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Immunotherapy, also called biologic therapy, is a type of cancer treatment that boosts
the body's natural defenses to fight cancer.
Immunotherapies are certainly exciting and revolutionized how we approach patients with cancer.
Unlike chemotherapy, which can cause low blood counts or loss of hair, immunotherapies are
designed to let your own body fight cancer.
So for most patients, they’re extraordinarily well tolerated.
But sometimes because immunotherapies "rev up" your immune system, releasing the brakes
on your immune system, they can overshoot the target, the cancer cell can sometimes
attack your normal organs often like an autoimmune disease.
As the immune system is activated to fight the cancer, it may cause other, unintended
changes to your body called side effects.
There can be many different side effects from immunotherapy so it’s important to talk
with your health care provider about what you should watch for before treatment begins.
It is also very important to let your health care team know right away about changes in
how you are feeling, such as when a side effect first appears, continues, or becomes worse.
Some common side effects of immunotherapy include skin and hair changes, flu-like symptoms,
hormone changes, and other side effects such as breathing problems, pain, swelling, and
vision problems.
Sometimes you can have a fever after an infusion reaction.
Occasionally we’ll see things like inflammation in the lungs, like pneumonitis, inflammation
in the gut, colitis.
Often we’ll see skin rashes, dermatitis or arthritis.
And then, we’ll sometimes see later effects like endocrine disorders such as hypophysitis
or thyroiditis.
All of these side effects are generally well managed if they’re detected early.
Often, we treat them with corticosteroids and other immunosuppressive medications that
shut down or temper the T-cell response to your own body.
The side effects from immunotherapy can be mild, but sometimes the side effects can be
life-threatening, dramatic, and urgent, requiring immediate medical attention.
If you need emergency medical care, be sure to use the word “immunotherapy” with the
health care providers at the emergency room when talking about your cancer care.
When side effects are more dramatic, it’s important that patients let any healthcare
provider know that they’re on immunotherapeutic medications because anti-inflammatory such
as corticosteroids can completely dampen the immune response and make a scary situation
much, much more manageable.
We ask patients to be vigilant.
Is there a change in bowel movements?
Are they having a slight cough?
Are they becoming more short of breath?
It doesn’t have to be dramatic.
But, early detection of these side effects is essential, and communication is essential.
Some immunotherapies are given by itself, while others can also be used in combination
with other cancer treatments, called modalities, such as chemotherapy drugs and radiation therapy.
Each type of treatment can bring different side effects.
Side effects from those other modalities need to be taken in account when we’re educating
patients about potential side effects.
Unlike traditional chemotherapies in which the time course of giving the drug and seeing
side effects is very well known, with immunotherapies, often side effects can occur late in treatment.
And so, patients who do well on immunotherapy can be on these drugs for up to two years.
Side effects can happen at any time.
And sometimes even after discontinuation of the drug side effects can happen.
Again, although these side effects are common, they’re generally very mild.
And ones that are serious are well managed if they’re detected early.
Research continues to be done about many different immunotherapies, and there are many sources
for information about this type of cancer treatment.
Finding, credible, trusted, and up to date information is important for understanding
treatment and making decision about your care.
I tell patients and their caregivers to visit Cancer.Net to find more about immunotherapies
as well as related side effects.
For more information about immunotherapy side effects and treatment, talk with your doctor
and visit Cancer.Net/immunotherapy.
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