problems
- constipation
- diarrhea
- dry mouth
- easy bruising
- excessive bleeding
- fatigue
- fertility changes
- fever
- frequent infections
- hair loss
- insomnia
- loss of appetite
- lymphedema
- memory problems
- mouth sores
- nausea
- pain from nerve damage
- skin changes
- vomiting
- weight loss
Induction chemotherapy may be used for a number of different cancers, including:
- Esophageal cancer. Induction chemotherapy may be used to treat people with
esophageal cancer that has spread to surrounding tissues. Surgical removal remains the standard treatment for patients with early-stage esophageal cancer. - Head and neck cancers.
Clinical trials have found that induction chemotherapy seems to be at least equally as effective as chemotherapy and radiation therapy together for treating head and neck cancers. However, there’s still some debate about its effectiveness. - Lung cancer. A
2016 study found evidence that patients with stage 2 or stage 3 non-small cell lung cancer may benefit from induction chemotherapy before concurrent chemotherapy and radiation therapy. - Breast cancer.
Neoadjuvant chemotherapy , which is chemotherapy before surgery, is being used increasingly more often to treat breast cancer that has spread locally. Neoadjuvant is sometimes also referred to as induction chemotherapy. - Acute leukemias. Acute leukemias are often treated with induction therapy and consolidation chemotherapy once the cancer is in remission.
- Pancreatic cancer. A
2018 study found evidence that a treatment called irreversible electroporation ablation combined with induction therapy may have a survival benefit for people with locally advanced pancreatic cancer.
Induction chemotherapy is associated with significant tumor shrinkage for some types of cancers. But for many types of cancer like head and neck cancers, its efficiency is still debated.
Some advantages and disadvantages of induction chemotherapy include:
Pros
- It may decrease the risk of cancer spreading to distant parts of the body in high-risk people.
- There’s evidence to support its use for treating some types of cancers such as
laryngeal carcinoma . - It may minimize the toxicity of undergoing radiation therapy and chemotherapy at the same time.
Cons
- People in poor health may not do well on induction chemotherapy because of its intensity.
- There’s no proven survival benefit for its use in many types of cancers.
- It typically involves an extended hospital stay.
It’s important to discuss treatment options with your doctor or oncologist before starting chemotherapy. Your doctor can discuss other treatment options for you and let you know the pros and cons of each option.
Your doctor can also provide you information on what to expect during your treatment, give you an idea about your outlook, and answer any specific questions you have.
Questions to ask your doctor
- What drugs will I be given?
- How often will I need treatment?
- How long will treatment last?
- What are the chances of success?
- Are there other treatment options?
- Is there anything I can do to reduce side effects?
- What precautions should I take while on chemotherapy?
- Are there any clinical trials I can participate in?
- I’d like to know how much of the treatment my insurance will cover. Can you point me to someone in your office who I could talk to about this?
Cancer support programs
You can find local cancer support programs through the
Other places to explore include:
- websites of cancer centers and national organizations
- recommendations from your local hospital
- advice from other patients
- the National Cancer Institute’s list of
support services
Induction chemotherapy is administered at the beginning of your cancer treatment. Its goal is to shrink your cancer before you receive radiation therapy.
The term induction chemotherapy is sometimes also used to refer to chemotherapy given before surgery, but the proper term is neoadjuvant chemotherapy.
Consolidation chemotherapy is used after initial therapy. It’s intended to target any remaining cancer cells.
Researchers are continuing to look at the pros and cons of induction chemotherapy compared to other treatment options for many types of cancer.
Be sure to discuss the pros and cons of all your treatment options with your doctor before starting induction therapy.