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Over the past few decades, there have been major advancements in cancer treatment, with more focused and less harmful options becoming accessible, with chemotherapy and immunotherapy being the two most popular treatments. Although both of these are used to treat cancer, they differ in their mode of action and adverse effects.
What is immunotherapy?
In an interview with HT Lifestyle, Dr Raman Narang, senior consultant – medical oncologist at Andromeda Cancer Hospital in Sonipat, explains in simple terms that a type of cancer treatment – called immunotherapy – works by strengthening the body’s defences against cancer cells. Several forms of immunotherapy exist, such as:
- Checkpoint inhibitors: Drug that prevents cancer cells from using “shut down” signals to evade the immune system.
- CAR-T cell therapy: An intervention that enhances the ability of the patient’s immune system to recognize and fight cancer.
- Cancer Vaccines: Designed to produce an immune response against specific proteins associated with cancer.
Mechanism of Action: Immunotherapy vs. Chemotherapy
According to Dr. Raman Narang, immunotherapy and chemotherapy differ most in the way they target cancer –
- Chemotherapy: Chemotherapy targets cancer cells that grow rapidly. Because they disrupt cell division, these drugs are cytotoxic, meaning they cause cell death. It can destroy rapidly dividing healthy and malignant cells found in the blood, intestines and skin. So its negative effects can be more severe and widespread.
- Immunotherapy: This treatment stimulates the body’s immune system to identify and fight cancer rather than attacking cancer cells directly. Immunotherapy works by stimulating immune cells such as T-cells to help them identify cancer cells, which often escape the immune system’s recognition. This approach is more targeted because it boosts the immune system’s natural response to fight only cancer, leaving healthy cells largely unaffected.
Side Effects: Immunotherapy vs. Chemotherapy
Dr Pooja Babbar, Medical Oncology Consultant at CK Birla Hospital, Gurugram, shared her expertise and said that due to the difference in the mechanism of action of these treatments, patients may face different side effects. She explained in detail –
- Side effects of chemotherapy: Side effects are more common with chemotherapy because it affects all rapidly dividing cells. Common side effects include:
– tiredness or weakness
– Hair loss
– Vomiting and nausea.
– Mouth ulcers – Infection
– Anemia
The side effects of chemotherapy can be intense, but they often subside after treatment ends when healthy cells recover.
- Side effects of immunotherapy: Although immunotherapy is generally more tolerable than chemotherapy, it still has some drawbacks. **Immune-related adverse events (irAEs) are side effects that are often associated with immune system activity because it stimulates the immune system. Commonly occurring adverse effects include:
– Fatigue Immunotherapy can make you tired, just as chemotherapy does, although this doesn’t usually last as long.
– Skin reactions: many patients develop rashes, itching or other skin problems associated with activation of the immune system.
– Inflammation: As the immune system grows stronger, it can attack normal tissues, resulting in inflammation of organs such as the liver (hepatitis), lungs (pneumonitis), intestine (colitis) and endocrine glands (thyroiditis).
– Fever and chills: When the immune system activates, people can have flu-like symptoms, such as body aches
– Autoimmune reactions: In rare cases, the immune system can overreact, attacking healthy organs and tissues, leading to autoimmune diseases.
Side effects of immunotherapy can occur weeks or months after treatment begins and are usually latent. They can usually be treated with corticosteroids or other immune-suppressing drugs, but can sometimes become chronic.
Similarities
1. Goal: Both aim to increase the patient’s life expectancy while destroying cancer cells.
2. Combination: It is often used in combination with radiation or surgery, among other treatments.
3. Monitoring: Both treatments require regular monitoring and follow-up.
How should one make a decision?
Dr Pooja Babbar highlights that choosing between immunotherapy and chemotherapy requires careful consideration in consultation with a physician. Important elements include –
- Type and stage of cancer: Specific treatment plans are recommended based on how a cancer responds to chemotherapy and immunotherapy.
- Molecular Marker: Some tumors have markers in their DNA that indicate they will respond better to immunotherapy.
- Patient preferences: Taking into account the patient’s lifestyle, taste and level of tolerance to side effects.
Dr. Pooja Babbar concludes, “Both immunotherapy and chemotherapy have advantages and disadvantages. A customized approach to therapy should be adopted, taking into account the unique characteristics of the cancer as well as the patient’s preferences and general health. With continued breakthroughs in this field, patients now have more options than ever to fight cancer effectively.”
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor for any questions about any medical condition.
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