Let's learn about the side effects of immunotherapy, a cancer treatment?

When we learn that we have cancer, and then talk about treatment, we often get scared, don't we? Especially about the side effects. But the treatment method we are going to talk about today, called immunotherapy, is a little different from traditional methods like chemotherapy. It uses your own army, that is, the immune system, to fight cancer cells. So let's take a look at this wonderful treatment and the possible side effects, simply, so that you can understand.

What is immunotherapy?

Simply put, immunotherapy is a treatment that uses your body's own natural defense system, the immune system, to find and destroy cancer cells. Think of it like a police force inside our bodies. Their job is to find and destroy harmful things like germs, viruses, and abnormal cells that grow in our bodies, keeping us healthy.

But cancer cells are a very cunning type of cell. They can hide from this immune system without being caught. Just like a thief hides from the police. Once hidden like that, they quickly divide, spread, and cause a big problem.

So what immunotherapy does is give your immune system a special training and boost , making it stronger to fight cancer cells. This can happen in two ways:

• It stimulates your immune system and makes it produce more cancer-fighting cells.
• It helps existing immune cells to precisely identify and destroy hidden cancer cells.

Because it strengthens your body's own defense system, immunotherapy has become a very successful treatment for many types of cancer.

Why do immunotherapy cause side effects?

Like any treatment, immunotherapy can have side effects. The reason for this is simple. As we mentioned earlier, this treatment works by supercharging the immune system. So, these overactive immune cells can sometimes mistakenly start attacking not only cancer cells, but also your healthy cells .

This attack on healthy tissue is called an `immune-related adverse effect (irAE).` This is what causes inflammation in healthy tissue, and you start to feel it in the form of various side effects.

How common are these side effects?

Don't be alarmed by this. Not everyone gets side effects. Only about 20% of people taking immunotherapy experience this kind of `irAE`. Also, most of the side effects that do occur are very mild and easy to manage.

But the most important thing is to tell your doctor immediately about any changes you notice in your body, whether during or after immunotherapy treatment. It doesn't matter how small it is, it's always best to be informed.

You may be more likely to experience side effects if you take multiple immunotherapy drugs at the same time, or if you already have an autoimmune disease. An autoimmune disease is a condition in which your immune system mistakenly attacks your own healthy tissues.

What are the most common side effects?

The most common mild side effects are:

• Fatigue: Feeling extremely tired to the point of not being able to do anything.
• Itchy rash: Red, itchy rash on the skin.
• Diarrhea: Bowel movement.
• Nausea and vomiting: Feeling sick and vomiting.
• Decreased thyroid hormone levels: Impaired functioning of the thyroid gland.

How does immunotherapy affect different organs?

Since our immune system protects the entire body, this system, strengthened by immunotherapy, can affect any organ in the body. While most of these symptoms are minor, some can be serious. Therefore, it is imperative to inform your doctor about any symptoms .

To make it easier to understand, let's break these effects down by the body systems in which they can occur.

Do side effects vary depending on the type of immunotherapy?

Yes, the side effects you may experience may vary depending on the type of immunotherapy you receive. Let's look at some of the main types.

Immune Checkpoint Inhibitors (ICI)

This is the most commonly used type. These drugs work by blocking the 'signals' that cancer cells use to hide from immune cells (T-cells). This means that the cancer cells can no longer hide. The most common side effects of this type are fatigue, diarrhea, and skin rashes.

Adoptive Cell Therapy (T-cell transfer therapy)

This is a slightly more complicated procedure. What you do here is take T-cells (cancer-fighting cells) from your own body, modify them in a lab, "train" them to recognize cancer cells better, and then put them back into your body.

• In a type of CAR T-cell therapy , a condition called `Cytokine Release Syndrome (CRS)` can occur. In this, the immune system suddenly becomes overactive, causing symptoms such as fever, headache, and difficulty breathing. But your doctors know how to manage this condition.

Monoclonal Antibodies

These are special proteins made in a lab. They are designed to target and attack a specific weakness in cancer cells. They can cause flu-like symptoms such as fever, body aches, changes in blood pressure, and skin lesions.

Treatment Vaccines

These are like vaccines that we get before we get sick. But these are used after cancer has developed. These vaccines "teach" the immune system to recognize and destroy cancer cells. They can cause things like flu-like symptoms and high blood pressure.

Immune System Modulators

These drugs work by changing the way the immune system works, prompting it to fight cancer. Some drugs can cause side effects such as fatigue, nerve damage (neuropathy), and blood clots.

When do these side effects start and end?

There is no exact day or time for this. Immunotherapy takes time to work. Therefore, it can take months, sometimes even more than a year, for side effects to appear. Also, some side effects appear more than a year after treatment begins.

Most side effects are temporary. But rarely, they can have long-term effects. Sometimes, you may have side effects for a while after you finish treatment. This is because immunotherapy is not a drug that works only while it is in your body. It makes long-term changes to your immune system.

How to manage side effects?

The most important thing is to tell your doctor about any symptoms you experience, no matter how minor . Sometimes, even if they seem normal to you, they could be an early sign of a serious condition.

Your doctor may change your treatment or give you other medications to control side effects. This is usually done by:

• Treatment is temporarily stopped and the immune system is given time to "calm down" a bit.
• Medications are prescribed to reduce the activity of the immune system. For example, medications such as steroids or immunosuppressants .

Does the occurrence of side effects mean that the treatment is successful?

This is a question that many people ask. Some studies have shown that the occurrence of side effects can be a sign that the treatment is successfully destroying the cancer.

So don't worry about the lack of side effects. The only way to know for sure is through tests performed by your doctor.

So what are the benefits of immunotherapy?

When talking about side effects, you may wonder, "Is this treatment worth it?" But we also need to understand the benefits of immunotherapy.

• It increases the chance of long-term survival in many types of cancer.
• It helps destroy cancerous tumors and prevent cancer from coming back .
• It can prevent cancer from spreading to other parts of the body.
• Even after you stop treatment, your strengthened immune system continues to fight cancer cells .
• Compared to traditional treatments like chemotherapy, the side effects of immunotherapy are generally less severe .

Ultimately, immunotherapy is not a one-size-fits-all treatment. It depends on many factors, including the type of cancer you have and your overall health. So, talk to your doctor about the pros and cons of this treatment and make the decision that's best for you.