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A person may receive induction chemotherapy before maintenance chemotherapy, radiation therapy, or surgery. Induction chemotherapy is an intensive cancer treatment that can improve survival rates for certain types of cancer. However, the treatment has links to certain risks and side effects and may not be suitable for everyone. This article explores induction chemotherapy in more detail and lists the different types of cancer it can help treat. We also describe the potential benefits and risks of induction chemotherapy. Learn more about chemotherapy here. Definition Share on Pinterestjes2ufoto/Getty ImagesInduction therapy refers to the first-line treatment for a particular disease. The National Cancer Institute refers to it as first-line therapy, primary therapy, or primary treatment. Induction chemotherapy is the initial chemotherapy a person receives before undergoing additional cancer treatment, such as maintenance chemotherapy, radiation therapy, or surgery. The goal of induction chemotherapy is to destroy as many cancer cells as possible to offer the best possible chance of disease remission. The length and intensity of induction therapy may vary, depending on several factors, including:the cancer type and severitythe person’s agethe person’s overall health Induction treatment may be an appropriate treatment option for people who have cancer with a high risk of spreading. Which cancers Doctors may recommend induction chemotherapy for various cancers, including:acute myeloid leukemia (AML)head and neck cancersesophageal cancernasopharyngeal cancerslung cancerbreast cancerpancreatic cancer Benefits Below are some potential benefits of induction chemotherapy according to cancer type. Acute myeloid leukemia Acute myeloid leukemia (AML) is an aggressive form of leukemia that affects white blood cells. The American Cancer Society (ACS) states that induction chemotherapy is the first of two treatment phases for AML, with the second phase being consolidation or “post-remission therapy.” The goal of induction therapy in AML is to destroy as many leukemia cells as possible. However, the intensity of the treatment depends on the person’s age and overall health. For example, doctors may suggest an intensive chemotherapy treatment for people below the age of 60 years. This treatment typically involves the chemotherapy agents cytarabine and daunorubicin or idarubicin. Daunorubicin and idarubicin belong to a class of chemotherapy drugs called anthracyclines, which derive from certain strains of bacteria. These drugs may be unsafe for people with heart problems. If a person has an underlying heart condition, their doctor may recommend a different chemotherapy drug, such as fludarabine or etoposide. Learn more about AML treatment here. Head and neck cancers A 2019 study suggests that people with certain types of head and neck cancers may benefit from induction chemotherapy involving a combination of the following chemotherapy agents: docetaxelcisplatinfluorouracil The researchers also note that inductive chemotherapy with this combination of chemotherapies has similar results in comparison with inductive chemotherapy and radiation therapy. However, the evidence is inconclusive, so researchers cannot make any definite recommendations. Learn more about head and neck cancer here. Esophageal cancer A 2016 review article notes that induction chemotherapy and removing part or all of the esophagus may improve outcomes in individuals with locally advanced esophageal tumors that surgeons cannot remove. Learn more about esophageal cancer here. Nasopharyngeal carcinoma Nasopharyngeal carcinoma refers to cancers of the nasopharynx. This is the area at the top of the throat, behind the nose, and above the roof of the mouth. A 2019 clinical trial found that a combination of induction chemotherapy and chemoradiation improved overall survival. This was without a recurrence in comparison with chemoradiation alone in people with locally advanced nasopharyngeal carcinoma. This study used the induction chemotherapy agents gemcitabine and cisplatin. A 2021 clinical review found that induction treatment with gemcitabine and cisplatin may also help manage symptoms of locally advanced nasopharyngeal carcinoma. Lung cancer According to a 2016 study, carboplatin-based induction chemotherapy may help improve survival rates in people with stage 2 or 3 non-small cell lung cancer. Carboplatin is an injectable chemotherapy agent. This induction chemotherapy may help improve survival rates and rates of recurrence in people with stage 2 or 3 non-small cell lung cancer. Learn more about non-small cell lung cancer here. Breast cancer Some medical professionals use the terms neoadjuvant chemotherapy and induction chemotherapy interchangeably. However, neoadjuvant chemotherapy specifically refers to induction chemotherapy a person receives before surgery. Doctors may recommend this chemotherapy technique to help shrink a tumor so that the subsequent surgical procedure is less extensive. A 2019 study found that neoadjuvant chemotherapy improved survival rates in people with locally advanced breast cancer. However, this study did not show that this technique improved the chances of the cancer not recurring in the area of the original tumor. Learn more about breast cancer here. Pancreatic cancer Irreversible electroporation ablation (IEA) is a procedure that involves using high-voltage electrical impulses to damage and destroy cancer cells. Doctors may recommend this treatment for individuals with locally advanced pancreatic cancer. A 2018 review investigated the effects of combined induction chemotherapy and IEA on locally advanced pancreatic adenocarcinoma. It found that this combination of treatments can help increase survival rates in people with this form of pancreatic cancer. Learn more about pancreatic cancer here. Risks and disadvantages Induction chemotherapy has associations with certain risks and disadvantages. These may vary according to various factors, including:cancer type and severityinduction chemotherapy agentsinduction chemotherapy treatment dosages and regimenwhether the person receives additional cancer treatments, such as radiation therapy or surgerythe person’s age and overall health Some possible risks of induction chemotherapy are below. Side effects People undergoing induction chemotherapy typically receive high doses of one or more chemotherapy drugs in an effort to destroy as many cancerous cells as possible. However, chemotherapy drugs indiscriminately target any type of fast-dividing cell within the body, whether it is cancerous or not. This can result in side effects. According to the United Kingdom’s National Health Service (NHS), people receiving intensive induction chemotherapy for AML may experience several side effects, including: skin rashesmouth soreshair lossbruising or bleedingappetite lossnausea or vomitingdiarrheatirednessinfertility The above side effects may disappear after a person completes or otherwise stops their treatment. The ACS adds that someone receiving cytarabine during the induction phase of AML treatment may develop eye dryness or balance issues. If this occurs, a doctor may consider reducing the dose or stopping the treatment. Infection The ACS states that people undergoing chemotherapy treatment are more prone to developing infections. This is because chemotherapy drugs damage the cells of the immune system, making individuals more susceptible to bacteria and viruses. However, this tends to be a short-term effect, with natural immunity recovering once a person stops chemotherapy treatment. Tumor lysis syndrome Tumor lysis syndrome (TLS) is a potential side effect of chemotherapy, particularly high dose induction chemotherapy. TLS occurs in response to the sudden and widespread destruction of cancer cells. In TLS, the cancer cells break down, releasing their toxic chemicals into the bloodstream at a rate faster than the body is able to clear. This can trigger potentially life threatening electrolyte imbalances and other metabolic issues. Psychological effects Induction chemotherapy is an intensive treatment. While it can improve survival rates in many cases, it can significantly affect a person’s immediate health and day-to-day life. In turn, this can take a toll on their mental health. According to the Centers for Disease Control and Prevention (CDC), people who receive chemotherapy may also experience problems with thinking and memory either during or after their treatment. Cancer survivors refer to this as “chemo brain.” The condition can exacerbate feelings of anger, frustration, or anxiety a person may already feel in relation to their diagnosis or treatment. Summary Induction chemotherapy is a first-line chemotherapy treatment that aims to destroy as many cancer cells as possible within a person’s body. An individual may receive induction chemotherapy before other cancer treatments, such as maintenance chemotherapy, radiation therapy, or surgery. Induction therapy may form part of the treatment plan for various types of cancer, including AML and cancers of the head and neck, breast, lung, and pancreas. The therapy typically involves a combination of chemotherapy drugs. The types of drugs a person receives will depend on the cancer type and severity as well as the individual’s age and overall health. Research indicates that induction chemotherapy can improve survival rates in many cases. However, people should be aware of the potential side effects and risks. A person can discuss these with their doctor before undergoing treatment. Last medically reviewed on August 29, 2022Breast CancerLeukemiaLung CancerPancreatic CancerCancer / OncologyHead and Neck Cancer 16 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Ahmed, I., et al. (2016). Modern induction chemotherapy before chemoradiation for bulky locally-advanced nonsmall cell lung cancer improves survival [Abstract]. https://pubmed.ncbi.nlm.nih.gov/27461680/Chemotherapy for acute myeloid leukemia (AML). (2020). https://www.cancer.org/cancer/acute-myeloid-leukemia/treating/chemotherapy.htmlCommon feelings after cancer treatment. (2022). https://www.cdc.gov/cancer/survivors/healthy-living-guides/emotional-health/common-feelings.htmGau, M., et al. (2019). Induction chemotherapy in head and neck cancers: Results and controversies [Abstract]. https://pubmed.ncbi.nlm.nih.gov/31345386/Huang, K.-W., et al. (2018). The efficacy of combination of induction chemotherapy and irreversible electroporation ablation for patients with locally advanced pancreatic adenocarcinoma [Abstract]. https://pubmed.ncbi.nlm.nih.gov/29878378/Induction therapy. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/induction-therapyInfections in people with cancer. (n.d.). https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/infections.htmlInduction chemotherapy. (n.d.). https://www.sciencedirect.com/topics/medicine-and-dentistry/induction-chemotherapyKlein, J., et al. (2019). Locally advanced breast cancer treated with neoadjuvant chemotherapy and adjuvant radiotherapy: A retrospective cohort analysis. https://bmccancer.biomedcentral.com/articles/10.1186/s12885-019-5499-2Liu, T., et al. (2021). The best choice of induction chemotherapy for patients with locally advanced nasopharyngeal carcinoma: Bayesian network meta-analysis [Abstract]. https://onlinelibrary.wiley.com/doi/abs/10.1002/hed.26932Overview: Acute myeloid leukemia. (2019). https://www.nhs.uk/conditions/acute-myeloid-leukaemia/Terada, M., et al. (2019). Phase III study of tri-modality combination therapy with induction docetaxel plus cisplatin and 5-fluorouracil versus definitive chemoradiotherapy for locally advanced unresectable squamous-cell carcinoma of the thoracic esophagus (JCOG1510: TRIANgLE). https://academic.oup.com/jjco/article/49/11/1055/5549797Typical treatment of acute myeloid leukemia (Except APL). (2022). https://www.cancer.org/cancer/acute-myeloid-leukemia/treating/typical-treatment-of-aml.htmlWatanabe, M., et al. (2020). Recent progress in multidisciplinary treatment for patients with esophageal cancer. https://link.springer.com/article/10.1007/s00595-019-01878-7Yokota, T., et al. (2016). Phase II study of chemoselection with docetaxel plus cisplatin and 5-fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer.https://pubmed.ncbi.nlm.nih.gov/27811857/Zhang, Y., et al. (2019). 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