Breakthroughs in Immunotherapy and Their Role in Surgical Oncology

Reviewed by

Dr. Lovedeep Singh Chauhan MCh Surgical Oncology (Tata Memorial Hospital, Mumbai), Consultant Surgical Oncologist, Max Super Speciality Hospital, Mohali

Introduction: A New Era in Cancer Treatment

Cancer treatment has changed dramatically over the last decade. For years, surgery, chemotherapy, and radiation were the three pillars of oncology. Today, a powerful fourth pillar has emerged immunotherapy — and it is changing what is possible for cancer patients across India.

From Mohali to Ludhiana, patients who were once told their cancer was inoperable are now responding to immunotherapy well enough to become eligible for life-saving surgery. Under the guidance of an experienced oncologist in Punjab, this is no longer a distant future—it is happening right now in cancer centres across the state and the country.

This article explains what immunotherapy is, how it works alongside surgery, which cancer types benefit the most, and what patients in Punjab should know when exploring their treatment options.

What Is Immunotherapy? A Simple Explanation

Your immune system is designed to find and destroy abnormal cells including cancer cells. But cancer is clever. Many tumours develop ways to "hide" from immune cells or actively suppress the immune response, allowing them to grow unchecked.

Immunotherapy works by removing those defences. It uses medications, proteins, or engineered cells to help your immune system recognise and attack cancer more effectively. Unlike chemotherapy, which attacks all rapidly dividing cells, immunotherapy is more targeted; it trains your own body to fight the disease.

There are several types of immunotherapy used in cancer care today. These include checkpoint inhibitors (such as PD-1 and PD-L1 blockers), monoclonal antibodies, CAR-T cell therapy, and cancer vaccines. Each works differently, and the right type depends on the cancer, its stage, and the patient's overall health.

The Connection Between Immunotherapy and Surgical Oncology

Surgical oncology has always been about more than removing a tumour. A skilled surgical oncologist considers tumour biology, margins, lymph node involvement, and the risk of recurrence. Immunotherapy now adds another layer to that planning.

There are three key ways immunotherapy intersects with surgery in modern oncology practice:

1. Neoadjuvant Immunotherapy (Before Surgery) In some cases, immunotherapy is given before surgery to shrink the tumour, making it easier to remove or making surgery possible in a case that was previously inoperable. This is increasingly seen in head and neck cancers, certain colorectal cancers, and advanced breast cancers.

2. Adjuvant Immunotherapy (After Surgery) After tumour removal, immunotherapy can be used to kill any remaining microscopic cancer cells and reduce the risk of recurrence. This is particularly relevant in urological malignancies like bladder and kidney cancer, as well as certain gynecological malignancies.

3. Concurrent Use During Complex Procedures In advanced peritoneal cancers, where procedures like HIPEC (Hyperthermic Intraperitoneal Chemotherapy) are performed, immunotherapy is increasingly being studied as a complementary approach to improve long-term outcomes. Patients with peritoneal metastases from colorectal or ovarian cancer are among those who may benefit from this combined strategy.

Cancers Where Immunotherapy Is Making the Biggest Difference

Colorectal Cancer

Colorectal cancer with a specific genetic marker called MSI-H (microsatellite instability-high) responds particularly well to checkpoint inhibitors like pembrolizumab. For patients in Mohali and Chandigarh diagnosed with advanced colorectal cancer, testing for this marker has become a standard part of evaluation.

Studies have shown that in MSI-H colorectal cancer, immunotherapy can achieve complete tumour response in some patients, potentially reducing the extent of surgery required. This is a meaningful quality-of-life benefit, especially for rectal cancers where surgery can affect bowel and bladder function.

Related read: Early Signs of Colorectal Cancer You Should Not Ignore — learn what symptoms to watch for before cancer advances.

Gynecological Malignancies

In ovarian, cervical, and endometrial cancers, immunotherapy is showing promising results. Cervical cancer driven by HPV infection has shown strong responses to checkpoint inhibitors. Endometrial cancer with mismatch repair deficiency (dMMR) now has immunotherapy as a first-line recommendation in advanced cases.

For patients in Patiala and Ludhiana seeking treatment for gynecological cancers, it is important to have biomarker testing done early to determine immunotherapy eligibility alongside surgical planning.

Breast Cancer

Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes, and for years, options were limited. Immunotherapy agents like pembrolizumab combined with chemotherapy have now shown significant improvement in outcomes for early and advanced TNBC.

Breast-conserving surgery is increasingly being achieved in patients who respond well to neoadjuvant immunotherapy preserving both the breast and the patient's quality of life.

Related read: Breast Cancer Survival Story After Breast-Conserving Surgery and Reconstruction — a real patient perspective on recovery and outcomes.

Head and Neck Cancers

Head and neck squamous cell carcinomas cancers of the mouth, throat, and larynx have seen a paradigm shift with the approval of immunotherapy agents for both first-line and recurrent disease. In patients with high PD-L1 expression, immunotherapy is now part of the standard treatment protocol.

For surgical oncologists managing head and neck cancers, immunotherapy is reshaping what constitutes resectable disease and improving survival when used alongside surgery.

Urological Malignancies

Bladder cancer and kidney (renal cell) cancer have been at the forefront of the immunotherapy revolution. Checkpoint inhibitors have become standard in muscle-invasive bladder cancer both before and after surgery. In renal cancer, immunotherapy combinations have replaced older targeted therapies as preferred first-line options for metastatic disease.

Patients from across Punjab visiting Mohali for urological cancer treatment are now routinely evaluated for immunotherapy suitability as part of their surgical oncology workup.

Endocrine Malignancies

While immunotherapy is not yet standard for most thyroid or adrenal cancers, certain aggressive forms including anaplastic thyroid cancer are being evaluated in clinical trials. This remains an evolving area, and patients with rare endocrine tumours should seek care from specialist oncologists who are aware of current trial options.

How Surgical Oncologists in Punjab Are Adapting

A good oncologist in Punjab today does not work in isolation. Modern cancer care is multidisciplinary, meaning surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists discuss each patient's case together before deciding on a treatment plan.

Dr. Lovedeep Singh Chauhan, a Consultant Surgical Oncologist at Max Super Speciality Hospital, Mohali, follows this multidisciplinary approach for every patient. Whether a patient requires surgery alone, surgery combined with immunotherapy, HIPEC for peritoneal disease, or robotic and laparoscopic surgery for minimally invasive cancer removal each plan is individualised based on tumour biology, staging, and patient fitness.

Patients from Chandigarh, Patiala, Ludhiana, Mohali, and across Punjab seeking an oncologist in Punjab can consult Dr. Lovedeep Singh Chauhan for a comprehensive surgical oncology opinion that factors in the latest advances including immunotherapy.

Related read: How to Choose the Right Cancer Treatment Based on Stage — surgery vs chemo vs targeted therapy explained simply.

What Patients Should Ask Their Doctor About Immunotherapy

If you or a family member has been recently diagnosed with cancer, here are some questions worth raising with your oncologist:

• Has my tumour been tested for biomarkers like PD-L1, MSI-H, or dMMR?
• Am I a candidate for immunotherapy before or after surgery?
• What side effects should I be aware of if immunotherapy is recommended?
• Is there an active clinical trial I may be eligible for?
• How will immunotherapy affect my surgery timeline or eligibility?

These questions are not just for specialists; any well-informed patient has the right to ask them and receive clear, evidence-based answers.

Related read: How to Read a Cancer Diagnosis Report: Understanding Biopsy, TNM Staging & Markers — decode your pathology report with confidence.

Limitations and Honest Expectations

Immunotherapy is not a cure for all cancers. It works well in specific tumour types and in patients whose cancer carries certain genetic features. Not every patient will respond, and immune-related side effects though different from chemotherapy side effects can be serious and require careful monitoring.

It is also worth noting that immunotherapy is expensive, and access across smaller cities in Punjab can be limited. Patients are encouraged to discuss cost, availability, and insurance coverage openly with their oncology team.

Research in this field is moving fast. What is a clinical trial finding today may become a standard protocol within two to three years. Staying informed and working with an experienced surgical oncologist ensures patients are not left behind as the field evolves.

Conclusion: The Future Is Integrative

Immunotherapy is not replacing surgical oncology, it is making it better. The combination of precise surgery and powerful immune-based therapies is giving patients across Punjab outcomes that were unthinkable just a decade ago.

If you are facing a cancer diagnosis in Mohali, Chandigarh, Ludhiana, or Patiala, the most important step is to get a proper evaluation from a qualified surgical oncologist who understands both the surgical and systemic sides of cancer care.

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Disclaimer

This article is intended for general informational purposes only and does not constitute medical advice. Cancer treatment decisions should always be made in consultation with a qualified oncologist. If you or a loved one has been diagnosed with cancer, please consult Dr. Lovedeep Singh Chauhan or another certified oncologist for personalised guidance.