Guide to Immunotherapy And Cancer Patients
Learn how immunotherapy fights cancer by empowering your immune system. Discover types, treatment process, side effects, and who can benefit.
Written by Dr. Dhankecha Mayank Dineshbhai
Reviewed by Dr. Vasanthasree Nair MBBS
Last updated on 25th Sep, 2025
Introduction
A cancer diagnosis often brings to mind treatments like chemotherapy and radiation—therapies designed to directly attack cancer cells. But what if you could harness the power of your body’s own sophisticated defence network to fight the disease? This is the promise of immunotherapy, a revolutionary approach that has transformed the landscape of cancer care. Unlike traditional methods, immunotherapy works by empowering your immune system to recognise and destroy cancer cells more effectively. For many patients, it has offered new hope, especially in cases where other treatments have stopped working. This guide is designed to demystify immunotherapy for cancer patients and their loved ones. We will break down how it works, explore the different types available, discuss what to expect during treatment, and address common questions about its benefits and side effects. Our goal is to provide you with the knowledge you need to have informed conversations with your healthcare team.
What is Immunotherapy? Unleashing Your Body's Natural Defence System
Immunotherapy, sometimes called biologic therapy, is a type of cancer treatment that uses substances made by the body or in a laboratory to boost or restore the immune system's natural ability to fight cancer. Think of your immune system as a highly trained security force. It constantly patrols your body, identifying and eliminating threats like viruses and bacteria. However, cancer cells are clever; they can develop ways to hide from these security patrols or even shut them down. Immunotherapy intervenes by either making the cancer cells more visible to the immune system or by reactivating the immune cells that the cancer has deactivated.
The Immune System vs. Cancer: Why It Needs Help
Your immune system is equipped with T-cells, a type of white blood cell that acts as a primary soldier. Normally, T-cells identify abnormal cells and attack them. Cancer cells, however, can exploit "checkpoints" on T-cells—essentially, off-switches that prevent the immune system from attacking healthy cells. By producing specific proteins, cancer cells can activate these checkpoints, tricking the T-cells into standing down. This is a primary reason why the immune system often fails to control cancer on its own. Immunotherapy drugs, particularly checkpoint inhibitors, are designed to block this interaction, allowing the T-cells to see the cancer and attack.
How is Immunotherapy Different from Chemo?
This is a crucial distinction for patients to understand. Chemotherapy works by killing fast-dividing cells, which includes cancer cells but also affects healthy cells like those in your hair follicles and digestive tract, leading to well-known side effects like hair loss and nausea. Immunotherapy does not directly target the cancer cell. Instead, it targets the immune system's response. It's more like a strategic command than a broad-spectrum attack. Because of this, the side effects of immunotherapy cancer treatments are different, often related to inflammation as the revved-up immune system can sometimes attack normal organs.
Consult an Oncologist for the best advice
Main Types of Immunotherapy for Cancer
There isn't just one kind of immunotherapy. It's a broad category with several approaches, each working in a unique way. Your oncologist will recommend a specific type based on your cancer type, stage, and genetic markers.
Checkpoint Inhibitors: Taking the Brakes Off the Immune System
These are the most widely used forms of immunotherapy. They "inhibit" the checkpoints that cancer uses to break the immune system. Drugs like pembrolizumab (Keytruda) and nivolumab (Opdivo) target the PD-1/PD-L1 pathway, while ipilimumab (Yervoy) targets a different checkpoint called CTLA-4. By blocking these pathways, these drugs release the brakes, allowing T-cells to attack the cancer. They have shown remarkable success in treating melanoma, lung cancer, and many other types. Naturally incorporates LSI term: PD-1/PD-L1.
CAR T-Cell Therapy: Engineering a Super-Army
This is a highly personalised and sophisticated treatment. A sample of the patient's T-cells is collected and genetically engineered in a lab to produce special receptors called chimeric antigen receptors (CARs) on their surface. These CARs allow the T-cells to recognise and bind to specific proteins on the patient's cancer cells. The engineered "CAR T-cells" are then multiplied in the lab and infused back into the patient, where they become a living drug, seeking out and destroying cancer cells. This is particularly effective for certain blood cancers like leukemia and lymphoma. The CAR T-cell therapy process is complex but represents a pinnacle of personalised medicine.
Monoclonal Antibodies: Targeted Missiles for Cancer Cells
These are laboratory-made molecules designed to serve as substitute antibodies. They can be designed to attach to specific targets on cancer cells, flagging them for destruction by the immune system. Some monoclonal antibodies are also considered targeted therapy because they can directly block signals that cancer cells use to grow. Rituximab (Rituxan) is a well-known example used for lymphomas.
Cancer Vaccines and Immune System Modulators
Cancer vaccines are designed to trigger an immune response against cancer cells. Unlike traditional vaccines that prevent disease, most cancer vaccines are therapeutic, treating an existing cancer. Immune system modulators are drugs that generally enhance the body's immune response against cancer. Interleukin-2 (IL-2) and interferon are examples, though they are used less commonly now than newer agents.
Are You a Candidate? Cancers Treated with Immunotherapy
Immunotherapy is not a one-size-fits-all solution. Its effectiveness varies greatly depending on the type of cancer. It has become a standard of care for several cancers, including:
- Melanoma
- Non-small cell lung cancer
- Kidney cancer
- Bladder cancer
- Hodgkin lymphoma
- Head and neck cancers
- Liver cancer
Research is ongoing, and new approvals are happening rapidly. The list of cancers for which immunotherapy is effective continues to grow, offering hope for many patients.
The Importance of Biomarker Testing (Like PD-L1)
A critical step in determining if you are a candidate for immunotherapy is biomarker testing. This involves testing a sample of your tumour (from a biopsy) for specific genetic or protein markers. For example, testing for the PD-L1 protein can help predict whether a patient will respond to checkpoint inhibitors. Other biomarkers, like tumour mutational burden (TMB), also provide clues. This is why it's essential to have detailed conversations with your doctor about comprehensive biomarker testing. If you have recently been diagnosed, consulting a specialist through Apollo24|7 can help you understand what tests are necessary to determine the best treatment path, including eligibility for immunotherapy.
What to Expect: The Immunotherapy Treatment Journey
Understanding the treatment process can help reduce anxiety and prepare you and your family.
Before Treatment: Tests and Preparation
Before starting, you will undergo several tests to establish a baseline. This typically includes blood tests to check organ function, imaging scans (like CT scans) to measure the current size of your tumours, and a review of your overall health. It's important to discuss all medications you are taking with your doctor, including over-the-counter drugs and supplements.
During Treatment: Administration and Timeline
Most immunotherapies are given as an intravenous (IV) infusion, similar to chemotherapy. You will sit in a chair for a period of time while the drug drips into your vein. Treatments are usually given in cycles—for example, once every two, three, or four weeks—to allow your body time to recover. The total duration of treatment varies; some patients may be on it for a fixed period (e.g., two years), while others may continue as long as it is effective and side effects are manageable.
Monitoring Response and Side Effects
Your medical team will monitor you closely. Scans are usually repeated every few months to see if the treatment is working. Response can be dramatic, but sometimes tumours may appear to grow initially as immune cells invade them (pseudoprogression) before they shrink. Monitoring for immune-related adverse events is equally critical, as side effects can appear anywhere in the body and at any time, even after treatment has ended.
Managing Immunotherapy Side Effects
While often different from chemotherapy, immunotherapy side effects must be taken seriously.
Common Side Effects (Fatigue, Skin Rash)
Fatigue is very common. Skin reactions, such as rash or itching, are also frequent. Other common side effects can include diarrhoea, nausea, and joint pain. Many of these are mild to moderate and can be managed with supportive care.
Understanding and Managing Immune-Related Adverse Events (irAEs)
The most significant side effects are immune-related adverse events (irAEs). Because immunotherapy revs up the immune system, it can sometimes attack healthy organs, causing inflammation. This can lead to serious conditions like colitis (inflammation of the colon), pneumonitis (inflammation of the lungs), hepatitis (liver inflammation), or endocrinopathies (affecting hormone-producing glands). It is vital to report any new or worsening symptoms to your doctor immediately. Most irAEs are manageable with corticosteroids or other immunosuppressive drugs if caught early. If you experience severe symptoms like difficulty breathing, intense abdominal pain, or significant changes in urination during your treatment, it is crucial to seek immediate medical attention, either at a hospital or by consulting a doctor online urgently via Apollo24|7.
The Future of Immunotherapy in Cancer Care
The field of immunotherapy is advancing at a breathtaking pace. Researchers are working on next-generation therapies, including combination treatments that pair different immunotherapies or combine them with chemotherapy, radiation, or targeted therapy to improve outcomes. Efforts are also focused on making treatments like CAR T-cell therapy effective for solid tumours and finding new biomarkers to better predict which patients will benefit. The goal is to make immunotherapy safer, more effective, and accessible to more people.
Conclusion
Immunotherapy has undoubtedly ushered in a new era of hope in oncology. For many cancer patients, it has provided a path to long-term remission and a better quality of life during treatment. While it is a powerful tool, it is also complex, with a unique set of benefits, challenges, and side effects that require careful management by a specialised medical team. Being an informed and proactive participant in your care is one of the most important things you can do. Ask questions, understand your biomarker test results, and communicate openly with your doctors about what you are experiencing. The journey with cancer is deeply personal, and having a clear understanding of all your treatment options, including the potential of immunotherapy, is the first step toward making empowered decisions about your health. If you have questions about whether immunotherapy might be right for you or a loved one, consider seeking a second opinion from an oncology specialist.
Consult an Oncologist for the best advice
Consult an Oncologist for the best advice
Dr. Amit Choraria
Surgical Oncologist
18 Years • MBBS, MS (Surgery) Fellow, Surgical Oncology, Tata Medical Center (FSO) Fellow, European Board of Surgery (Surgical Oncology) (FEBS) Fellow, Minimal Access Surgery (FMAS) Fellow, Indian Association of Gastrointestinal Endosurgeons (FIAGES) UICC Fellow, Royal Marsden NHS, London, UK Visiting Scholar, Plastic Reconstructive Surgery, CGMH, Taiwan Fellow, Robotic Surgical Oncology, Vattikuti Foundation, USA
Kolkata
Apollo Multispeciality Hospitals , Kolkata, Kolkata
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Gopal Kumar
Head, Neck and Thyroid Cancer Surgeon
15 Years • MBBS, MS , FARHNS ( Seoul, South Korea ), FGOLF ( MSKCC, New York )
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
Dr. Praveen Kumar Garg
Surgical Oncologist
26 Years • MBBS, M.S.(Gen.Surg.), M.Ch.(OncoSurg.)
Delhi
Apollo Hospitals Indraprastha, Delhi
(50+ Patients)
Consult an Oncologist for the best advice
Dr. Amit Choraria
Surgical Oncologist
18 Years • MBBS, MS (Surgery) Fellow, Surgical Oncology, Tata Medical Center (FSO) Fellow, European Board of Surgery (Surgical Oncology) (FEBS) Fellow, Minimal Access Surgery (FMAS) Fellow, Indian Association of Gastrointestinal Endosurgeons (FIAGES) UICC Fellow, Royal Marsden NHS, London, UK Visiting Scholar, Plastic Reconstructive Surgery, CGMH, Taiwan Fellow, Robotic Surgical Oncology, Vattikuti Foundation, USA
Kolkata
Apollo Multispeciality Hospitals , Kolkata, Kolkata
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Gopal Kumar
Head, Neck and Thyroid Cancer Surgeon
15 Years • MBBS, MS , FARHNS ( Seoul, South Korea ), FGOLF ( MSKCC, New York )
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
Dr. Praveen Kumar Garg
Surgical Oncologist
26 Years • MBBS, M.S.(Gen.Surg.), M.Ch.(OncoSurg.)
Delhi
Apollo Hospitals Indraprastha, Delhi
(50+ Patients)
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Frequently Asked Questions
1. What is the success rate of immunotherapy?
The success rate varies significantly depending on the cancer type, stage, and specific biomarkers. For some patients with advanced cancer, it has led to long-lasting remissions. However, not everyone responds, which is why ongoing research is focused on increasing response rates.
2. How long does it take for immunotherapy to work?
Response times can vary. Some patients may see results within a few months, while for others, it may take longer. Sometimes, scans initially show stable disease or even a slight increase in size (pseudoprogression) before shrinkage occurs.
3. Is immunotherapy better than chemotherapy?
It's not necessarily 'better,' but different. For cancers where it is effective, immunotherapy can offer more durable responses and fewer traditional side effects like hair loss. However, it can cause unique immune-related side effects. The choice depends entirely on the individual's specific cancer.
4. What is the cost of immunotherapy for cancer, and is it covered by insurance?
Immunotherapy drugs are often very expensive. In many countries, they are covered by insurance, especially for FDA-approved indications. However, coverage can vary, and patients should check with their insurance provider and hospital financial counselors.
5. Can immunotherapy be used for late-stage cancer?
Yes, immunotherapy is often used for advanced or metastatic cancer that has not responded to other treatments. In many cases, it has shown remarkable effectiveness in controlling late-stage disease and extending life.