TREATMENT

IMMUNOTHERAPY

Overview

What is immunotherapy?

Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. The concept of immunotherapy is based on the body's natural defence system, the immune system, which helps protects us against a variety of diseases. Immunotherapy is a type of biological therapy. Biological therapy is a type of treatment that uses substances made from living organisms which harness or mimic the body’s immune system, to fight cancer cells.

Understanding immunotherapy

Since immunotherapy is based on the body's natural defence system, it is worth understanding the immune system. The immune system is made up of white blood cells and organs and tissues of the lymph system. Immunotherapy is a treatment that uses certain parts of a person's immune system to fight diseases such as cancer. Although we are less aware of it, the immune system also works to aid our recovery from many illnesses, and there is evidence that in many cancer patients the immune system slows down the growth and spread of tumours. This can be done in a couple of ways:

  • By stimulating the body’s own immune system to work harder or smarter to attack cancer cells
  • By enhancing your immune system with man-made immune system proteins

By doing this, immunotherapy works by slowing the growth of cancer cells and stopping the spreading of cancer to other parts of the body. Immunotherapy works better for some types of cancer than for others. It's used by itself for some of these cancers, but for others, it seems to work better when used with other types of treatment.

There are several types of immunotherapy, including:
  • Monoclonal antibodies and tumour-agnostic therapies
  • Non-specific immunotherapies
  • Oncolytic virus therapy
  • T-cell therapy
  • Cancer vaccines

In the last few decades, immunotherapy has become an important part of treating some types of cancer. Newer types of immune treatments are now being studied, and they'll impact how we treat cancer in the future.

How is immunotherapy administered?

You may receive immunotherapy in your oncologist’s office, or in an outpatient unit in a hospital. Depending on the type of immunotherapy chosen, it may be administered in different ways, including:

  • Intravenously (IV) in the form of direct injections or an infusion
  • Orally in the form of tablets.
  • Topically through a cream or ointment.
  • Intravesically directly into the bladder.

How often and how long you receive immunotherapy depends on the type of cancer, its stage, the type of immunotherapy and the reaction to treatment. Your oncologist will explain your treatment plan with you personally. You may have treatment every day, week, or month. Some types of immunotherapy given in cycles in which treatment is followed by a rest period to allow the body time to respond and build new healthy cells. Your blood tests and scans will show whether or not there are changes in the size of your tumour. Based on those results, treatment may be altered.

Side effects of immunotherapy

Immunotherapy can cause side-effects when it because so active it starts to attack the healthy cells within the body. The aim of the following information is to give you an idea of what side effects may be a result of a highly active immune system.

1Skin reactions
You may have skin reactions at the needle site, such as:

  • Pain
  • Swelling
  • Soreness
  • Redness
  • Itchiness
  • Rash

There are creams and lotions that can help treat these; please discuss this with the nursing staff.
2Flu-like symptoms
Fever, chills, weakness, fatigue, headaches, difficulty breathing, dizziness, muscle aches, nausea & vomiting are all common side-effects of an overactive immune system. In some cases, heart palpitations and sinus congestion are also experienced.
3Swelling and weight gain from retaining fluid
4Organ inflammation
One type of immunotherapy, called immune checkpoint inhibitor therapy, can trigger inflammation of the organs, which may lead to the following complications:

  • Bleeding problems, anaemia and neutropenia.
  • Vision changes and/or eye pain.
  • Lowered blood pressure.
  • Decreased urine you production due to kidney inflammation.
  • Hepatitis, jaundice, nausea or vomiting, stomach pain & fatigue.
  • Tingling in the hands, feet or face.
  • Encephalitis, high fever, confusion, hallucinations, seizures & vomiting.
5Diarrhoea
Be sure to drink clear fluids (soup, soft drinks, tea and ± two litres of water per day) to prevent your body from dehydrating. Eat a lot of bananas, carrots (cooked), grated apple (without the skin) and maizena porridge. If you want more information, please talk to the nursing staff or dietician to assist you with this.

You must consult your general practitioner or oncologist immediately should you have more than 4 loose stools per day.