A new ray of hope in cancer treatment: Immunotherapy
Saying that immunotherapy has led to exciting results in cancer treatment in recent years, Liv Hospital Medical Oncology Specialist Prof. Dr. Haluk Onat gave comprehensive information about the important developments in this field and the details that are curious about immunotherapy: “Immunotherapy stops the growth and spread of cancerous cells by strengthening the body’s immune system to make effective and stronger attacks against cancerous cells. The aim of immunotherapy is to strengthen the immune system, that is, to ensure that the body defeats cancer itself.
What is immunotherapy?
Immunotherapy is a new dimension of drug therapy in cancer. Millions of cancer cells are born in our bodies every day. There are cells in the human immune system to defeat cancer cells. When the immune system recognizes cancer cells, it immediately takes action and destroys the cell. T cells (T lymphocytes) in the immune system fight them. T cells fight against the cancer cell and try to destroy it. However, thanks to the receptor on the cancer cells, it binds the T cells to their receptors and prevents them from fighting against themselves.
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Immunotherapy drugs prevent T cells and cancer cells from connecting through these receptors and enable T cells to do their job. The aim of immunotherapy is to strengthen the immune system and enable the body to defeat cancer itself.
How is it different from chemotherapy?
- Until now, 3 types of drug treatment were applied for cancer. The first is “cytotoxic” chemotherapy treatment that kills cancer cells (stereotaxic in cancer). Secondly, hormone therapy methods are used to break the hormonal mechanisms in cancers such as breast and prostate that develop due to hormones. The third is targeted therapy, which has been used for the last 15 years and is increasing day by day, the aim of this treatment was to block the mechanisms that lead to the development and spread of cancer. In immunotherapy, the target is to strengthen the immune system, that is, to enable the body to defeat cancer itself.
- They differ from each other in terms of mechanism. Chemotherapy kills cells, immunotherapy strengthens the immune system.
- The side effects are different. Side effects such as hair loss, low blood pressure, nausea and vomiting seen in chemotherapy are not seen in immunotherapy. Immunotherapy side effects are mostly the side effects caused by the stimulation of the immune system.
- In order to apply chemotherapy, the patient’s performance must be good and body functions must be in place. Both the disease and the problems associated with chemotherapy should not harm the patient. Immunotherapy is also effective in patients with poor performance. It can be applied even to patients who are very weak and cannot get up.
How is immunotherapy done?
Immunotherapy drugs, like chemotherapy, are given intravenously via serum. But it is more comfortable than chemotherapy. It does not cause any significant problems while applying.
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Who can use immunotherapy?
Immunotherapy drugs are not currently used in early disease relapses, they are used in patients who have spread and metastasized. It can be used in patients in stage 4. But for the results to be good, the patient must be in the early stage of the 4th stage.
In which cancers can immunotherapy be used?
It has been tested in many cancer types and is promising. But today it is the most important medicine of malignant melanoma, i.e. mole cancers. In malignant melanoma, chemotherapy has almost no effect, whereas immunotherapy is very effective. It is used as the first choice in non-small cell lung cancer, in progressive disease after chemotherapy. In other words, chemotherapy is applied first, and if the disease progresses, immunotherapy drugs are given as the second choice. The third area of use is kidney cancer. Here, too, immunotherapy is used in the second choice when targeted drugs fail. Fourth, it is used in lymph cancers (Hodgkin’s disease).
What other cancers can immunotherapy be used for?
It is promising for bowel, bladder, stomach and breast cancer. At the research stage, not yet used.
What kind of side effects can immunotherapy cause?
Immunotherapy has side effects related to the immune system. These may be some symptoms on the skin, diarrhea in the intestines. Inflammation in the lung (non-germ pneumonia) may have effects on the hormone system. For example, it can act on the thyroid gland, causing it to work slowly or quickly. It can cause adrenal gland failure.
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There may be insufficiency of the pituitary gland. Fatigue can cause loss of appetite. Side effects should be well known and patients should be followed closely. Therefore, medical oncologists who apply immunotherapy should know when to discontinue the drug, when to continue, and take precautions when these side effects occur.
Not only medical oncologists, but also physicians in other branches such as chest diseases, endocrinology, gastroenterology should know how to intervene in case of any side effects. For example, using cortisone can save lives when side effects occur. Therefore, the physician should know when to use cortisone.