What Is Immunotherapy?

Immunotherapy is a type of cancer treatment that works by boosting your immune system to fight the cancer. Your immune system is like your body’s army that comes out to fight when you need to go into battle with something that your body detects as foreign.

With cancer, some of your cells in your body begin to divide in an abnormal way. Our trillions of cells in our body are constantly dividing and replacing old cells and building new ones to help us grow and remain healthy. But, in cancer, cells begin to divide abnormally, and form clumps known as tumours. These tumours can grow into surrounding tissue and cause pressure, pain and other problems that make our bodies difficult to function. The cells in the tumours can also travel beyond the surrounding tissue into the blood or lymph system and spread to other parts of your body. When this happens, the cancer is said to have metastasised and is known as advanced cancer or Stage 4.  

It is not easy to get a cancer diagnosis and many people feel very overwhelmed and uncertain as to what their future holds. But, the good news is that many cancers can be well treated and cured, and immunotherapy is one tool in the arsenal of treatments against cancer. Like all cancer treatments, it may be used alone but it is usually combined with other treatments to get the best result.

It can, for example, help other treatments such as chemotherapy to be more effective. In some cases, however, certain cancers only respond to immunotherapy, and it may be used when chemotherapy and radiation therapy have been tried and failed. Immunotherapy is also used to treat diseases other than cancer. These include allergic reactions, autoimmune diseases including rheumatoid and psoriatic arthritis, tissue and organ transplants, inflammatory diseases and immunodeficiency disorders.  

How Does Immunotherapy Work?

Our immune system is made up of white blood cells, organs and tissues of the lymph system (for example, bone marrow). This is what immunotherapy targets to give our system a better chance to fight off the cancer. There are many types of immunotherapies and with medical science advancing every day, the options are increasing and encouraging. 

One of the advantages of immunotherapy is that your body learns how to attack the cancer cells and if the cancer returns, then the body knows what to do to fight it. Unfortunately, with some people, the immunotherapy may work at first, and then for some reason, stop being effective and the cancer can grow back again. 

Not everyone responds to immunotherapy and it can take some time before it works. Sometimes it causes the cancer to stop growing or shrink but doesn’t remove the cancer completely. We don’t know yet why and in whom, immunotherapy will work or not. It is often a trial to see if your body will respond well or not. 

What Are the Different Kinds of Immunotherapy? 

• Immune Checkpoint Inhibitors - We all have these points in our immune system which are normal and keep our immune system in check. Inhibitors block these checkpoints and in doing so, allow our body’s immune cells to respond very strongly to the cancer.  
• T-Cell Transfer Therapy - T-cells are part of our body’s immune system. In T-cell transfer therapy the health provider takes out immune cells from the cancer tumour and finds those that are working best against your cancer. In a laboratory, these powerful cells are selected and put back into your body via an injection. This therapy is also called “adoptive cell therapy, or immune cell therapy. 

• Monoclonal Antibodies - These are also called therapeutic antibodies. They are designed in the laboratory to bind onto cancer cells and help your own immune system target and destroy the cancer. 
• Treatment Vaccines - These vaccines boost your natural immune system response to the cancer. They are used for example with prostate cancer or melanomas (skin cancers). Vaccines help your body’s immune system to recognise and destroy “tumour-associated antigens” that are substances found mainly in cancer and not normal cells.  
• Immune System Modulators - These boost your body’s immune response against the cancer.  

Is Immunotherapy Painful? 

Some kinds of immunotherapy can be given orally and this simply requires swallowing a pill or capsule which is painless. Skin cancer may be treated with topical immunotherapy. Other forms of immunotherapy are given by injection and you may experience a pin prick pain on the needle entering your body and it can also cause itchiness, pain, swelling around the area of the injection. This usually passes soon.

In most cases, you don’t need to be hospitalised for this treatment and many patients take the treatment at home, in the doctor’s office or at a clinic. It is taken in different regimes, depending on the type of cancer you have. It could be daily, weekly, fortnightly doses or even in cycles, with rest periods in between. Your doctor will explain all these options to you when you visit. Be sure to write down all your questions so you can be better prepared when you meet with your health care team. 

Are There Side Effects to Immunotherapy? 

Yes, there can be, as is the case with most medicines and treatments. With all cancer treatments, it is difficult to predict what side effects you will get as we are all different and respond to treatments differently. Some people experience very few side effects, while others are not so lucky.

Common side effects include:

• Flu-like symptoms e.g. fever, chills and tiredness
• Swelling
• Weight gain
• Heart palpitations
• Headaches
• Diarrhoea
• Rashes
• Blisters
• A stuffy head
• Shortness of breath
• Weakness
• Insomnia 

These side effects are mostly manageable and there are treatments to alleviate these symptoms. However, there are also more serious and life-threatening side effects that can be caused by immunotherapy. More serious side effects include high blood pressure, blood clots, kidney or liver damage, seizures, bleeding and severe rashes. Serious side effects happen when some of the immunotherapy drugs attack organs like your heart, liver, lungs or intestines. 

Is Immunotherapy Right for Me? 

It is important to speak to a health care provider to understand what the potential side effects are and to help you to weigh up the pros and cons of taking immunotherapy. In most instances, the risk of a poor outcome due to the cancer, outweighs the chances of the more serious side effects happening and the milder effects may be well controlled through lifestyle and medications.