Last reviewed: March 2026 | Written by Dr. Ekta Vala Chandarana, Medical Oncologist & Immunotherapy Specialist, Medisquare Superspeciality Hospital, Ahmedabad
If you or someone you love has just been diagnosed with cancer, one of the first questions that comes up is: “What treatment will I need?” For many patients, the answer is no longer simply “chemotherapy”. Cancer medicine has transformed dramatically over the last decade, and today there are three main categories of systemic cancer treatment – chemotherapy, targeted therapy, and immunotherapy each working in a completely different way, with different side effects, different costs, and different suitability for different patients.
The confusion between these three treatments is one of the most common things I see in my clinic at Medisquare Hospital, Ahmedabad. Patients often arrive having read conflicting information online, or having been told by a well-meaning relative that “immunotherapy is better than chemo” which is sometimes true and sometimes not true at all, depending entirely on the individual patient and their cancer type.
This guide is my attempt to explain clearly, honestly, and without jargon what each treatment is, how it works, who it is suitable for, what the side effects look like, and how much it costs in India. By the end, you will have a much clearer picture of the landscape, though the final decision on which treatment is right for you must always be made with your oncologist based on your specific diagnosis.
What is Chemotherapy?
Chemotherapy uses powerful drugs to kill cancer cells. These drugs work by targeting rapidly dividing cells – which is the defining characteristic of cancer cells. The problem is that several healthy cells in your body also divide rapidly – hair follicles, the lining of your mouth and gut, and bone marrow. This is why chemotherapy affects these areas and causes the side effects most people associate with cancer treatment.
How chemotherapy is given
- Intravenous (IV) infusion at a hospital or day-care oncology unit – most common
- Oral tablets taken at home – some modern chemotherapy agents are oral
- Given in cycles – for example 6 cycles, each 3 weeks apart with rest periods in between to allow normal cells to recover
Common chemotherapy side effects
- Hair loss (alopecia) – one of the most distressing but temporary side effects
- Nausea and vomiting – well controlled today with modern anti-emetic medications
- Fatigue – often the most persistent complaint throughout treatment
- Mouth sores (mucositis)
- Increased risk of infection (neutropenia) – requires monitoring and sometimes hospitalisation
- Anaemia and low platelets – may require blood transfusions
- Peripheral neuropathy – numbness/tingling in hands and feet with certain drugs
When is chemotherapy the right choice?
Chemotherapy remains the backbone of cancer treatment for many situations — particularly when cancer has spread to multiple sites, when the cancer type does not have a targetable mutation, when a patient needs a rapid response, or when used before surgery (neoadjuvant) to shrink a tumour or after surgery (adjuvant) to eliminate remaining cells. It is also used in combination with immunotherapy and targeted therapy in many modern protocols.
Chemotherapy is available at Medisquare Superspeciality Hospital, Ahmedabad. Cost ranges from ₹10,000 to ₹1,00,000+ per cycle depending on the drugs used and whether generic versions are available.
What is Targeted Therapy?
Targeted therapy uses drugs specifically designed to block particular proteins, genes, or pathways that cancer cells need to grow and survive. Unlike chemotherapy, which attacks all fast-dividing cells, targeted therapy is – as the name suggests – targeted. It goes after specific vulnerabilities in your specific cancer’s molecular profile.
This is why targeted therapy requires biomarker testing or genetic testing of your tumour before it can be prescribed. A tumour biopsy is sent for molecular analysis tests like NGS (Next Generation Sequencing), FISH testing, or IHC to see if your cancer has a targetable mutation or overexpressed protein. If it does, there is likely a targeted drug designed specifically to block it. If it does not, targeted therapy may not be an option for you.
Examples of targeted therapy in common cancers
- Lung cancer: EGFR inhibitors (Gefitinib, Erlotinib, Osimertinib), ALK inhibitors (Crizotinib, Alectinib)
- Breast cancer: HER2-targeted (Trastuzumab/Herceptin, Pertuzumab, T-DM1), CDK4/6 inhibitors (Palbociclib, Ribociclib)
- Blood cancer: BCR-ABL inhibitors (Imatinib/Gleevec for CML), FLT3 inhibitors for AML
- Colorectal cancer: VEGF inhibitors (Bevacizumab), EGFR inhibitors (Cetuximab — only if KRAS wild-type)
- Multiple Myeloma: Proteasome inhibitors (Bortezomib, Carfilzomib), PARP inhibitors for BRCA-mutated ovarian cancer
Side effects of targeted therapy
Side effects are generally fewer and more predictable than chemotherapy because targeted drugs spare most normal cells. However, each drug has its own specific toxicity profile:
- Skin rash and dry skin – very common with EGFR inhibitors
- Diarrhoea – common with many oral targeted agents
- Liver enzyme elevation – requires regular monitoring
- Fatigue, nausea – milder than chemo typically
- Cardiac effects – some drugs require heart monitoring (e.g. Trastuzumab)
- Hypertension – common with anti-VEGF drugs
When is targeted therapy the right choice?
Targeted therapy is appropriate when your tumour has a known, druggable mutation or biomarker. It is often used as first-line treatment for patients with these mutations — frequently achieving better outcomes with fewer side effects than chemotherapy alone. However, cancers often develop resistance to targeted therapy over time, which is why treatment is monitored closely and second/third-generation targeted drugs are available for many mutation types.
Targeted therapy with biomarker testing is available at Medisquare Superspeciality Hospital, Ahmedabad under Dr. Ekta Vala Chandarana. Costs vary widely — oral targeted drugs range from ₹20,000 to ₹3,00,000+ per month. Generic versions of some drugs have significantly reduced costs in India.
What is Immunotherapy?
Immunotherapy is a fundamentally different approach to treating cancer. Instead of directly attacking cancer cells the way chemotherapy or targeted therapy does, immunotherapy activates and strengthens your own immune system so that it can recognise and destroy cancer cells itself.
Cancer cells are clever — they often develop mechanisms to hide from the immune system or to actively suppress the immune response. The most commonly used immunotherapy drugs — PD-1 and PD-L1 inhibitors (also called checkpoint inhibitors) — work by removing these brakes, freeing the immune system to do what it is naturally designed to do: hunt down and eliminate abnormal cells.
Common immunotherapy drugs used in India
- Pembrolizumab (Keytruda) — lung cancer, cervical cancer, breast cancer (TNBC), MSI-H solid tumours
- Nivolumab (Opdivo) — lung cancer, stomach cancer, liver cancer, head and neck cancer
- Atezolizumab (Tecentriq) — lung cancer, liver cancer, bladder cancer
- Durvalumab (Imfinzi) — lung cancer, biliary tract cancer
- Daratumumab — Multiple Myeloma (monoclonal antibody)
- CAR-T cell therapy — relapsed blood cancers (rapidly expanding in India)
Side effects of immunotherapy
Because immunotherapy activates the immune system broadly, side effects are immune-related — meaning the immune system can attack healthy tissues as well as cancer. These are called immune-related adverse events (irAEs) and require prompt attention:
- Skin rash and itching — most common, usually manageable
- Colitis (inflammation of the colon) — diarrhoea, abdominal pain
- Thyroid problems — hypothyroidism or hyperthyroidism
- Pneumonitis (lung inflammation) — can be serious, requires early detection
- Hepatitis (liver inflammation) — monitored with regular blood tests
- Rare but serious: Type 1 diabetes, adrenal insufficiency, neurological effects
Important: Most immune-related side effects are manageable if caught early. This is why regular monitoring appointments during immunotherapy are not optional — they are essential. If you are receiving immunotherapy in Ahmedabad and develop any new or unusual symptom, contact your oncologist immediately.
Who is eligible for immunotherapy?
Not everyone with cancer will benefit from immunotherapy. Eligibility depends on several factors — and biomarker testing is essential before starting:
- PD-L1 expression level – higher expression generally predicts better response
- MSI-H (Microsatellite Instability High) or dMMR – strong predictor of immunotherapy response across many cancer types
- TMB (Tumour Mutational Burden) – high TMB associated with better immunotherapy outcomes
- Specific cancer types – some cancers respond very well (melanoma, lung, kidney), others less so
- Overall health and immune function – patients on high-dose steroids or with autoimmune conditions require careful evaluation
Immunotherapy is available in Ahmedabad at Medisquare Superspeciality Hospital under Dr. Ekta Vala Chandarana, one of Gujarat’s most experienced immunotherapy oncologists. Cost ranges from ₹1,50,000 to ₹5,00,000+ per cycle. Insurance coverage is improving, see our guide on immunotherapy insurance coverage in India.
Immunotherapy vs Chemotherapy vs Targeted Therapy – Side-by-Side Comparison
| Chemotherapy | Targeted Therapy | Immunotherapy | |
| How it works | Kills all fast-dividing cells — cancer and healthy | Blocks specific proteins/mutations driving cancer growth | Activates your own immune system to find and destroy cancer cells |
| Who it works for | Most cancer types — broad use | Patients with specific genetic mutations (testing required) | Patients whose tumours express certain markers (PD-L1, MSI-H etc.) |
| Side effects | Hair loss, nausea, fatigue, infection risk, mouth sores | Targeted — fewer general side effects but specific toxicities per drug | Immune-related — rash, colitis, thyroid issues, pneumonitis |
| How given | IV infusion or oral tablets, in cycles | Usually oral tablets taken daily at home | IV infusion every 2–6 weeks depending on drug |
| Response speed | Often rapid — effects seen within first 1–2 cycles | Can be rapid but may take weeks to assess | Can be slower — sometimes response seen after months |
| Duration | Fixed number of cycles (6–8 typically) | Continuous — taken as long as effective | Fixed number of cycles or continuous depending on cancer type |
| Cost in India | ₹10,000–1,00,000+ per cycle depending on drugs | ₹20,000–3,00,000+ per month depending on drug | ₹1,50,000–5,00,000+ per cycle — highest cost |
| Available in Ahmedabad | Yes — fully available at Medisquare Hospital | Yes — with genetic testing at Medisquare Hospital | Yes — Dr. Ekta Vala specialises in immunotherapy |
Which Treatment Works for Which Cancer?
The table below gives a simplified overview of which treatments are used for common cancer types. This is a guide only – actual treatment decisions depend on your specific tumour profile, stage, and overall health.
| Cancer type | Chemotherapy | Targeted therapy | Immunotherapy |
| Lung cancer (NSCLC) | Yes | Yes — if EGFR/ALK/ROS1 mutation | Yes — if PD-L1 high or MSI-H |
| Breast cancer | Yes | Yes — HER2+ (Trastuzumab), HR+ (CDK4/6) | Yes — Triple negative (Pembrolizumab) |
| Blood cancer (Leukaemia) | Yes | Yes — BCR-ABL (Imatinib), FLT3 | Yes — CAR-T for relapsed cases |
| Cervical cancer | Yes | Limited | Yes — Pembrolizumab (PD-L1+) |
| Colorectal cancer | Yes | Yes — KRAS/BRAF/HER2 | Yes — MSI-H / dMMR tumours |
| Multiple Myeloma | Yes | Yes — Proteasome inhibitors, IMiDs | Yes — Daratumumab, CAR-T |
| Ovarian cancer | Yes | Yes — BRCA mutation (PARP inhibitors) | Limited — selected cases |
| Liver cancer (HCC) | Limited | Yes — Sorafenib, Lenvatinib | Yes — Atezolizumab + Bevacizumab |
| Stomach cancer | Yes | Yes — HER2+ (Trastuzumab) | Yes — Nivolumab, Pembrolizumab |
Can These Treatments Be Combined?
Absolutely and in many modern cancer treatment protocols, combination therapy is the standard of care. Some of the most effective combinations currently used in India include:
- Chemotherapy + Immunotherapy – widely used in lung cancer (pembrolizumab + carboplatin/pemetrexed), triple-negative breast cancer, and stomach cancer
- Targeted therapy + Immunotherapy – increasingly used in kidney cancer, liver cancer, and lung cancer
- Chemotherapy + Targeted therapy – used in colorectal cancer (FOLFOX + Bevacizumab), breast cancer (chemo + HER2 agents)
- Chemotherapy before surgery + targeted/immunotherapy after – a common sequence in many solid tumours
The key principle is that no two patients receive the same treatment plan. What works best depends on your cancer’s biology, its stage, your overall health, prior treatments, and your preferences. This is why a detailed consultation with an experienced oncologist – who can order the right biomarker tests and interpret them correctly is the essential starting point for every cancer patient.
Cost of Cancer Treatment in India – What to Expect
One of the most common questions patients ask at our Ahmedabad clinic is about cost. Here is an honest overview:
- Chemotherapy: ₹10,000–1,00,000+ per cycle. Generic drugs have made many regimens significantly more affordable in India.
- Targeted therapy: ₹20,000–3,00,000+ per month for oral drugs. Generic imatinib, gefitinib, and erlotinib are now available in India at a fraction of branded costs.
- Immunotherapy: ₹1,50,000–5,00,000+ per cycle – currently the highest cost. Insurance coverage is improving but patchy.
Dr. Ekta Vala Chandarana at Medisquare Hospital, Ahmedabad, provides complete cost transparency at the time of consultation including guidance on health insurance claims, Ayushman Bharat eligibility, hospital payment plans, and pharmaceutical patient assistance programmes that can significantly reduce out-of-pocket costs for expensive targeted and immunotherapy drugs.
Read more:
Is immunotherapy covered under insurance in India?
Cost of chemotherapy in Ahmedabad
Frequently Asked Questions
Is immunotherapy better than chemotherapy?
Not universally, it depends entirely on your cancer type and tumour biology. Immunotherapy produces remarkable, long-lasting responses in patients whose tumours have the right biomarkers (high PD-L1, MSI-H). For patients without these markers, chemotherapy or targeted therapy may be significantly more effective. The question is never which treatment is “better” it is which treatment is right for your specific cancer.
Can I choose between chemotherapy and immunotherapy?
Treatment choice is based on what your cancer’s biology supports, it is not purely a personal preference decision. Your oncologist will recommend the most appropriate treatment based on biomarker testing, staging, and international treatment guidelines. You can and should discuss options, ask about clinical trials, and seek a second opinion but the biology of your tumour is the primary guide.
Does targeted therapy work without genetic testing?
No. Genetic or biomarker testing of your tumour is essential before starting targeted therapy. Without knowing which mutations your tumour carries, prescribing a targeted drug is guesswork and an expensive, potentially harmful guess. At our Ahmedabad oncology clinic, we arrange the appropriate molecular testing before recommending any targeted therapy.
Is immunotherapy available in Ahmedabad?
Yes, Immunotherapy including pembrolizumab (Keytruda), nivolumab (Opdivo), atezolizumab (Tecentriq), and daratumumab is fully available in Ahmedabad at Medisquare Superspeciality Hospital under the care of Dr. Ekta Vala Chandarana. Patients in Gujarat do not need to travel to Mumbai or Delhi for immunotherapy.
How do I know which treatment is right for me?
The answer starts with a detailed consultation with a medical oncologist followed by the appropriate staging investigations and biomarker testing. Dr. Ekta Vala Chandarana at Medisquare Hospital, Ahmedabad, will review your diagnosis, arrange any required tests, and present you with a personalised treatment plan that explains exactly which treatment is recommended, why, what to expect, and what it will cost.
Can immunotherapy cure cancer?
In some cases yes, A small but meaningful proportion of patients who respond to immunotherapy achieve durable, long-term remissions that resemble a functional cure, particularly in melanoma, lung cancer, and Hodgkin lymphoma. For most patients, immunotherapy controls the cancer for an extended period. Research is advancing rapidly, and the proportion of patients achieving long-term remission is growing every year.
What happens if targeted therapy stops working?
Resistance to targeted therapy is common and planned for in advance. Most oncologists will discuss a second-line targeted therapy option at the time of starting first-line treatment. For example, in EGFR-mutant lung cancer, if first-generation gefitinib stops working, osimertinib (a third-generation EGFR inhibitor) is a well-established next step. Immunotherapy or chemotherapy may also be introduced at this stage.
Is chemotherapy always necessary?
No, An increasing number of cancer patients particularly those with targetable mutations are being treated without chemotherapy as their primary systemic treatment. This is one of the most significant shifts in oncology over the last decade. However, chemotherapy remains essential and highly effective for many cancer types and situations, and should not be dismissed based on its reputation for side effects modern supportive care has transformed the chemotherapy experience significantly.
Speak to an Oncologist in Ahmedabad About Your Treatment Options
If you have been diagnosed with cancer and are trying to understand whether chemotherapy, targeted therapy, or immunotherapy is the right path for you please do not try to make this decision alone or based solely on what you have read online. Every cancer is different, and every patient is different.
Dr. Ekta Vala Chandarana is a medical oncologist and immunotherapy specialist in Ahmedabad with over 10 years of experience designing personalised cancer treatment plans. She sees patients at Medisquare Superspeciality Hospital, Ahmedabad, and consults in English, Hindi, and Gujarati.
Book an appointment: Call 08866843843 | Medisquare Superspeciality Hospital, O-201/202, Gala Empire, Drive In Road, Gurukul, Ahmedabad 380052
Also read:
Which cancers respond best to immunotherapy?
Who is eligible for targeted therapy?
Is immunotherapy covered under insurance?
Oncologist in Ahmedabad
Written & Medically Reviewed by
Dr. Ekta Vala Chandarana
Medical Oncologist & Hemato-Oncologist | Immunotherapy & Targeted Therapy Specialist
Medisquare Superspeciality Hospital, Ahmedabad, Gujarat | 10+ years experience