OSF Oncologist Explains How Immunotherapy Helps Fight Cancer
Dr. Manpreet Sandhu describes how treatment draws on the immune system and why a patient’s health, cancer stage and preferences help guide recommendations.
When you hear about cancer care, chemotherapy, radiation and surgery are often the terms you hear the most. But your oncologist might also recommend immunotherapy. What does my immune system have to do with all this? Can this treatment really help me? Manpreet Sandhu, MD, an OSF HealthCare oncologist, says like any treatment, immunotherapy has a lot of “it depends.” As in, it depends on each patient’s wants and needs. But, she says it’s worth approaching immunotherapy with an open mind.
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Immunotherapy 101
Dr. Sandhu says immunotherapy is systemic, meaning it targets your whole body. It uses your immune system to fight the cancer. It can treat many cancers, she says.
“It utilizes your body’s T cells [also called lymphocytes, white blood cells or immune cells] to identify certain cancer markers and antigens and attack them,” Dr. Sandhu says.
In deciding whether to pursue immunotherapy, a doctor would consider how advanced the cancer is. If the disease is far along, Dr. Sandhu says she might recommend chemotherapy and immunotherapy at the same time because chemotherapy works quicker.
“Chemotherapy for the initial ‘slam’ to the cancer and immunotherapy more for maintenance,” she says, adding that these therapies together don’t always mean side effects will be doubled. She says most of the well-known side effects, like losing your hair, come from chemotherapy.
“With immunotherapy, if people are going to get the rare, more serious side effects, it’s usually after weeks or months,” Dr. Sandhu says. Those rare side effects include rash, diarrhea or pain in the abdomen. But regardless of the road ahead, Dr. Sandhu says providers always educate the patient about why they’re recommending a treatment, what to expect and what unique health concerns to consider (for example, modifying treatment if a person has reduced kidney function).
Dr. Sandhu says the immunotherapy medicine is typically delivered through an IV, but doing so via a shot is an emerging option. The sessions usually last 30 to 60 minutes and are every three to four weeks for one to two years.
Speaking of stage four cancer patients undergoing immunotherapy: “Most patients will improve their lifespan. The cancer is treated and controlled for longer,” Dr. Sandhu says. “There are maybe about 5% of cases where there’s a complete response. For five years, we’re not really seeing the cancer.”
Have the conversation
Dr. Sandhu says she’s seen late-stage cancer patients be wary of trying new treatment. She says their mindset is: if my disease is terminal, why bother?
“If immunotherapy is brought as an option by the physician, at least consider that,” Dr. Sandhu urges. “Even in people with poor performance status – elderly or people with multiple medical problems – immunotherapy is generally a very well-tolerated treatment.”
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