Today is World Cancer Day, which is celebrated to raise awareness surrounding this disease in its many forms, their effects, as well as treatments and recovery.
Thankfully, cancer-fighting technology has improved in leaps and bounds in recent years. And one particular advancement that has proven to be particularly effective is immunotherapy.
Immunotherapy is unique in that it uses the body’s own immune system to fight cancer. According to Dr Hafizah Zaharah Ahmad, consultant clinical oncologist at a medical centre in Kuala Lumpur, the immune system is like the police force for people’s bodies – it is designed to protect the body against infection, illness and disease.
It also protects the body from the development of cancer, identifying and destroying faulty or mutated cells before they become a significant threat.
Cancer, however, can develop when the immune system is not strong enough to kill cancerous cells, or when these cells – which have the ability to resemble normal cells – “hide” from the immune system.
What makes immunotherapy different?
In a nutshell, immunotherapy can boost or change how one’s immune system works so it recognises and destroys cancer cells, Hafizah explained.
Certain cancer cells can apply “brakes” on immune cells so that the immune system does not attack them. Through immunotherapy, checkpoint inhibitors remove these “brakes”, allowing the body to recognise and attack these dangerous cells.
Immunotherapy can be used to treat various cancers including non-small-cell lung cancer, triple-negative breast cancer, head and neck cancer, cervical cancer, gastric cancer, oesophageal cancer, bladder cancer, melanoma, liver cancer, renal cell carcinoma, endometrial cancer, and colon cancer.
Immunotherapy agents are given as an infusion into a vein (IV) typically once every two, three or four weeks. This treatment is given by itself or in combination with targeted therapy or chemotherapy.
For advanced-stage cancer, immunotherapy treatment is generally given for two years, with close monitoring, Hafizah said.
Staying on the right track
Although immunotherapy may seem like the light at the end of the tunnel for cancer patients, Hafizah warned that not all cancers will respond well to it.
Before embarking on immunotherapy, patients have to first undergo specific biomarker tests such as the PD-L1 test, which will need to be carried out on the cancer specimen.
Hafizah shared her experience with patients who have responded well to immunotherapy, including one with advanced malignant melanoma (a type of skin cancer) that had spread and was resistant to chemotherapy.
After undergoing immunotherapy, this patient has remained in complete remission until today.
“Another patient undergoing immunotherapy treatment in my care has stage-4 colon cancer. A biomarker test was done on the cancer specimen, and he was confirmed to be suitable for immunotherapy.
“His latest imaging showed near complete resolution of the cancer,” she revealed, stressing, however, that immunotherapy is not necessarily suitable for everyone, and it will depend on the outcome of biomarker tests.
Side effects and symptoms
As with any form of treatment, immunotherapy is generally well tolerated, but side effects exist such as feeling tired, skin rash, or muscle or joint pain, Hafizah said.
“Although rare, some patients could also exhibit allergic reactions including dizziness, fast heart rate, face swelling, or breathing problems.
“Autoimmune reactions that could cause serious problems may occur in the lungs, intestines, liver, hormone-making glands, kidneys, skin, or other organs.”
Symptoms to look out for include diarrhoea, severe abdominal pain, worsening cough, shortness of breath or difficulty in breathing.
Each patient will have his or her own cancer journeys, but Hafizah provided assurance that cancer research has pushed treatment to new frontiers, leading to higher control and cure rates.