Radiation Oncologist providing radiotherapy to a cancer patient.
Radiation Oncologist providing radiotherapy to a cancer patient.
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Immunotherapy

Understanding immunotherapy, side effects, treatment costs and FAQs.

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What is immunotherapy?What is immunotherapy?

The immune system is made up of cells and organs that protect the body from threats such as infections, toxins and abnormal cell growth. The immune system recognises when a foreign organism, such as a germ, enters the body and attacks it to stop it from harming the body.

Immunotherapy, or biologic therapy, is a type of treatment that uses your own immune system to fight cancer.

Even though the immune system can prevent or slow cancer growth, cancer cells have ways to avoid destruction by the immune system. For example, cancer cells may:

  • have genetic changes that make them less visible to the immune system
  • have proteins on their surface that turn off immune cells
  • change the normal cells around the tumour so they interfere with how the immune system responds to the cancer cells

Immunotherapy helps the immune system to better act against cancer.

Smiling cancer patient
Smiling cancer patient

How is immunotherapy given?

How often the treatment is given will depend on the type of immunotherapy, the type of cancer, how advanced the cancer is, how the cancer responds to treatment or the side effects you experience. Different forms of immunotherapy may be given in different ways, including orally, directly into a vein through an intravenous injection or infusion (IV), by applying a cream, directly into the bladder, or injected into a tumour.

What are the side effects of immunotherapy?

Immunotherapy side effects can affect people in different ways and will depend on how healthy you are before treatment, your type of cancer, how advanced it is, the type of therapy you are getting, and the dose.

The most common side effects are skin reactions at the needle site, which can include pain, swelling, soreness, redness, itchiness and a rash. You may experience flu-like symptoms, such as fever, chills, weakness, dizziness, nausea or vomiting, muscle or joint aches, fatigue, headache, trouble breathing, and low or high blood pressure.

Other side effects might include swelling and weight gain from fluid retention, heart palpitations, sinus congestion, diarrhoea and risk of infection. Immunotherapy can cause side effects, many of which happen when the immune system that has been revved up to act against the cancer also acts against healthy cells and tissues in your body.

Rarer side effects of some immunotherapies, such as immune checkpoint inhibitors can include widespread inflammation. Depending on the organ of your body that is affected, inflammation can lead to:

  • changes in skin colour, rash, and feeling itchy, caused by skin inflammation
  • cough and chest pains, caused by inflammation in the lungs
  • belly pain and diarrhea, caused by inflammation in the colon
  • diabetes, caused by inflammation in the pancreas
  • hepatitis (inflammation of the liver)
  • hypophysitis (inflammation of the pituitary gland)
  • myocarditis (inflammation of the heart muscle)
  • nephritis (inflammation of the kidney) and impaired kidney function
  • overactive or underactive thyroid
  • nervous system problems such as muscle weakness, numbness, and trouble breathing

What types of immunotherapy treatments are there?What types of immunotherapy treatments are there?

  • Cancer vaccines

    Cancer vaccines are medicines that trigger the body’s immune system to detect cancer cells and either prevent cancer cells from developing or prompt the immune system to fight existing cancer cells.

  • Non-specific immunotherapies

    Non-specific immunotherapies refer to the use of proteins produced by white blood cells to control immune responses that help the body’s immune system destroy cancer cells. They are often given with other cancer treatments, such as chemotherapy or radiation therapy.

  • Monoclonal antibodies

    Monoclonal antibodies, also known as therapeutic antibodies, are immune system proteins designed to attach to specific targets found on cancer cells so that they will be better seen and destroyed by the immune system.

  • Checkpoint inhibitors

    Checkpoint inhibitors are medicines that help the immune system respond more strongly to a tumour by releasing “brakes” that keep T cells (a type of white blood cell and part of the immune system) from killing cancer cells.

  • CART T-cell therapy

    CAR T-cell therapy is an emerging type of treatment in which a patient’s T cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells.

Frequently asked questionsFAQs

Why doesn’t the immune system stop cancer?

Cancer cells learn to survive and grow in a hostile environment due to their ability to hide from the immune system and avoid detection by the body’s own self defences. Once the immune system is alerted and activated, other healthy cells may be recognised as different and vulnerable to attack by the body’s own defence systems. This is what causes some of the side effects of immunotherapy.

What if I have an autoimmune disease?

If you have an autoimmune disorder such as rheumatoid arthritis, lupus, ulcerative colitis, or Crohn’s disease, be sure to inform your cancer specialist. Immunotherapy might still be an option, but there are additional considerations.

Autoimmune disorders cause the immune system to become overactive, attacking healthy cells and leading to inflammation. The heightened immune response from immunotherapy can worsen these symptoms.

What if I have had an organ transplant?

Consult with your specialists if you’ve undergone an organ transplant. You are likely on medications that suppress your immune system to prevent organ rejection; the right balance between these medications will need to be established alongside the increased immune activity from immunotherapy treatment.

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