By Carrie Bergener, MHA, RN
Cancer treatment has come a long way since its earliest days, and one of the most exciting advances is immunotherapy. While it might seem like a modern breakthrough, the concept of harnessing the immune system to fight cancer is over a century old. And today, immunotherapy stands alongside surgery, chemotherapy, and radiation as the fourth pillar in the fight against cancer.
What Is Immunotherapy?
Immunotherapy is a treatment that empowers the body’s own immune system to find and attack cancer cells. Unlike chemotherapy and radiation, which can’t distinguish between healthy and cancerous cells, immunotherapy targets only the cancer, sparing healthy cells. However, this heightened immune response can sometimes lead to serious side effects, known as immune-related adverse events (irAEs). While side effects can include nausea, vomiting, and diarrhea, they are likely to be much less severe than the stereotypical severe side effects of chemotherapy. The Oncology team manages these symptoms and treatment schedules, providing support to maintain quality of life.
The Treatment Process
The most common method of administering immunotherapy is intravenous infusion at an oncology clinic, generally an hour long per session. Depending on the type and stage of cancer, treatment cycles are every few weeks or months, and the cancer’s response guides the determination of repeating cycles.
The Science Behind Immunotherapy
The mid-1900s marked a turning point, as scientists studied T cells and deepened their understanding of immunology. T cells are the immune system’s warriors, recognizing and fighting infection, foreign material, and cancer cells. Cancer has a clever trick: it can “turn off” T cells, blocking their ability to attack cancer cells.
However, our immune system also contains naturally occurring Checkpoint Inhibitors that prevent T cells from overworking. A key innovation in immunotherapy is the development of lab-made proteins that block the body’s Checkpoint Inhibitors. So, when cancer cells would normally impair T cells’ ability to fight, the Immunotherapy blocks Checkpoint Inhibitors, allowing the T cells to unleash their full power against cancer. This is the essence of immunotherapy.
Challenges and Next Steps
Despite its promise, immunotherapy isn’t a magic bullet. Cancer cells can adapt, exhaust the immune system, and continue to grow. When resistance develops, doctors may switch the type of immunotherapy, combine it with chemotherapy or radiation, or enroll patients in clinical trials for new treatments. Targeted therapies, which focus on unique genetic mutations, are another avenue of hope.
The Road Ahead
There’s no way to predict the success or failure of any cancer treatment. The guide to medical decisions is statistics, best practices, and the patient’s individual response. Immunotherapy is changing the landscape of cancer. Survival rates are increasing at a historical pace, and cancers previously considered untreatable are now showing significant gains in survival. And as science advances, so does our ability to fight cancer. We are better than we were – and we continue to improve.
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