The Facts About Immunotherapy

Immunotherapy is a treatment method that uses a patient's immune system to fight cancer. It boosts or alters the lymphatic system so it recognizes and attacks cancer cells. Some types of immunotherapy stimulate your immune system's natural response to work smarter, while other types create additional immune system components in a laboratory to help your body.

Unlike chemotherapy, which kills cancer cells and healthy cells, immunotherapy fights only cancer cells. While it's a good approach, there are side effects that need to be considered.

The lymph system is part of the immune system and works as a drainage system, which runs throughout the body. It includes tubes (lymphatic vessels), filters (lymph nodes) and a clear fluid that travels through the system called lymph. Its main function is to bring fluid back into the bloodstream, which is filtered by white blood cells in the lymph nodes. This process helps fight infections and cancer cells.

There are five general strategies of immunotherapy:

1. Nonspecific immune stimulation gives a general boost to the immune system by injecting molecules that bind to receptors in the cell membrane. Activated cells then alert other immune cells like T cells, the main players in the fight against cancer.
2. Monoclonal antibodies (mAbs) deliver artificial antibodies against cancer cells. MAbs can work alone or have a radioactive particle or chemotherapy drug attached.
3. Immune checkpoint inhibitors remove blockades on immune checkpoint pathways to strengthen the immune response.
4. Adoptive T cell transfer extracts immune cells from a patient and activates them outside the body. T cell therapy works best with cells taken directly from the tumor, after which the process then activates and multiplies the cells before reintroducing them into the patient. This treatment is still considered experimental.
5. Vaccination strategies involve using different types of viral vaccines to direct immune cells to the cancer tissue.

Here are five cancers that can be treated with immunotherapy:

• Breast cancer. Immunotherapy is a treatment option for women with triple-negative breast cancer (TNBC). It's usually used in combination with other treatments such as chemotherapy, hormone therapies and targeted drugs.
• Cervical cancer. Immunotherapy can be used to treat advanced cases that aren't responsive to other treatments.
• Colorectal cancer. There are several FDA-approved immunotherapy treatments for tumors with high microsatellite instability (MSI-H) or DNA mismatch repair deficiency (dMMR), according to the Cancer Research Institute.
• Ovarian cancer. There's just one FDA-approved drug called Keytruda, an immune checkpoint inhibitor for ovarian cancer. Most women have to join clinical trials to try other immunotherapy drugs.
• Prostate cancer. Immunotherapy targets the infected lymph nodes and surrounding infected tissue.

Each treatment comes with its own set of side effects. For example, immune checkpoint inhibitors can cause diarrhea and fatigue. In general, though, it's common to have flu-like symptoms such as fever, chills, fatigue and headache. Other common symptoms include skin reactions, such as pain, itchiness, redness and soreness, at the injection site.

Different types of immunotherapy are given in different ways. Some common methods include:

• Injection. Medication in liquid form that's injected directly into a vein.
• Oral medication. A pill or capsule you swallow.
• Through the bladder. Liquid medication that's delivered to a specific body cavity, such as the bladder, using a catheter.
• Topical medication. Ointment or cream you apply to your skin.

Medication can be given daily, weekly or monthly, and can be combined with other treatments.

The best step to take during such treatment is to take care of your immune system. Here are guidelines to consider:

• Avoid alcohol
• Avoid caffeine
• Avoid spicy foods
• Eat well-cooked meat
• Wash fruits and vegetables before you eat them
• Wash your hands before and after prepping food

You should also avoid stress by getting enough rest, practicing meditation and mindfulness, and talking to a mental health professional, if needed.

Immunotherapy is measured by shrinking or stable tumors. The physician checks samples of blood, urine and other bodily fluids to look for abnormal cells.

Immunotherapy can take longer to work (weeks or months) than radiation or chemotherapy as it gradually helps the lymphatic system fight off cancer cells.

Certain side effects of cancer treatment—such as fatigue, diarrhea, nausea, pain and changes in appearance—can affect libido and sexual desire. Some treatments, especially ones injected into the bladder, can cause erectile dysfunction (ED).

Your doctor or nurse can help you manage changes in your sexual activity and intimacy during treatment, so don't be nervous to bring the subject up if you feel comfortable.

The American Cancer Society is a great resource for people dealing with cancer and treatment options. Additionally, you can look for local support groups, peer-to-peer networks, and counselors to help deal with the wide range of emotions that a cancer diagnosis and treatment bring on.

Many financial organizations help patients and families with medical billing and insurance claims. Ask your healthcare team for information about these resources. You can also find oncology social workers at CancerCare to help you navigate emotional and practical challenges.

What is immunotherapy used to treat?

Immunotherapy is used to treat a variety of cancers, including melanoma, lymphoma, bladder and kidney cancer, breast cancer, prostate cancer, ovarian cancer and more.

It's not as widely used as chemotherapy or radiation therapy but can be a good option if the cancer is not responsive to other treatments.

What are the common types of immunotherapy?

The main types of immunotherapy are nonspecific immune stimulation, monoclonal antibodies (mAbs), immune checkpoint inhibitors, adoptive T cell transfer and cancer vaccines. Each type of immunotherapy has its own side effects. It's important to work with your doctor to find out which one is best for you.

Can cancer be cured with immunotherapy?

Though immunotherapy can't cure cancer, it can help change outcomes and prolong life for many patients. It has a high success rate of attacking cancer cells over a long period of time, which can keep cancer from spreading to other parts of the body.