Nafisa Ali Sodhi, 69, who is currently battling a recurrence of stage 4 peritoneal and ovarian cancer, took to social media to apprise her followers about a change in her chemotherapy medication owing to an allergic reaction. “Last chemo (Friday) had to be stopped as I got allergic to it, so now … on a new chemo … to be taken once a week. Fighting the good fight,” Nafisa shared on Instagram.
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Taking a cue from her revelation, we asked experts about why chemotherapy drugs and allergic reactions.
Dr Jeyhan B. Dhabhar, a medical oncologist at the Head Neck Cancer Institute India (HNCII), said chemotherapy drugs are powerful medicines designed to attack cancer cells, but sometimes the body can react unexpectedly to them. “Allergic or hypersensitivity reactions to chemotherapy are not uncommon, especially with certain drugs that are given repeatedly over multiple treatment cycles,” said Dr Dhabhar.
These reactions can range from mild symptoms such as itching, skin rashes, flushing, or breathlessness to more severe complications such as swelling, a sudden drop in blood pressure, chest tightness, or difficulty breathing. According to Dr Dhabhar, in many cases, the immune system begins to recognise the drug as a foreign substance and mounts an exaggerated response against it. “Interestingly, some patients tolerate a drug well initially and develop reactions only after several cycles of treatment,” he pointed out.
The risk varies depending on the type of chemotherapy drug, the patient’s immune response, and prior exposure to the medication, said Dr Utkarsh Ajgaonkar, consultant surgical oncologist, TGH Onco Life Cancer Centre, Talegaon.
Here’s what you should consider (Photo: Getty Images/Thinkstock)
At the same time, patients need to understand that modern chemotherapy is not simply about administering a drug.
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“A major part of cancer care involves carefully fine-tuning how chemotherapy is delivered. When chemotherapy is given by an experienced oncology team, with the correct drug dilution, appropriate infusion duration, proper monitoring, and the right supportive medications, many side effects can be significantly reduced,” said Dr Dhabhar.
Dr Ajgaonkar too noted that in many cases, the patient is shifted to an “alternative chemotherapy plan” that is safer and better tolerated. “Cancer treatment today is highly personalised, and specialists work closely to balance effectiveness with patient safety and comfort. Patients should immediately report any unusual symptoms during or after chemotherapy so that timely action can be taken,” said Dr Ajgaonkar.
Pre-medications — which are medicines and injections given before chemotherapy — play a crucial role in preventing allergic reactions, nausea, vomiting, oral ulcers, acidity, and several immediate side effects associated with treatment. “Similarly, post-chemotherapy medications prescribed for home use help patients recover better and minimise delayed side effects after the infusion. The timing, dosage, and combination of these supportive medicines are extremely important in improving tolerance to treatment.”
The reassuring part is that an allergic reaction to one chemotherapy drug does not mean cancer treatment has reached a dead end, he asserted. “Modern oncology offers several alternatives and ways to safely continue treatment. Depending on the patient’s cancer type, overall condition, and prior response, oncologists may switch to another chemotherapy agent, modify the dosage, reduce the infusion speed, or shift to a weekly regimen that may be better tolerated.”
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Cancer treatment is rarely a completely linear journey, he noted. “It often requires adjustments and fine-tuning based on how the patient’s body responds over time. What is most important is close monitoring and prompt reporting of symptoms during chemotherapy sessions. Signs such as sudden itching, dizziness, chest discomfort, or breathing difficulty should immediately alert the medical team so intervention can happen early.”
With advances in medical oncology, treatment today is highly personalised. “Even when one drug has to be stopped, there are usually multiple effective alternatives available, allowing patients to continue their cancer treatment safely and meaningfully,” said Dr Dhabhar.