Immunotherapy
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Immunotherapy is a type of cancer treatment that helps your immune system recognise and fight cancer cells.
It works by boosting or modifying the body’s natural defences. Immunotherapy may be used on its own or alongside other treatments such as chemotherapy, surgery, or radiotherapy.
It is usually given through a drip (intravenously), but some types may be given as an injection.
There are different types of immunotherapy, including: monoclonal antibodies (MABs), checkpoint inhibitors, cytokines, cancer vaccines, CAR T-cell therapy. Each one uses the immune system in a different way.
This factsheet contains information about monoclonal antibodies (MABs) and checkpoint inhibitors, as these are the types of treatment we will usually offer you.
MABs can:
- trigger the immune system to attack and kill cancer cells (for example, trastuzumab).
- act on cells of the immune system to help the immune system attack cancer cells (these are referred to as the ‘checkpoint inhibitors’ and include ipilimumab, nivolumab and pembrolizumab).
Self-management tips
You will be provided with a “Treatment Record Book” on your first visit to the day unit which has helpful self-management tips in a lot more detail.
General advice:
- Stay hydrated by drinking plenty of fluids (around 1.5-2 litres a day).
- Get plenty of rest but try light activity. Weight baring exercises (e.g. walking) can reduce fatigue.
- Take care of your skin by moisturising with unperfumed cream daily and being careful not to get cuts. For example, by wearing gloves and long sleeves when gardening.
- Wear a high factor (ideally spf 50) if you are going out in the sun and wear a hat if you have lost any hair.
- Report new or unusual side effects early
- Monitor for symptoms like fever, diarrhoea, or breathing changes
- Keep a symptom diary
Sex and contraception
- Anti-cancer medicines can be very harmful to an unborn baby & with some immunotherapy drugs we do not know the potential harm. It is important to use barrier method contraception (e.g. condoms) during treatment if you could or your partner could get pregnant.
- If you think you could be pregnant, please ensure you tell your specialist team or hotline service as soon as possible.
Side effects of immunotherapy
- Immunotherapy can cause a range of side effects and your cancer specialist team will provide you with potential side effects related to your individual treatment plan.
- Breathlessness and a dry cough
- Loss of appetite
- Occasionally feeling or being sick)
- Abdominal (tummy) pain
- Diarrhoea
- Tiredness (fatigue)
- Dry, itchy skin or a skin rash
- Disruption to the normal working of the liver, kidneys and hormone-making glands (such as the thyroid)
How to ask for help
Before you start chemotherapy your cancer specialist team will discuss with you about your treatment plan including timings of drug administration and potential side effects. As if there’s anything you can do to prepare for potential side effects before you start.
Some chemotherapy medicines can cause fertility problems (which can be temporary or permanent), so you may wish to ask if there are options for storing your eggs or sperm.
Before each treatment your cancer specialist team may:
- Ask about any side effects you are experiencing
- Request a blood test to check if the medicine is affecting your blood cells
- Measure your height and weight to make sure you’re receiving the right dose of chemotherapy medicine.
- Request a scan to check how well the chemotherapy medicine is working
If you are feeling unwell
If you are experiencing:
- Sudden shortness of breath
- A fever (temperature above 38°C or under 36°C)
- Shivering episodes
You are to call 999 or attend your nearest A&E department
You are advised to call your hotline service if you are suffering from any of the following:
- Mouth ulcers that reduce the amount you can eat or drink
- Nausea that is not controlled with your anti-sickness medication
- Vomiting on more than one occasion
- A rash
- A swollen limb
- Worsening of pre-existing breathlessness
- Gum or nose bleeds or unusual bruising
- Constipation, cough or problems passing urine
- Come into contact with shingles or chicken pox
- Four or more bowel movements in 24hrs or diarrhoea
- You feel very unwell.
- Flu-like symptoms
Some of the potential side effects, such as diarrhoea, can be serious if not treated quickly. We will talk you through the possible side effects so you know what to look out for. If you experience any of these side effects or your symptoms get worse
If you are a solid tumour cancer or lymphoma patient call: 0783 114 7653 at any time. If the phone is not answered, please leave a message stating your name, hospital number and the problem you’re experiencing. A nurse will try to return your call as soon as possible.
If you are a Haematology patient (e.g. Leukaemia or Myeloma diagnosis) call:
- 020 8725 1680 Monday-Friday (excluding bank holidays) 09:00-17:00.
- At all other times call: 0208 672 1255 and ask for the haematology on call registrar.
We may give you steroid tablets if needed. If your symptoms get worse, you may need to come into hospital for treatment with steroids through a drip or other medicines that calm down the immune system. Research shows that having these stronger treatments does not stop your cancer from responding to immunotherapy.
In rare cases, we may need to stop your immunotherapy completely. Even if this happens, it does not always mean the treatment will stop working. This is because your immune system can continue to recognise and attack cancer cells for some time after the immunotherapy has stopped.
Resources
The IMPACT (I’M Prepared for Anti Cancer Treatment) video collection was designed by experts and patients at St George’s to help you prepare for starting treatment.
Cancer research UK “Your Treatment Record” – This booklet will help you to track your treatment and progress.
Macmillan Cancer Support – Types of immunotherapy treatment
Cancer Research UK – What-is-immunotherapy