Breast cancer has a strange way of being both familiar and frightening. Almost everyone knows someone who has battled it, and yet the details of treatment often sound like an alien language. According to the World Health Organisation, breast cancer is the most common cancer among women worldwide, with 2.3 million new cases in 2022 alone. Among these, about 15 to 20 per cent are HER2-positive, the type that is fast-moving, aggressive, and hard to ignore.

Increasingly, the doctors are turning to a strategy that feels a bit like hitting “pause” before the main act—neoadjuvant therapy.

What Makes HER2-Positive Breast Cancer Tricky

HER2 (human epidermal growth factor receptor 2) is a protein that helps cells grow. In HER2-positive breast cancer, the cells get an overdose of this protein. As a result, the cancer multiplies faster than usual and is often linked to poorer outcomes.

“HER2-positive breast cancer is an aggressive type,” explains Dr Mandeep Singh Malhotra, co-founder, Art Of Healing Cancer. “It is very important to give the right information to patients and their families for better outcomes. With the right treatment sequence, it is possible to offer better treatment to patients.”

What Is Neoadjuvant Therapy?

Neoadjuvant therapy (NT) is like a warm-up session but for cancer treatment. Instead of rushing into surgery to remove the tumour, doctors first administer chemotherapy and targeted drugs. The idea is to shrink the tumour, make surgery easier, and gather valuable intel on how the cancer responds.

“Nowadays, when we talk about HER2-positive breast cancer, we talk about targeted therapy and dual targeted therapy involving both trastuzumab and pertuzumab,” says Dr Malhotra. Both are monoclonal antibodies, meaning they are lab-made molecules designed to stick to specific parts of cancer cells. Together with chemotherapy, they not only shrink tumours but also improve surgical outcomes.

Why Doctors Like It

One of the superpowers of neoadjuvant therapy is its ability to act as a kind of crystal ball. By giving treatment before surgery, doctors can tell which patients are “responders” and which are not.

“As Dr Malhotra puts it, “Even at early stages, if we give NT and then operate, we are able to prognosticate. Responders have a better prognosis. Non-responders have poorer prognosis and a higher chance of the cancer coming back.”

This ability to sort patients into risk categories allows doctors to tailor follow-up care more precisely. For example, non-responders may be put on more aggressive treatments, offered newer diagnostic tests like liquid biopsy, or monitored more closely.

The Big Advantage Over Surgery-First

Surgery-first and neoadjuvant-first have similar survival data, but the latter provides an extra layer of information.

“If we do upfront surgery in these patients, we lose the chance of prognostication,” says Dr Malhotra. “Secondly, even if we do the upfront surgery, we will still have to give chemo with targeted therapy after surgery. So the treatment does not change; the sequence changes. And with neoadjuvant therapy, we get the added benefit of knowing who is high risk and who is low risk.”

In other words, neoadjuvant therapy is not just about shrinking tumours; it is about outsmarting them.

What Patients Need to Keep in Mind

For patients, all of this can feel overwhelming. Surgery often seems like the most direct way to “get rid” of cancer, so the idea of delaying it can cause anxiety. But Dr Malhotra reassures patients that this approach is carefully designed.

“Even in very early-stage breast cancer, with a less than 1 cm tumour, I will not go for surgery first,” he says. “I will first give targeted chemotherapy. The reason is I see a lot of patients who have already had surgery and then are given the option of dual therapy. They are confused and afraid that the cancer will come back if they cannot afford either trastuzumab or pertuzumab.”

Interestingly, cost can also play a role. If patients achieve a complete response, meaning no invasive cancer remains after neoadjuvant therapy, sometimes treatment can be stopped earlier, sparing both physical and financial strain. “We lose this opportunity if surgery is opted for first,” Dr Malhotra adds.

The Future of HER2-Positive Breast Cancer Treatment

The shift towards neoadjuvant therapy represents a significant change in how doctors approach HER2-positive breast cancer. Instead of rushing in with surgery, the modern strategy is more like a chess game, carefully setting up each move to give patients the best possible outcome.

By combining chemotherapy with targeted drugs like trastuzumab and pertuzumab before surgery, doctors can shrink tumours, assess risk, personalise treatment, and often improve long-term survival.

Breast cancer treatment has always been a mix of science, strategy, and courage. Neoadjuvant therapy, especially in HER2-positive cases, is proving to be more than just a pre-surgery step. It is a game-changer, giving both patients and doctors a crucial edge in the fight.

As Dr Malhotra puts it, “Neoadjuvant therapy is not an inferior modality. With current data, we feel it is a superior one.”

As artificial intelligence becomes a go-to source for quick answers, a new University of Oxford-led study on AI chatbots and medical advice is raising serious concerns about how safe it is to rely on these tools for health guidance.

The research suggests that while AI chatbots can provide medical information, their advice is often inaccurate, inconsistent, and difficult for users to interpret, potentially putting people at risk—especially when dealing with symptoms that need urgent care.

What the Oxford Study Found

The study involved 1,300 participants who were given realistic health scenarios, such as experiencing a severe headache or being a new mother feeling constantly exhausted. Participants were divided into two groups: one group used AI chatbots to understand their symptoms and decide next steps, while the other did not.

Researchers then assessed whether participants correctly identified what might be wrong and whether they made appropriate decisions, such as seeing a GP or visiting A&E.

The results were troubling. People who relied on AI frequently failed to identify the severity of their condition and were often unsure about when to seek professional medical help.

Why Chatbot Advice Can Go Wrong

According to the researchers, one major issue is that people don’t always know what to ask. The study found that chatbot responses varied widely depending on how questions were phrased. Even small changes in wording could lead to completely different answers.

The AI often produced a mix of helpful and misleading information, leaving users to decide which advice mattered. Many participants struggled to distinguish between reliable guidance and unnecessary or confusing details.

As one of the study’s authors explained, when an AI lists multiple possible conditions, users are left guessing which one applies to them—precisely the moment where mistakes can happen.

A Dangerous Gap in Symptom Interpretation

Dr Rebecca Payne, lead medical practitioner on the study, warned that asking chatbots about symptoms could be “dangerous”, particularly when users delay seeking professional care based on AI responses.

Dr Adam Mahdi, the study’s senior author, noted that while AI can share medical facts, people often share information gradually and leave out key details—something chatbots struggle to manage effectively.

Bias, Data, and the Limits of AI

Experts also point out that chatbots are trained on existing medical data, which means they may repeat long-standing biases baked into healthcare systems. As one psychiatry expert put it, a chatbot is only as accurate as human clinicians—and humans are far from perfect.

That said, not everyone is pessimistic.

What Comes Next for AI in Healthcare

Digital health experts argue the technology is evolving. Health-specific versions of general AI chatbots have recently been released by major developers, and these could perform differently in future studies.

The consensus among experts is clear: AI in healthcare should focus on improvement, regulation, and guardrails, not replacement of doctors. Used responsibly, it may support healthcare—but without safeguards, it risks doing more harm than good.

This common pregnancy drug could be linked to cancer. Wes Streeting has been urged to launch a public inquiry into a miscarriage drug called Diethylstilbestrol, which, reports say has "ruined and devastated" the lives of countless women. On Monday, the Health Secretary Streeting met victims of the pregnancy drugs, which has been linked to cancer, early menopause and infertility.

What Is Diethylstilbestrol?

Diethylstilbestrol, commonly known as DES, is a synthetic form of female hormone estrogen, which was prescribed to thousands of pregnant women from 1940 to 1970s.

The drug was used to prevent miscarriage, premature labor and complications of pregnancy. This was also used to suppress breast milk production, as an emergency contraception and to treat symptoms of menopause.

What Is The DES Controversy?

In 1971, Diethylstilbestrol (DES) was linked to a rare cancer of the cervix and vagina known as clear cell adenocarcinoma, prompting US regulators to advise that it should no longer be prescribed to pregnant women. Despite this, the drug continued to be given to expectant mothers across parts of Europe until 1978. DES has also since been associated with other cancers, including breast, pancreatic and cervical cancers, The Telegraph reported.

Campaign group DES Justice UK (DJUK) is now urging Health Secretary Wes Streeting to order a public inquiry and introduce an NHS screening programme to identify people who may have been exposed to the drug before birth.

Victims described DES as “one of the biggest pharmaceutical scandals this country has ever seen,” warning that “the impact of this terrible drug cannot be underestimated as it has ruined and devastated so many lives,” according to The Telegraph.

In November, Streeting acknowledged that the “state got it wrong” and issued an apology to those affected. He also advised anyone who believes they may have been exposed to DES to speak to their GP.

Susie Martin, 55, from Manchester, whose mother was prescribed DES during pregnancy, told The Telegraph she has undergone between 20 and 30 operations as a result of the drug’s effects.

“The impact of this terrible drug cannot be underestimated as it has ruined and devastated so many lives, including my own,” she said. “The physical and emotional pain has been unbearable. I live with a constant fear that I will need more surgery or develop cancer—and I am far from the only one.”

Calling DES a “silent scandal,” Martin said she hopes the government’s engagement will lead to concrete action. “While I welcome Mr Streeting meeting us, it will only matter if he commits to meaningful steps for victims of this shameful chapter in British medical history, including a screening programme and a full statutory public inquiry,” she added.

What Is Happening With The DES Victims?

The Telegraph reported that compensation schemes have been set up for DES victims in the US and Netherlands, however, UK does not have one yet.

"There are harrowing accounts of harm caused by the historic use of Diethylstilbestrol (DES). Some women and their relatives are still suffering from the associated risks of this medicine which have been passed down a generation, and haven’t been supported. The Secretary of State has been looking seriously at this legacy issue and carefully considering what more the government can do to better support women and their families who have been impacted. NHS England has alerted all cancer alliances to this issue so that healthcare professionals are aware of the impacts of DES and the existing NHS screening guidance which sets out the arrangements for those who show signs and symptoms of exposure,” said a Department of Health and Social Care spokesman to The Telegraph.

The World Health Organization (WHO)'s Montreal meeting focused on wearable technology like smartwatches and activity trackers as a reliable source of health tracking. The meeting discussed that wearables could in fact generate objective real-time data, which helps governments design targeted and evidence-based health interventions.

Physicians in the Montreal meetings discussed that wrist-worn devices are more reliable than traditional self-reported surveys. This is because the self-reported surveys could underestimate the levels of physical inactivity.

“Metrics such as step count, moderate-to-vigorous physical activity and sedentary time directly correlate with cardiovascular disease, diabetes and mental health outcomes. Having population-level data allows for early and preventive strategies,” said Dr Venkat Nani Kumar, consultant in internal medicine.

WHO Montreal Meeting: How Have Doctors Reacted The Shift To Wearables?

Doctors in India have welcomed this shift to wearable devices as a better way to generate data and make policies. Dr Kiran Madhala, professor at Gandhi Medical College, Secunderabad, said WHO’s shift reflects rapid advances in artificial intelligence and digital health tools, calling it a progressive step towards improved monitoring of physical activity worldwide.

City-based doctors also underlined the need for inclusive validation of devices. “Wearables must recognise varied movement patterns and step equivalents, especially in ageing populations,” a physician said, while stressing the importance of data privacy and ethical use of health information.

WHO Montreal Meeting: What Are Wearable Health Devices?

As per a 2022 study published in JMIR MHealth and UHealth, wearables refer to devices that are worn by individuals. In health care field, they assist with individual monitoring and diagnosis. Wearables are “seamlessly embedded portable computers...worn on the body," notes another 2018 study published in Telematics Informatics.

A 2018 study published in the journal Sensors noted that wearable health devices are increasingly helping people to better monitor their health status both at an activity/fitness level for self health tracking and at a medical level providing more data to clinicians with a potential for earlier diagnostic and guidance of treatment.

WHO Montreal Meeting: What Are Some Examples Of Wearables?

Blood Pressure Monitor

This is a blood pressure monitor that consists of a cuff that is placed in upper arm with a digital display that provides real time reading of systolic and diastolic blood pressure.

Glucose Monitoring Device

This device estimates your glucose levels in every few minutes. It can be worn in upper arm, with a phone sensor connected to measure readings. It also includes real time glucose alarms to make informed decisions.

Wearable ECG Monitor

ECG patches are interconnected with smartphones, where one can see their readings. They not only measure electrocardiograms, but also detect any abnormalities.

Fitness Tracker

Smartwatches or fitbits that could be worn on your wrist. They help track real time data of your health, steps, heart rate, calorie consumptions, and even sleep patterns. It can also help keep track of oxygen levels.

Integrated Activewear

These activewears come with microscopic sensors to safeguard wearer's body or assist them in reaching their fitness objective.