Skip to main content

The New Super Heros of Cancer Treatment - Immunotherapy


There have been many advances in cancer treatments since I started working in the area of cancer care, nearly 30 years ago.  Back then, patients with metastatic colon cancer were treated with a simple (but reasonably ineffective) chemotherapy regimen and the average life expectancy was 6 months.  Now the treatment is more complex, uses new medications, and the life expectancy is 5-fold!

So, what has changed.  Essentially, many of the advances made over the last 10-15 years have come down to a new class of medications called immunotherapy.

Immunotherapy, or the use of medications to modify the body’s own immune system to treat illness, is such an exciting development.  Immunotherapy is not only being used to treat cancer, but many other illnesses as well, such as multiple sclerosis, Crohn's disease and rheumatoid arthritis.

The body’s immune system is truly remarkable.  A finely tuned, interconnected "ecosystem" of hundreds or maybe even thousands of parts. The immune system is designed to recognise foreign proteins on the surface of cells such as bacteria, viruses and fungi and once activated kill and remove the unwanted guest.  It is also designed to recognise the body’s own cells that have gone rogue, such as cancer cells.  

Cancer cells can be tricky little devils though, and they develop ways to evade being detected.  Because of this they can continue to grow unchecked by the body’s immune system.

Enter immunotherapy.  Immunotherapy modifies the body’s immune system boosting its ability to detect and kill off cancer cells through a number of different mechanisms. 

To be honest though, we have known for a long time that the immune system was important in cancer.  To start with, some patients with "immune sensitive" cancers such as melanoma and renal cell cancer have about a 5% spontaneous remission rate.  That is, the cancer goes away with NO treatment.  Also, earlier on, use of immune therapies such as interferon (a protein made and released naturally by the immune system) also improved the outcome of patients with theses cancers, though when given at high doses by infusion its use was limited because it was too toxic.

What has changed is both our understanding of the immune system, and the availability of medications which are able to harness its potential, effectively with greater safety.

Immunotherapy is being used widely to treat cancer.  The list of cancers which these medications are being used in successfully is growing monthly.  With increased use we are learning more about how to best use these medications, and how to manage their unique side-effects.  The side-effects, probably not surprisingly, predominantly affect the immune system and result in inflammatory responses in organs such as the gut, liver and skin (though pretty much any part of the body can be affected). These immune responses can be unpredictable, sometimes very severe and may even occur long after the medication is stopped.  It means these medications should only be given and managed by health professionals experienced in their use.

It is an amazing time to be involved in cancer care.  At chemo@home we feel very privileged to be able to administer immunotherapy to patients in their own homes. 

 Julie
Labels:

Comments

Post a Comment

Popular posts from this blog

Is chemo in the home a “pink batts disaster” in the making?

There are few of us who escaped the news coverage of what happened when the Australian  government wanted to boost the economy back in 2009, by funding the installation of “pink batts” into homes. Tragically, four young men died, from what was found to be a lack of oversight by the government resulting in massive system failures.  Simply put, the government provided the money, but did not ensure that there was the appropriate legislation, regulation or training available to make it safe.  And where there is money to be made, there will always be some who will want to profit from it.  Some of these people will have no regard for the safety of the product they are supplying, some will be ignorant of what is needed to make it safe.  The result is the same. When people ask me, “is giving chemo in the home safe?”, I find it difficult to answer.  To be honest the answer is both yes and no. I have worked managing a “home chemo” service for just under 20 years.  I’ve developed a
Post a Comment
Read more

So, you want a second opinion??

Recently I had an abnormal test result come back.   I’ll withhold the details, so those who are squeamish don’t stop reading.   Suffice to say it is a test that only women need to have done, it is done as an early detection test for cancer, and no woman enjoys it. The abnormal result is not one you want, and means you need further tests to confirm the findings, to work out if any treatment is needed and importantly to make sure there is no cancer.   So, my fabulous GP, Penny, did a referral and off I toddled to a surgeon for more tests. In the surgeon’s office the additional tests undertaken where inconclusive, that is, there was nothing bad found but he also couldn’t see all the bits he needed to be able to see to say that everything was definitely OK.   His recommendation at this stage was a very reasonable one, and one that many surgeons in the same position would have given.   The recommendation was to do a “biopsy’ and send it off to the lab for further analysis.   To ca
Post a Comment
Read more

In whose best interests?

Recent media reports have highlighted the somewhat complex and hidden costs associated with health care.   The Four Corners report “Mind the Gap” focused on out-of-pocket expenses and hidden fees from surgeons.   Whilst the ABC medical report on “Secret Pacemaker Payments Boosting Private Hospital Coffers” focused on the hidden rebates hospitals receive for using various medical devices. The two issues are separate, but very much related.  Both point to the lack of transparency of financial interactions between specialists, hospitals and a variety of other stakeholders in the health care market. The first media report highlighted the issue around “informed financial consent”.   It is mandatory for all patients receiving care from a specialist in a private hospital to sign a document stating that they agree to the charges related to the procedure or care for which they are being admitted.   But how “informed” is the financial consent?   At a vulnerable time, how likely is a pat
Post a Comment
Read more