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If you or a loved one is facing cancer treatment, your doctors may recommend immunotherapy. This innovative approach uses the body’s natural defenses to fight cancer and has shown remarkable results for some people. We are here to help answer your questions and offer support.
Our team is here to listen and support you.
The power of immunotherapy lies in its ability to help your immune system recognise and fight cancer cells more effectively. It can be used on its own or alongside other treatments, often when cancer hasn’t responded to initial therapies or has returned. In some cases, it may be included as part of the first treatment plan.
Checkpoint inhibitors, a type of immunotherapy, have shown great success for some people, though they don’t work for everyone.
In Australia, immunotherapy has primarily been used to treat cancers such as head and neck, bladder, kidney, melanoma, leukaemia, liver, lung, and lymphoma.
The immune system is a network of cells, chemicals, tissues and organs. It includes the lymph nodes, spleen, thymus, tonsils and bone marrow, as well as white blood cells known as lymphocytes. Together, they act as a defence team, protecting us against infections and abnormal cells like cancer cells.
When a germ enters your body or a cell becomes abnormal, the immune system usually detects it and takes action to prevent harm. This is called an immune response.
But sometimes cancer cells can find ways to evade detection, allowing it to grow unchecked.
They may do this by creating barriers, called “checkpoints,” that prevent the immune system from recognising them, or by mutating over time to stay hidden from detection.
Immunotherapy for cancer aims to overcome these challenges and help the immune system recognise and attack cancerous cells more effectively.
Drugs for immunotherapy help boost the immune system to work better against cancer or remove the barriers that stop your immune system from identifying and attacking cancer. There are several types of immunotherapy, each working in its own unique way, including:
Cancer can sometimes use “checkpoints” on T-cells to hide from the immune system. Checkpoint inhibitors are drugs for immunotherapy that block these proteins, allowing T-cells to recognise and destroy cancer cells. These are the most widely used form of immunotherapy for cancer, and some are subsidised under the Pharmaceutical Benefits Scheme (PBS), making them more accessible for eligible patients.
Immune stimulant therapies aim to kickstart the immune system, helping it to reactivate and attack cancer cells more effectively
Chimeric antigen receptor (CAR) T-cell therapy improves the natural cancer-fighting ability of T-cells. This involves collecting T-cells from your blood, modifying them to better detect cancer, and returning them to your bloodstream through an intravenous drip.
This innovative treatment uses viruses that specifically target and infect cancer cells, causing them to die while also stimulating the immune system to fight the cancer. It is sometimes used for melanoma, and ongoing research is testing its effectiveness for brain cancer and some other cancers.
Checkpoint inhibitors are prescribed by a medical oncologist or haematologist and are given as a liquid through an intravenous drip. Depending on your situation, you may receive these medications alongside chemotherapy or targeted therapy drugs.
Immunotherapy is usually given as an outpatient treatment, meaning you visit the hospital or treatment centre for the infusion and then go home.
It is typically given in cycles with rest periods of 2 to 6 weeks between treatments. The frequency and duration depend on factors such as the type and stage of cancer, how your cancer responds, and any side effects you experience.
It’s important to know that checkpoint inhibitors may take weeks or even months to show results, as they depend on your immune system and the cancer’s response. In some cases, the benefits can continue even after treatment ends, but this can vary from person to person.
Side effects of immunotherapy can vary based on the treatment and how your body responds. Common side effects include fatigue, skin rashes, diarrhea, abdominal pain, dry eyes, weight changes, and joint pain. Less common effects may include headaches, vision changes, shortness of breath, fainting, yellowing of the eyes, thyroid issues, and muscle pain, among others.
Because immunotherapy works differently to other treatments, you need to work closely with your care team to monitor side effects and cancer response. Reporting new or worsening symptoms early can prevent serious issues.
Side effects are graded on a scale of 1–4, and your doctor will guide you on how to manage mild to moderate symptoms. Severe side effects may require steroids or hospitalisation, and in some cases, treatment may need to be stopped. In these cases, you may still benefit from the immunotherapy, as the treatment you have done will have trained your immune system to recognise cancer cells.
Because the immune system has a “memory,” immunotherapy can continue working long after treatment ends. As a result, side effects may also appear months or even years later.
Immunotherapy and chemotherapy are both cancer treatments, but they work in different ways. Chemotherapy targets and kills cancer cells directly, while immunotherapy helps strengthen the body’s immune system to fight cancer.
Checkpoint inhibitors can be expensive, often costing thousands of dollars per dose. However, the Australian Government covers most of the cost for certain drugs and cancer types through the Pharmaceutical Benefits Scheme (PBS). If a drug isn’t listed on the PBS, you may be able to access checkpoint inhibitors through clinical trials or, in some cases, through compassionate access or cost-share programs offered by the pharmaceutical company.
Even if immunotherapy is recommended as a treatment, it’s difficult to predict how well it will work. Its success varies depending on the type of cancer and individual factors. You can ask your specialist about the treatment’s success rate for people with the same type of cancer as you.
Immunotherapy with checkpoint inhibitors has worked for some people, but it doesn’t help everyone. It’s available for cancers like bladder, head and neck, lymphoma, kidney, liver, lung, melanoma, and Merkel cell carcinoma.
While most patients who receive checkpoint inhibitors have advanced cancer, it’s becoming an option for some early-stage cancers as well.
Success rates vary, so it’s hard to predict if it will work for you. To decide if immunotherapy is an option for you, your doctor will consider factors like the type and stage of cancer, your treatment history, and overall health. To access immunotherapy, talk with your specialist.
According to a study published in 2022, Audiovestibular irAEs (Immune related adverse events are a rare complication of immunotherapy. Suspicion for symptoms including hearing loss, tinnitus, and/or vertigo should prompt an expedient referral to the otolaryngologist for evaluation, as symptoms may improve.
(Audiovestibular Toxicity Secondary to Immunotherapy: Case Series and Literature Review. J Immunother Precis Oncol. 2022 Feb 3;5(1):2–6. )
Further to this, a review article published in the Polish Journal of Otolaryngology, Volume: 78, No.: 3, 2024; Published: 30-06-2024, stated that while hearing impacts were noted as a side effect, most of the cases of ICI-related hearing loss presented in the literature were reversible.
In summary, whilst the priority of oncological treatment is to cure cancer, Immunotherapy may potentially impact hearing. This is treatable in many cases so people experiencing this should report their concerns to their treating team.
