Immunotherapy

Immunotherapy is a type of cancer treatment that helps your body's own immune system fight cancer. It works by boosting your immune system's ability to recognize and destroy cancer cells, much like your body fights off infections. This approach differs from traditional treatments by targeting the immune system rather than the cancer cells directly.

What is Immunotherapy?

Immunotherapy is a treatment that uses your body's natural defenses, called the immune system, to fight cancer and other diseases. It works by stimulating or restoring your immune system's ability to find and attack harmful cells. This approach helps your body recognize cancer cells as foreign invaders, similar to how it identifies bacteria or viruses.

Your immune system is a complex network of cells, tissues, and organs that protect your body from infection and disease. Normally, it can identify and destroy abnormal cells, including cancer cells. However, cancer cells sometimes find ways to hide from the immune system or suppress its response. Immunotherapy helps overcome these defenses. It can either boost the immune system's general ability to fight cancer or train it to specifically target cancer cells. Different types of immunotherapy work in various ways, such as using laboratory-made antibodies or modifying your own immune cells. The goal is to make your immune system stronger and smarter in its fight against the disease.

Why it's done

Immunotherapy is done primarily to treat various types of cancer, especially when other treatments have not been effective or when the cancer has spread. It is also used for some non-cancerous conditions. The aim is to harness your body's natural defenses to target and eliminate diseased cells, offering a different approach to treatment.

Doctors use immunotherapy for many different cancers, including melanoma, lung cancer, kidney cancer, bladder cancer, and Hodgkin lymphoma. It can be a primary treatment, used after surgery, or combined with other therapies like chemotherapy or radiation. The decision to use immunotherapy depends on the type of cancer, its stage, and your overall health. This treatment is particularly valuable because it can offer long-lasting responses in some people. Unlike chemotherapy, which often has broad effects on rapidly dividing cells, immunotherapy aims for a more targeted attack on cancer cells by involving the immune system. This can lead to different side effect profiles and, in some cases, sustained control of the disease.

How to prepare

Preparing for immunotherapy involves several steps to ensure you are ready for treatment and to help your medical team plan effectively. You will typically undergo various tests, discuss your medical history, and review potential side effects with your doctor. This preparation helps tailor the treatment plan to your specific needs and health status.

Before starting immunotherapy, your doctor will conduct a thorough evaluation. This usually includes blood tests to check your general health, organ function, and specific markers related to your immune system. Imaging tests, such as CT scans or MRI scans, may also be performed to assess the cancer's extent and location. You will have detailed discussions with your healthcare team about your medical history, including any existing health conditions, allergies, and medications you are currently taking. It is important to tell your doctor about all prescription and over-the-counter drugs, vitamins, and herbal supplements. Your doctor will explain the specific type of immunotherapy you will receive, how it works, and what to expect during and after treatment. This is also a good time to ask any questions you have.

What happens during

During immunotherapy, the treatment is typically given in cycles, meaning you receive the therapy for a period, followed by a rest period. The method of delivery often depends on the specific type of immunotherapy, but it is commonly administered intravenously (through a vein) or as an injection. A healthcare professional will carefully monitor you throughout the process.

Most immunotherapy treatments are given as an infusion into a vein (intravenously) in an outpatient clinic or hospital. This means a needle is inserted into a vein, usually in your arm, and the medication slowly drips into your bloodstream over a period of time, which can range from 30 minutes to several hours. Some types of immunotherapy may be given as an injection under the skin (subcutaneously) or, less commonly, as pills. The treatment schedule varies widely depending on the specific drug, the type of cancer, and your response. You might receive treatment once every two, three, or four weeks. These cycles are designed to give your body, and especially your immune system, time to recover between doses. Your medical team will closely monitor you for any immediate reactions or side effects during each session.

Recovery & timeline

Recovery from immunotherapy varies greatly among individuals, as the treatment's effects on the immune system can be long-lasting and cumulative. There isn't a single defined recovery timeline; instead, it involves managing side effects as they arise and monitoring your body's response. Your healthcare team will guide you through this process, which may continue for months after your last dose.

Unlike some other cancer treatments, immunotherapy often does not have a sharp "recovery" period in the traditional sense. Instead, you will continue to be monitored for side effects and treatment effectiveness for an extended period, sometimes even after active treatment stops. This is because immunotherapy can continue to work in your body for months, and side effects related to an overactive immune system can emerge or persist. Your medical team will schedule regular follow-up appointments to check your progress and manage any side effects. These appointments may include blood tests and imaging scans. It is crucial to report any new or worsening symptoms to your doctor promptly. While some people may feel well enough to resume normal activities quickly, others might experience fatigue or other immune-related side effects that require ongoing management and adjustments to their daily routines.

Risks & side effects

Immunotherapy can cause a range of side effects because it activates your immune system, which can then attack healthy cells in addition to cancer cells. Common side effects include fatigue, skin rashes, and flu-like symptoms. More serious, though less common, side effects can affect major organs. Your medical team will monitor you closely and help manage these reactions.

The side effects of immunotherapy are often called "immune-related adverse events" because they result from an overactive immune system. Common side effects can include feeling tired (fatigue), skin rashes or itching, diarrhea, nausea, and muscle or joint pain. Some people may also experience flu-like symptoms such as fever and chills. These side effects are usually mild to moderate and can often be managed with medication. More serious side effects, though less common, can occur when the immune system attacks healthy organs like the lungs (pneumonitis), colon (colitis), liver (hepatitis), or endocrine glands (like the thyroid or adrenal glands). These can be severe and may require treatment with steroids or other immune-suppressing medications. It is vital to report any new or unusual symptoms to your doctor immediately, as early intervention can prevent severe complications. Your healthcare team will provide specific instructions on what symptoms to watch for and when to seek medical attention.

Success rate

The success rate of immunotherapy varies significantly depending on the type of cancer, its stage, and individual patient factors. While it has led to remarkable and long-lasting responses for some people, it does not work for everyone. For certain cancers, immunotherapy has transformed treatment outcomes, offering new hope and improved survival rates compared to traditional therapies.

Immunotherapy has shown significant promise and has been approved for treating many different types of cancer. For some advanced cancers, such as melanoma and certain lung cancers, immunotherapy has dramatically improved survival rates and quality of life for a subset of patients. For example, a notable percentage of people with advanced melanoma treated with specific immunotherapies experience long-term remission, which was rare with older treatments. However, it is important to understand that not everyone responds to immunotherapy. Researchers are actively working to identify biomarkers that can predict which patients are most likely to benefit. Even when successful, the response can vary from shrinking tumors to stabilizing the disease. Your doctor will discuss the likelihood of success based on your specific diagnosis and the available evidence, helping you understand the potential benefits and limitations for your situation.

Frequently asked questions

How long does immunotherapy treatment last?

The duration of immunotherapy treatment varies widely. It can range from a few months to several years, depending on the type of cancer, the specific drug, your response to treatment, and how well you tolerate the side effects. Your doctor will determine the optimal length of treatment for your individual case.

Can immunotherapy cure cancer?

For some people, immunotherapy can lead to long-lasting remissions, meaning the cancer goes away and does not return for a significant period. While it has shown remarkable success in controlling or eliminating cancer in certain cases, it is not always a cure for everyone. The goal is often to achieve long-term disease control and improve quality of life.

Is immunotherapy painful?

The administration of immunotherapy, usually through an intravenous (IV) infusion, typically involves a brief pinch when the needle is inserted, similar to a blood draw. The infusion itself is generally not painful. However, some people may experience discomfort or pain from side effects, such as muscle aches or joint pain, which can be managed with medication.

How soon will I see results from immunotherapy?

The time it takes to see results from immunotherapy can vary significantly. Unlike some other treatments, immunotherapy often works by gradually activating your immune system, so it may take weeks or even months for the full effects to become apparent. Your doctor will monitor your progress with regular tests and scans.

Can I take other medications while on immunotherapy?

It is crucial to discuss all medications, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements, with your doctor before and during immunotherapy. Some medications can interfere with how immunotherapy works or increase certain side effects. Your healthcare team will advise you on safe medication use.

What should I do if I experience side effects?

If you experience any side effects during or after immunotherapy, it is very important to contact your healthcare team immediately. Do not wait for your next appointment. Early reporting allows your doctors to assess the side effect, determine if it is immune-related, and provide prompt treatment to manage symptoms and prevent them from becoming severe.

Sources

• MedlinePlus — Immunotherapy
• Mayo Clinic — Immunotherapy
• Cochrane Library — Immunotherapy