REALITIES about cancer; no definite cure as yet, the real causes are not known, with the probable exception of cancer of the cervix, which epidemiological data show to be due to the human papilloma virus.
Of all the advances in cancer treatment over the last few decades, perhaps none has generated more excitement than immunotherapy; which in simpler terms include treatment that would harness or utilize our own body’s immune system to fight and hopefully eradicate cancer cells. In aggressive types including melanoma, lymphoma and lung cancer, reports have come in of immunotherapy shrinking and even eliminating tumors in some patients who have exhausted other treatment modalities.
But then, another stark and sad reality is the fact that no cancer treatment comes without side effects, and immunotherapy is not an exception to this rule. Doctors who are used to a fairly predictable set of side effects from chemotherapy drugs such as nausea, hair loss, all sorts of opportunistic infections; are suddenly seeing also a wide range of unfamiliar symptoms that arise when the immune system is stimulated, challenged and ramped up to fight cancer.
The most widely used type of immunotherapy currently used by oncologists- cancer specialists- is a class of drugs called “ immune checkpoint inhibitors” which are molecules produced by the body cells, and also by the cancer cells themselves that serve as a stop sign for the immune system. Check point inhibitors block this stop signal, thus liberating or freeing the immune system to attack.
In a newer type of the so-called personalized immunotherapy also known as adoptive cell transfer, immune cells are first removed from a person’s bloodstream. Then scientists or experts in the field of genetic engineering, will manipulate and modify them in the laboratory to recognize a specific type of cancer. Finally, millions of these improved cells are infused back into the bloodstream of the patient to hunt down the cancer cell. The good news is that a type of adoptive cell transfer called CAR-T cell therapy has recently been approved for some types of cancer particularly blood malignancies like leukemia.
The parts of the body most commonly affected by the immune checkpoint inhibitors are the skin, intestines, liver, lungs and endocrine glands. CAR-T cell therapy works differently from immune checkpoint inhibitors. The most common side effect, seen to date, is a whole-body immune system over-reaction called cytokine release syndrome with accompanying neurologic signs and symptoms like seizures and memory loss.
In general, side effects from immunotherapy are treated similarly regardless of where in the body they occur. If the side effects are mild, treatment continues, with simultaneous intake of corticosteroids, which have the ability to “calm down” or temper the immune system, aside from reducing inflammation. If more serious side effects arise, immunotherapy may be stopped for a while. Or a stronger drug to calm the immune system may be used, such as those who have received an organ transplant.
True enough, the use of immunotherapy is still in its infancy, so to speak, and obviously more grounds need to be dug up to improve the system, making it more specific against a particular cell type undergoing malignancy, and hopefully effect a more definitive cure, with relatively less adverse side effects. Meanwhile, while cancer, like the pincer of the crab continues to ravage mankind, the race to conquer it is also relentless. Hope springs eternal.