Immunotherapy and Possible Side effects

by Jane Ashley

Immunotherapy is becoming more prevalent for the treatment of cancer as researchers, through clinical trials, discover more types of cancer that respond to immunotherapy.

Flu Like Symptoms

We, as patients, are still a little bit baffled by how medication can turn on our immune system to kill our cancer. We’ve heard, through the grapevine, that immunotherapy treatment is “much easier” than chemo. For most patients, immunotherapy treatments are easier to tolerate, but immunotherapy does have side effects.

Immunotherapy works by allowing our immune system to “go into high gear” and attack our cancer. But when our immune system goes into overdrive, our immune system may attack healthy cells too — causing side effects that we might not expect.

What kinds of cancers can now be treated with immunotherapy?

While there were limited-use immunotherapy treatments before Keytruda’s approval in 2014, Keytruda, the first immune checkpoint inhibitor, is the immunotherapy drug that led the way to the development and approval of many new immunotherapy drugs.

• Bladder
• Breast
• Cervical
• Colorectal
• Esophageal
• Head and Neck
• Kidney
• Leukemia
• Liver
• Lung
• Lymphoma
• Melanoma
• Prostate
• Skin cancer

Not every patient with these types of cancer is eligible for immunotherapy treatment. Immunotherapy treatment is dependent on the genetic components at the cellular level, if our cancer has progressed and how far, and what other treatments have been used.

What are the potential side effects of immunotherapy?

What most patients like about immunotherapy is that side effects don’t occur as often and aren’t usually as severe. Most side effects occur within the first few weeks of treatment, but they can also occur later in treatment or even after treatment ends. Because some of immunotherapy’s side effects can be severe, it’s important to let your oncologist know if you develop new symptoms.

1. Diarrhea. Diarrhea is usually a sign that the immunotherapy treatment has caused inflammation in the gastrointestinal tract. Patients may see blood or mucous. Patients should let their oncologist know because frequent and severe diarrhea can cause dehydration and, possibly, an electrolyte imbalance. 

Diarrhea


2. Flu-like symptoms. Immunotherapy jumpstarts our immune system, similar to when we get our annual flu shot. We might experience chills and fever, nausea and vomiting, headaches, body aches, and fatigue. These symptoms usually resolve themselves — be sure to call your oncologist for help in managing these symptoms.
3. Rashes and other skin problems. One of the most common side effects is skin problems, including a rash, redness of the skin, or blistering. Mild skin irritations can usually be solved at home with a moisturizing ointment or cream. Severe outbreaks might require a trip to a dermatologist; be sure to call your treatment team if you experience a severe, widespread skin problem.
4. Vague, non-specific symptoms. Our bodies react in all sorts of ways to immunotherapy — joint or muscle pain, loss of appetite resulting in weight loss, irritability or nervousness, bloating, shortness of breath, or fatigue. Don’t assume that any new symptom is “normal,” and that you should just endure it. Always tell your oncologist or treatment team member of new symptoms. Your team wants to help us avoid problems with our treatment so that we continue our immunotherapy treatment.

Feeling Blah

Monitoring for Unseen Side Effects

Some side effects don’t manifest themselves as symptoms that a patient would notice. But our team of doctors monitors blood markers that indicate we might be experiencing internal side effects. They monitor our liver and kidney enzymes as well as all sorts of blood counts to ensure our overall health and well-being while we are on immunotherapy.

Rash

What if my type of cancer is not on the approved list?

Patients who have experienced progression or a recurrence may be eligible for one of the many clinical trials — some of these trials include immunotherapy in conjunction with chemotherapy or radiation. Talk to your oncologist if you’re interested in trying immunotherapy because your previous treatment hasn’t worked.

The Bottom Line

If you are receiving immunotherapy, please sure to write down the name and dosage of your treatment along with the phone number of your treatment clinic. On rare occasions, immunotherapy may cause an adverse event. If you’re out of town and have to go to the emergency room, it’s critical that you can provide the exact name of the cancer treatment that you are receiving to ensure prompt care if your symptoms are related to your treatment.

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