One of the major benefits of immunotherapy is its ability to more accurately & specifically target cancer cells. This means less collateral damage to healthy tissues, like what we see with chemotherapy & radiation therapy. Improved targeting of cancer cells means less side effects, less toxicities.
However, immunotherapy is not without side effects. In fact, you may not even know that immunotherapy has some significant toxicities as well.
With more patients treated with immunotherapy every year, it’s critical that you understand the basics of immunotherapy side effects & what they mean for our plans of care.
Immunotherapy causes side effects, but not for the reason you think
Many side effects associated with cancer treatments are due to collateral damage of normally functioning tissues. For example, chemotherapy damages cancer cells but also damages healthy cells like nervous tissue, mucous membranes, & other rapidly dividing cells. Radiation therapy passes through healthy tissues on its way to reach cancer cells, thereby damaging skin, muscle, bone, heart, lung, & other tissues.
Immunotherapy causes side effects largely because of its effects on the immune system. Its job is to activate, harness, or supercharge the immune system to better fight cancer cells.
Immunotherapy can often go overboard with this. Sometimes immunotherapy ramps up the immune system so much that it can also turn against healthy cells. It’s like immunotherapy is doing its job with such enthusiasm & vigor, that it starts to get trigger happy & damage non-cancerous body cells.
Side effects of Immunotherapy
What are the side effects of immunotherapy? To start us off with an old physical therapy adage, it depends.
It depends on the type of immunotherapy a person is undergoing, as well as a variety of other factors. For example, many patients will undergo other treatments in addition to immunotherapy for their cancer, such as chemotherapy & radiation.
So a patient can experience side effects/toxicities from their chemotherapy, radiation, & also immunotherapy.
There are 4 main categories of immunotherapy toxicities.
Four main categories of immunotherapy toxicities include dermatologic, gastrointestinal, endocrine, & neurological toxicities.
Dermatological toxicities are the most common side effects associated with immunotherapy.
While not as common, neurological toxicities can be very severe, even lethal in some cases.
For more information on CAR T-Cell Therapy side effects, listen to my interview with Dr. Adam Matichak in Episode 221.
Monitor for these side effects & toxicities.
Some of these side effects may sneak by you because they don’t seem super problematic at first. For example, nausea & diarrhea are common gastrointestinal toxicities associated with immunotherapy that we also see with chemotherapy. However, as with any of our oncology patients, these must be taken seriously when they first manifest. This diarrhea could be the result of internal inflammation, a sign of more severe toxicity than we initially realize.
For more on immunotherapy
My brand new courses with MedBridge are set to be released this winter, including my Immunotherapy course! To be the first to know when they drop & save up to $150 on your subscription, go to TheOncoPT.com/medbridge & use affiliate code ONCOPT when you sign up or renew your membership!
I also encourage you to check out these resources for more on immunotherapy side effects:
- NCI – Immunotherapy Side Effects: https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/side-effects#:~:text=Immunotherapy%20can%20cause%20side%20effects,people%20have%20different%20side%20effects.
- New Anticancer Immunotherapies: Implications for Physical Therapy – DOI: 10.1097/01.REO.0000000000000144
Until next time, this is Elise with TheOncoPT. And remember you are exactly the physical therapist that your patients with cancer need. So let’s get to work.