Medical Oncologist
CION Cancer Clinics
Surgery while on targeted therapy or immunotherapy | CION Cancer Clinics
Often yes, but only on your doctors' instructions. Drugs that block new blood vessels, such as bevacizumab, usually need the most planning because they slow wound healing. Many targeted tablets need only a short pause, and immunotherapy is checked mainly for immune side effects. Your surgeon, anaesthetist and oncologist agree the timing together. This page explains what they weigh and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
On this page
- Do you have to stop targeted therapy or immunotherapy before surgery?
- Which kinds of drugs does the surgical team watch most closely?
- How is the pause planned between your surgeon and your oncologist?
- What do the words on your oncology notes mean?
- What do families often get wrong about these drugs and surgery?
- What does the team weigh, and what can this page not tell you?
- Common questions about surgery on targeted therapy or immunotherapy
The short answer
Do you have to stop targeted therapy or immunotherapy before surgery?
Often yes, but not always, and never on your own. Some of these medicines are paused before an operation because they slow wound healing or raise the chance of bleeding. Others carry on with a short break, or with no break at all.
Why the answer differs from drug to drug
"Targeted therapy" and "immunotherapy" are family names, not single medicines. A tablet that blocks one gene change in a lung cancer behaves very differently from an injection that stops a tumour growing new blood vessels. Some leave the body quickly after the last dose. Others stay active for weeks. So a friend's pause may not apply to you.
Who sets the timing
The decision is shared between your surgeon, your anaesthetist and the medical oncologist who prescribed the drug. They weigh how much the cancer needs the medicine against the risks it adds to the operation. Sometimes the safer choice is to keep the drug going and plan around it. Sometimes it is the operation date that moves.
Keep taking the medicine exactly as prescribed until one of your doctors gives you a written instruction to pause it.Why it matters
Which kinds of drugs does the surgical team watch most closely?
Your prescription may carry only a brand name. Ask your oncologist which group it belongs to.
Drugs that block new blood vessels
Tumours need fresh blood vessels to grow, and so does a healing wound. Medicines that block this can slow healing and raise the chance of bleeding or a wound opening. This group usually needs the most careful planning.
Names you may see
- Bevacizumab
- Lenvatinib, sunitinib, pazopanib
- Regorafenib and cabozantinib
Tablets aimed at a gene change
Many of these are taken daily and clear from the body fairly quickly. The team checks whether they interact with anaesthetic drugs, affect your heart rhythm or lower your blood counts.
Names you may see
- Osimertinib, gefitinib, erlotinib
- Imatinib
- Alectinib and similar tablets
Immunotherapy injections
Drugs such as pembrolizumab and nivolumab release a brake on your immune system. Their effects can last long after the last dose. Occasionally the immune system inflames the thyroid, the adrenal glands, the gut or the lungs, and that changes how your body copes with the stress of surgery.
Antibody drugs and cell-cycle tablets
Trastuzumab can weaken the heart's pumping, so a recent heart scan is often asked for. Tablets such as palbociclib and ribociclib can lower the white cells that fight infection, so blood counts are checked before the date is fixed.
Not sure whether this applies to you?
Ask an oncologistStep by step
How is the pause planned between your surgeon and your oncologist?
-
Tell the surgeon at the first visit
Name every cancer medicine, the date of the last dose and when the next one is due. Bring the prescription and the strip or vial label. A clear photograph on your phone is enough.
-
The surgeon speaks to your oncologist
If they work in different hospitals, ask for a letter between them rather than a message passed by word of mouth.
-
Checks before the date is fixed
Usually blood counts, sugar, liver and kidney tests. Depending on the drug, a thyroid test, a heart scan or a check of your steroid hormones may be added.
-
A written plan
You should leave with the date of the last dose, the name of the doctor who decided it, and who will decide the restart. If anything is unclear, ask for it to be written again in plain words.
-
After the operation
The drug comes back only when your surgeon is happy with the wound and your recovery, and your oncologist agrees. The two of them make that call together.
!
One thing that cannot wait
If you have ever had immunotherapy and, after surgery, you develop severe loose motions, new breathlessness or cough, extreme tiredness with dizziness, or confusion, tell the ward team at once or go to an emergency department the same day. Say clearly that you have had immunotherapy and name the drug. These can be immune side effects, which are treated differently.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
On your notes
What do the words on your oncology notes mean?
- Targeted therapy
- A medicine designed to act on a particular change inside cancer cells, such as a faulty gene or protein. It is not chemotherapy, though some people take both.
- Immunotherapy
- A treatment that helps your own immune system recognise and attack the cancer.
- Checkpoint inhibitor
- The most common kind of immunotherapy. It switches off a brake that cancer cells use to hide from immune cells.
- Anti-angiogenic
- Blocking the growth of new blood vessels. Drugs described this way need the most care around surgery.
- Biomarker
- A test result on the tumour, such as EGFR, ALK or PD-L1, that shows whether a particular drug is likely to help.
Commonly believed
What do families often get wrong about these drugs and surgery?
"Stopping the tablet for surgery will let the cancer grow back."
A planned pause is weighed carefully by an oncologist who knows how your cancer has behaved. Stopping on your own, with no restart plan, is where the real risk sits. Ask how the pause fits into your treatment as a whole.
"Immunotherapy finished months ago, so the surgeon does not need to know."
Immune side effects can appear long after the last dose. The anaesthetist uses this history to plan steroid cover, sugar checks and thyroid tests. Always mention it, however long ago it was.
"Herbal remedies can fill the gap while the drug is paused."
Several herbal products thin the blood or interact with cancer tablets and anaesthetic drugs. A pause is not a gap to fill. List every supplement, including Ayurvedic ones.
"If the surgeon says stop, we do not need to ask the oncologist."
The surgeon knows the operation. The oncologist knows the drug and the cancer. Both views are needed, and a letter between them avoids mixed messages at home.
Being straight with you
What does the team weigh, and what can this page not tell you?
No web page can tell you how long to pause your own medicine. The answer depends on the exact drug, how long it stays in the body, the size of the operation and how your cancer is responding. Two people on the same tablet can be given different plans for good reasons.
What the team is balancing
On one side is the risk the drug adds: slower healing, bleeding, infection or immune side effects. On the other is the risk of the cancer growing during a break. For a small procedure, the team may keep the drug going. For a large operation on the bowel or chest, a longer pause is more common.
Who a pause may not suit
A pause may not suit someone whose cancer grew quickly during an earlier break, or someone whose drug is controlling pain or breathlessness. In those cases the team may move the operation rather than stop the medicine.
If anyone suggests stopping a cancer medicine without a plan for restarting it, ask who will make that decision before you leave.Questions we are asked
Common questions about surgery on targeted therapy or immunotherapy
Can the ward staff just stop my cancer tablet?
A pause should come from a doctor who knows both the operation and the drug, ideally agreed with your oncologist. If a nurse or pharmacist tells you to stop, ask which doctor made the decision and whether your oncologist knows.
Does immunotherapy make surgery more dangerous?
For many people it does not change the operation itself. What matters is whether it has caused immune side effects, particularly on the thyroid, the adrenal glands or the lungs. These are looked for with blood tests and questions before surgery, so the anaesthetist can plan for them in advance.
What if I need emergency surgery while on bevacizumab?
An emergency operation cannot wait for a planned pause. Tell the emergency team straight away that you take a drug that blocks new blood vessels, and name it. They will watch the wound and any bleeding more closely and contact your oncologist.
Will a break for surgery stop the drug working later?
A short planned break does not usually make a drug less effective when it restarts. Your oncologist may arrange a scan after you recover to check how the cancer is responding. If a break is a particular worry for your cancer, ask your oncologist directly before the operation date is fixed.
Do I need to stop for a biopsy or a small procedure?
Often not. A biopsy, a port placement or a minor skin procedure carries far less bleeding and healing risk than a major operation, and many drugs are continued. The doctors doing it still decide, so mention every cancer medicine you take, even for the smallest procedure.
Is a heart scan really needed before surgery on trastuzumab?
It is often requested because trastuzumab can weaken the heart's pumping. The anaesthetist wants to know how well your heart is working before giving anaesthetic drugs. If you have had a recent heart scan, such as an echo, bring the report. It may save repeating the test.
Who restarts the medicine after surgery?
Your oncologist, once your surgeon confirms the wound is healing and you are recovering well. Do not restart at home on your own just because the tablets are still in the cupboard. Ask at discharge who will make the call, and write down their name and contact number.
Will Aarogyasri or my insurance still cover the drug after the break?
A planned pause does not usually change whether you are eligible, but approvals under Aarogyasri, CGHS, ECHS, EHS or a cashless insurer are often tied to dates. Keep every letter about the pause, because a fresh approval may be needed when the drug restarts. Call the helpline and we will help you check.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Sources
- National Cancer Institute — Targeted therapy to treat cancer
- National Cancer Institute — Immunotherapy to treat cancer
- Cancer Research UK — Targeted cancer drugs
- Cancer Research UK — Immunotherapy
- American Cancer Society — Cancer surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Surgery While on ChemotherapyHow chemotherapy timing is planned around an operationWhich Medicines to Stop Before Cancer SurgeryThe full picture of what is paused and what continuesWhen Do You Restart Your Regular Medicines?The other half of the plan, after the operationTargeted therapy guideWhat targeted drugs are and how they workImmunotherapy guideImmune side effects and what to watch for
Talk to us
On a cancer drug and facing an operation?
Tell us which medicine you take and what surgery has been advised. We will help you reach a surgical team that can plan the timing with your oncologist.