Immunotherapy for Cancer Treatment in Delhi, India

Overview

Immunotherapy has emerged as a groundbreaking approach to the treatment of cancer. Unlike traditional methods such as chemotherapy and radiation, which directly target cancer cells, immunotherapy harnesses the power of the body's immune system to fight off the disease. This innovative treatment option activates and strengthens the immune response, enabling it to identify and destroy cancer cells more effectively.

With its ability to potentially offer long-lasting remission and improved quality of life for patients, immunotherapy has revolutionised cancer treatment. In this article, we will delve deeper into the concept of immunotherapy and its role in fighting cancer.

Types of Immunotherapy

There are several types of immunotherapy treatments available, each designed to target specific aspects of the immune response.

Let's take a look at some of the different types of immunotherapy available:

Immune checkpoint inhibitors: These drugs help to activate the immune system by blocking certain proteins that prevent immune cells from recognising and attacking cancer cells.
Monoclonal antibodies: These laboratory-made antibodies can be designed to specifically target proteins in cancer cells. By attaching to these proteins, monoclonal antibodies help the immune system recognise and destroy cancer cells more effectively.
Cancer vaccines: Unlike traditional vaccines, cancer vaccines are not used to prevent the disease but rather to stimulate an immune response against existing cancer cells. These vaccines can help boost the body's natural defences and improve outcomes for patients.
Adoptive T-cell therapy: This innovative treatment involves collecting T-cells (a type of immune cell) from a patient, modifying them in a laboratory to better recognise and attack cancer cells, and then reintroducing them back into the patient's body.
Immune system modulators: These drugs work by either enhancing or suppressing the immune system to improve its ability to fight cancer. They can help regulate the immune response and may be used in combination with other treatments.
Oncolytic virus therapy: This approach uses viruses that are modified in a laboratory to selectively infect and kill cancer cells while leaving healthy cells unharmed. Oncolytic virus therapy can also stimulate an immune response against cancer cells.

Who Needs Immunotherapy Treatment?

Immunotherapy treatment is particularly beneficial for individuals who have advanced-stage cancer or those who do not respond well to traditional treatments like chemotherapy or radiation therapy.

That being said, immunotherapy treatment is not just limited to cancer patients. It can be beneficial for a range of health conditions and diseases.

Here are some examples of who may benefit from immunotherapy:

Autoimmune diseases: Immunotherapy can help manage autoimmune diseases such as rheumatoid arthritis, lupus, and multiple sclerosis by modulating the immune system response.
Infectious diseases: Certain types of immunotherapy, such as monoclonal antibodies, can be used to treat infectious diseases like COVID-19, HIV/AIDS, and hepatitis.
Allergies: Immunotherapy is commonly used to treat allergies, especially those that do not respond well to traditional medications or avoidance strategies. It helps desensitise the immune system to specific allergens.
Chronic Inflammatory conditions: Conditions like Crohn's disease, ulcerative colitis, and psoriasis can be managed with immunotherapy drugs that target specific molecules involved in the inflammatory response.
Immunodeficiencies: Individuals with weakened immune systems due to genetic disorders or certain medical treatments may benefit from immunotherapy to enhance their immune response.
Asthma: Some forms of asthma can be treated with immunotherapy called omalizumab (Xolair), which reduces IgE antibodies responsible for allergic reactions.
Lymphoma and Leukemia: Immunotherapy has shown promising results in treating certain types of lymphomas and leukaemias by boosting the body's immune response against cancer cells.
Head and neck cancer: Immunotherapy drugs like pembrolizumab (Keytruda) have been approved for the treatment of recurrent or metastatic head and neck squamous cell carcinoma.
Kidney cancer: Immunotherapy has revolutionised the treatment of advanced kidney cancer with drugs like nivolumab (Opdivo) and ipilimumab (Yervoy), offering improved survival rates.

Who Should Not Consider Immunotherapy Treatment?

While immunotherapy has shown promising results in treating various types of cancers, it may not be suitable for everyone. It is important to understand that each individual's medical condition is unique, and certain factors may indicate that immunotherapy is not the ideal treatment option.

Let's explore who should not consider immunotherapy treatment.

Lack of adherence: Patients who struggle with adhering to treatment regimens or have difficulty attending regular appointments may not be suitable candidates for immunotherapy. Adherence is crucial for successful outcomes, and missing doses or follow-up visits can impact the effectiveness of the treatment.
Pregnancy before the start of immunotherapy treatment: If a patient is pregnant or planning to become pregnant, it is generally advised to avoid starting immunotherapy treatment. The potential effects on the developing fetus are not yet fully understood, so it is best to err on the side of caution.
Beta-blockers: Beta-blockers are commonly used medications for heart conditions and high blood pressure. Some studies suggest that the use of beta-blockers during immunotherapy may reduce its efficacy, although more research is needed in this area.
Certain age groups: While there isn't an upper age limit for receiving immunotherapy, older patients might have weaker immune systems or pre-existing conditions that could impact their ability to tolerate the treatment effectively.
Uncontrolled asthma: Immunotherapy may not be recommended for individuals with uncontrolled asthma as it can potentially worsen breathing difficulties. It is important to have asthma well-managed before considering immunotherapy.
Autoimmune diseases: Patients with autoimmune diseases such as rheumatoid arthritis, lupus, or multiple sclerosis may have overactive immune systems that could react negatively to immunotherapy treatment.
Malignancies: In some cases, individuals with other malignancies may not be suitable candidates for immunotherapy. The presence of certain cancers, such as active brain metastases or small-cell lung cancer, may affect treatment options.
Sublingual immunotherapy is contraindicated in severe asthma: Sublingual immunotherapy is a different form of allergy treatment that involves placing allergens under the tongue. However, it should be avoided in individuals with severe asthma due to potential risks and complications.

Diagnosis for Immunotherapy

To determine whether a patient is a good candidate for immunotherapy, certain diagnostic tests must be conducted.

Blood and urine tests: These tests can help detect certain substances or biomarkers in the body that may indicate the presence of cancer. For example, elevated levels of certain proteins or genetic mutations can provide valuable information.
Mammogram: While mammograms are primarily used for breast cancer screening, they can also help identify nodules in women due to their ability to capture detailed images of the chest area.
Ultrasound: This painless imaging technique uses sound waves to create images of internal organs and tissues. It can help visualise abnormalities in the body and aid in diagnosis.
Biopsy: A biopsy is often considered the gold standard for diagnosing cancer. During this procedure, a small sample of tissue is extracted from the affected area for further examination under a microscope. The sample may be taken using various techniques such as bronchoscopy, needle biopsy, or surgical biopsy.
Magnetic Resonance Imaging (MRI): MRI scans use powerful magnets and radio waves to produce detailed images of the body's tissues and organs. In some cases, MRI scans may be recommended to get a more accurate view of tumours and their potential impact on surrounding structures.

How Immunotherapy Works?

Immunotherapy has emerged as a promising treatment option for various types of cancer. This innovative approach utilises the body's immune system to target and destroy cancer cells.

Immunotherapy harnesses the power of the immune system: The immune system is our body's natural defence mechanism against infections and diseases. Immunotherapy for cancer treatment aims to enhance this response by stimulating the immune system to recognise and attack cancer cells.
Checkpoint inhibitors: One type of immunotherapy used in cancer treatment is known as checkpoint inhibitors. These medications work by blocking certain proteins, called checkpoints, that prevent immune cells from attacking cancer cells. By inhibiting these checkpoints, the body's immune system can effectively recognise and destroy cancer cells.
Boosting the immune response: Another approach to immunotherapy involves boosting the overall immune response. This can be achieved through therapies such as cytokines, which are signalling molecules that stimulate immune cell activity. By strengthening the immune response, these therapies help in fighting off cancer cells.
Personalised treatment: One of the significant advantages of immunotherapy is its potential for personalised treatment. As each person's immune system is unique, immunotherapy can be tailored to target specific characteristics of an individual's tumour. This personalised approach maximises the effectiveness of treatment and minimises side effects.
Combination therapies: In some cases, immunotherapy may be combined with other treatments, such as chemotherapy or targeted therapy. These combinations can enhance the overall effectiveness of treatment and improve outcomes for patients with cancer.

How to Prepare for Immunotherapy

Preparing for immunotherapy is an important step in the cancer treatment process. By taking certain measures, one can ensure that one is ready both physically and emotionally for this form of treatment.

Here are some guidelines to help prepare:

Consultation with medical team: Before starting immunotherapy, it is crucial to have a comprehensive discussion with one's medical team. They will explain the treatment plan, and potential side effects, and answer any questions or concerns one may have.
Understand the treatment: Taking the time to understand how immunotherapy works and what to expect during the treatment process, will help reduce anxiety and allow one to actively participate in one's care.
Address pre-existing conditions: It is essential to inform one's medical team about any pre-existing medical conditions, such as autoimmune disorders or allergies, as they can affect one's suitability for immunotherapy.
Quit smoking and limit alcohol: If a person smokes, quitting before starting immunotherapy is highly recommended. Smoking can impair the effectiveness of the treatment. Additionally, limiting alcohol consumption is important as it can weaken the immune system.
Stay hydrated: Drinking plenty of water helps flush toxins from a person's body and keeps their immune system functioning optimally. It is essential to stay hydrated before, during, and after immunotherapy.
Follow dietary guidelines: A balanced diet plays a vital role in supporting a person's immune system. Incorporate a variety of fruits, vegetables, whole grains, and lean proteins into meals. Consider consulting a nutritionist for personalised advice.
Arrange transportation: Immunotherapy treatments may cause fatigue or flu-like symptoms that can make driving difficult. It's a good idea to arrange transportation to and from appointments to ensure one's safety and comfort.
Emotional support: Going through cancer treatment can be emotionally challenging. Seek support from loved ones, join support groups, or consider speaking with a therapist who specialises in oncology.
Pre-treatment evaluations: Medical teams will conduct various evaluations, such as blood tests and imaging scans, to assess a person's overall health before starting immunotherapy. These evaluations help determine the best course of action for specific needs.

Possible Complications and Side Effects After Immunotherapy

While immunotherapy offers hope and promise, like any treatment, it can come with its own set of complications and side effects.

Here are some common side effects associated with immunotherapy for cancer treatment:

Infusion-related reactions: Some individuals may experience allergic reactions during or shortly after receiving an infusion of immunotherapy medication.
Diarrhoea or colitis: Inflammation of the digestive tract can lead to symptoms like diarrhoea, abdominal pain, and blood in the stool.
Flu-like symptoms: Fever, chills, and body aches resembling flu-like symptoms can occur after immunotherapy treatment.
Loss of appetite: Some patients may experience a decrease in appetite, which can lead to weight loss.
Mouth sores: Painful sores or ulcers in the mouth and throat can make eating and drinking uncomfortable.
Bone or muscle pain: Immunotherapy can cause pain in the bones or muscles, similar to how one might feel after a strenuous workout.
Weight gain from extra fluids: Retention of fluids can lead to temporary weight gain.
Skin rash: Skin reactions, such as rashes or itching, may occur during immunotherapy treatment.
Fatigue: Feeling drained of energy is a common side effect associated with immunotherapy.
Headaches: Some individuals may experience headaches as a result of immunotherapy treatment.
Swelling: Swelling in different parts of the body, including hands, feet, ankles, or face, can occur due to fluid retention.
Heart palpitations: Sensations of a rapid or irregular heartbeat may be experienced by some individuals undergoing immunotherapy.
Stuffy head: Nasal congestion or a "stuffy" feeling in the head can occur as a side effect.
Shortness of breath or pneumonitis: Inflammation in the lungs can lead to symptoms like shortness of breath or coughing.

Recovery and Care After Immunotherapy

As we continue to make strides in medical advancements, it's crucial to understand the importance of recovery and care after undergoing immunotherapy treatment. Let us explore the necessary steps for a successful recovery and learn how to navigate through this journey.

After undergoing immunotherapy for cancer treatment, it is important to take proper care of one's body to aid in the recovery process. Here are some key steps to follow:

Rest and hydration: Rest is crucial for allowing the body to heal and recover. Additionally, staying hydrated is important for maintaining overall health and helping the body function optimally.
Monitor side effects: Immunotherapy treatment can sometimes cause side effects. It's important to monitor any changes in the body and promptly report them to the medical team. This way, they can provide appropriate management strategies and ensure the individual's well-being.
Follow medication instructions: Be sure to follow all medication instructions provided by the medical team.
Nutrition: Eating a healthy diet is essential for supporting the immune system and aiding in the healing process.

Focus on consuming a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats.
Include foods rich in antioxidants, such as berries, citrus fruits, spinach, and nuts.
Avoid processed foods, sugary drinks, and excessive salt intake.
Consult a registered dietitian for personalised nutrition advice.

Avoid exposure to infections: During recovery, it is important to minimise the risk of infections. Avoid close contact with individuals who are sick, wash hands frequently with soap and water, use hand sanitisers when necessary, and maintain good personal hygiene practices.
Sun protection: It is important to protect one's skin from harmful UV rays by wearing sunscreen with at least SPF 30, seeking shade during peak sunlight hours, wearing protective clothing (such as wide-brimmed hats and long-sleeved shirts), and using sunglasses that block UVA and UVB rays.
Physical activity: Engaging in regular physical activity can help improve overall well-being and aid in the recovery process. Consult the medical team for guidance on appropriate exercise routines based on individual needs and capabilities.
Emotional support: Dealing with cancer and its treatment can be emotionally challenging. Seeking support from family, friends, or support groups can help cope with any feelings of anxiety, stress, or depression that may arise during this time.
Follow-up care: Regular follow-up appointments with the medical team are crucial to monitor a person's progress and address any ongoing concerns. Making sure to attend these appointments and discuss any new symptoms or questions is important.
Monitor blood counts: Immunotherapy can sometimes affect blood cell counts. The medical team will closely monitor these levels through regular blood tests. Individuals should notify the team if they experience any unusual bleeding, bruising, or persistent fatigue.

With its ability to boost the body's immune response against cancer cells, immunotherapy offers new hope for those affected by this disease. As research continues advancements in immunotherapy develop, we can expect even more effective treatments and improved survival rates.

For someone who has been diagnosed with cancer, it is vital to explore all available treatment options. Speaking with the oncologist about the potential benefits of immunotherapy and whether it may be a suitable option for a person is an important step. Remember, early detection and intervention are crucial in combating this disease.

Frequently Asked Questions

1. Are there any alternative therapies to complement immunotherapy?

Complementary therapies can be used alongside immunotherapy to support the immune system and enhance its effectiveness. These may include acupuncture, yoga, meditation, and dietary changes.

2. Can immunotherapy replace traditional cancer treatments?

Whether immunotherapy can completely replace traditional treatments depends on various factors such as the type and stage of cancer, as well as individual patient characteristics. In many cases, a combination of treatments may be recommended for the best outcome.

3. What are the costs associated with immunotherapy?

The cost of immunotherapy can vary depending on several factors, including the specific type of therapy, the duration of treatment, and the region where it is administered.

4. How is immunotherapy different from chemotherapy and radiation?

Unlike chemotherapy and radiation, which directly target cancer cells, immunotherapy stimulates the body's immune system to recognize and attack cancer cells. Immunotherapy is also generally well-tolerated with fewer severe side effects. Additionally, immunotherapy has the potential to provide long-lasting benefits.

5. Can immunotherapy be used in combination with other cancer treatments?

Yes, immunotherapy can be used in combination with other cancer treatments such as chemotherapy, radiation, and targeted therapy.

6. What is the typical duration of immunotherapy treatment?

The duration of immunotherapy treatment varies depending on several factors, including the type and stage of cancer, as well as individual patient response. Some patients may undergo immunotherapy for a few months, while others may continue treatment for several years.

7. Can immunotherapy be used as a preventive measure for cancer?

Currently, immunotherapy is primarily used as a treatment option for diagnosed cancers. However, ongoing research is exploring the potential of using immunotherapy as a preventive measure in individuals at high risk for developing certain types of cancer, such as those with genetic mutations or pre-cancerous conditions.