Immunotherapy is a type of treatment that helps the body’s own immune system fight diseases such as cancer. Normally, the immune system works to protect the body from infections and abnormal cells. However, some cancers can hide from the immune system or create signals that prevent it from attacking. Immunotherapy works by strengthening or re-training the immune system so it can recognise and target cancer cells more effectively.

How Does Immunotherapy Work?

There are several approaches to immunotherapy, and each works in a different way:

• Checkpoint inhibitors – medicines that “release the brakes” on the immune system, allowing it to attack cancer cells more strongly.
• Monoclonal antibodies – laboratory-made proteins that can mark cancer cells so the immune system can find and destroy them.
• Cancer vaccines – treatments that help the immune system learn to recognise cancer cells.
• Cytokines – natural proteins that boost the immune system’s activity.
• Cell-based therapies (such as CAR T-cell therapy) – treatments that involve modifying a patient’s own immune cells to better detect and attack cancer.

Who Can Benefit from Immunotherapy?

Immunotherapy may be recommended for certain types of cancers, including melanoma, lung cancer, kidney cancer, bladder cancer, and some blood cancers. Not all cancers respond to immunotherapy, and the suitability of treatment depends on the type of cancer, its stage, and individual patient factors.

Benefits of Immunotherapy

• Offers a different option when chemotherapy or radiation may not be effective.
• Can provide longer-lasting responses, as the immune system may “remember” how to fight cancer.
• May be used alone or in combination with other treatments.

Possible Side Effects

Because immunotherapy stimulates the immune system, it can sometimes cause the immune system to attack healthy cells as well as cancer cells. Side effects may vary depending on the treatment used but can include:

• Fatigue
• Skin rash or itching
• Flu-like symptoms (fever, chills, muscle aches)
• Digestive changes (nausea, diarrhoea)
• Inflammation in organs such as the lungs, liver, or thyroid

Most side effects are manageable and improve with prompt medical care. It is important that patients report new or unusual symptoms early, so the care team can provide the right support.

What to Expect During Treatment

Immunotherapy is usually given through an intravenous (IV) drip, an injection under the skin, or sometimes as oral medication. Treatment schedules vary – some patients may receive therapy every few weeks, while others may follow a longer cycle. Regular blood tests and scans are often needed to monitor progress and adjust treatment as required.

Key Takeaways

• Immunotherapy uses the body’s own immune system to fight cancer.
• It works in different ways, including “unblocking” immune cells, marking cancer cells, or boosting immune responses.
• Not all cancers respond, but it is especially effective for certain types like melanoma, lung, kidney, bladder, and some blood cancers.
• Side effects are possible but usually manageable with timely care.
• Treatment is personalised, and patients are closely monitored by their specialist team.

Chemotherapy is a type of cancer treatment that uses powerful medicines to destroy or slow down the growth of cancer cells. These drugs are specially designed to target cells that divide quickly, which is one of the main characteristics of cancer.

While chemotherapy is effective against cancer cells, it can also affect some healthy cells that naturally divide rapidly, such as those found in the bone marrow, hair follicles, and digestive system. This is why side effects such as fatigue, hair loss, or nausea may occur.

How is Chemotherapy Given?

Chemotherapy medicines can be delivered in different ways:

• Intravenously (IV): The drugs are given through a vein using a drip.
• Orally: The treatment is taken as a tablet or capsule.

Treatment is often provided in cycles, which include a period of chemotherapy followed by a rest period. These breaks allow the body time to recover and regain strength before the next cycle.

When Chemotherapy is Used

Chemotherapy can be given:

• On its own as the main treatment
• Before surgery or radiation to shrink a tumour
• After surgery or radiation to reduce the risk of cancer returning
• Alongside other therapies to improve overall treatment effectiveness

Side Effects and Support

The side effects of chemotherapy vary depending on:

• The type of drugs used
• The dosage and schedule
• Individual response to treatment

Some people experience only mild effects, while others may notice more changes. Oncologists and care teams will carefully monitor each patient throughout treatment. There are many strategies and supportive medications available to help manage side effects and maintain quality of life during chemotherapy.

Key Takeaways

• Chemotherapy uses medicines to kill or slow cancer cells that grow and divide rapidly.
• Treatment can affect some healthy cells, which may cause side effects.
• Chemotherapy is usually given through a vein or taken as tablets/capsules.
• It is often delivered in cycles, with rest periods in between.
• Chemotherapy can be used alone or in combination with other treatments.
• Each patient’s care team will closely monitor treatment and provide support to reduce side effects.

Targeted therapy is a type of cancer treatment that works by focusing on specific molecules or pathways that play a role in the growth and spread of cancer cells. Unlike chemotherapy, which affects both healthy and cancerous cells, targeted therapy is designed to act more selectively, aiming at the unique changes that occur within cancer cells.

How Targeted Therapy Works

Cancer cells often develop abnormalities in their genes and proteins that allow them to grow, divide, and survive in ways that normal cells cannot. Targeted therapy identifies these abnormalities and disrupts the processes that cancer cells rely on, while leaving most healthy cells less affected.

There are two main types of targeted therapy:

1. Small Molecule Drugs

• These medicines are small enough to enter cancer cells directly.
• Once inside, they interfere with specific molecules that the cancer cells depend on to survive and grow.
• Examples include:
  • Tyrosine kinase inhibitors (TKIs): These block certain enzymes that promote cancer cell growth.
  • Proteasome inhibitors: These stop proteins that cancer cells need to function and survive.

2. Monoclonal Antibodies

• These are laboratory-made proteins designed to attach to specific targets on the surface of cancer cells.
• By binding to these targets, they can block signals that encourage cancer cells to grow and divide.
• Some monoclonal antibodies also stimulate the immune system to recognise and destroy cancer cells.

When is Targeted Therapy Used?

Targeted therapy may be used on its own or in combination with other treatments such as chemotherapy, immunotherapy, or radiation therapy.

It has shown effectiveness in treating several types of cancers, including breast cancer, lung cancer, melanoma, and certain forms of leukemia.

Things to Keep in Mind

Not every cancer or patient will respond to targeted therapy. The effectiveness depends on the presence of specific genetic changes in the tumour.

Like all treatments, targeted therapy can cause side effects, although these may differ from those caused by chemotherapy.

An oncologist will carefully assess whether targeted therapy is appropriate by reviewing the type of cancer and relevant test results.

Key Takeaways

• Targeted therapy is designed to block specific molecules or pathways that help cancer cells grow and spread.
• There are two main types: small molecule drugs (work inside the cell) and monoclonal antibodies (attach to cell surfaces).
• It can be used alone or alongside other treatments.
• Not all patients benefit, and side effects are possible, so treatment decisions are tailored to each individual.

Hormonal therapy, also called endocrine therapy, is a type of cancer treatment designed to block or reduce the effects of hormones that can stimulate the growth of certain types of cancer cells. Hormones are natural substances produced by glands in the body that regulate key functions, including growth, metabolism, and reproduction.

In some cancers, such as breast cancer and prostate cancer, hormones like estrogen and testosterone can promote the growth of cancer cells. Hormonal therapy works by interfering with these hormones, either by blocking their effects on cancer cells or by reducing their production. By doing so, hormonal therapy can slow down or stop the growth of cancer cells.

How is Hormonal Therapy Administered?

Hormonal therapy can be given in several ways, depending on the type of cancer, the patient’s overall health, and treatment goals:

• Oral Medication
  • Hormonal therapy drugs can be taken as tablets or capsules by mouth. These medications work by blocking hormone receptors or reducing hormone levels in the body.

• Injections
  • Certain hormonal therapy drugs are administered as injections under the skin or directly into a muscle. These injections help to reduce hormone levels or block hormone activity.

• Implants
  • Small pellets containing hormonal therapy drugs can be inserted under the skin. These implants gradually release medication over time to maintain hormone suppression.

• Surgery
  • In some cases, surgery may be used to remove hormone-producing glands. For example:
    • Ovaries in women, which produce estrogen
    • Testicles in men, which produce testosterone

Side Effects of Hormonal Therapy

Hormonal therapy is generally well tolerated, but it can cause side effects due to its impact on hormone levels. Common side effects include:

• Hot flashes
• Fatigue
• Mood changes, such as irritability or anxiety
• Changes in sexual function or libido

It is important for patients to discuss the potential risks and benefits of hormonal therapy with their oncologist to ensure the treatment plan aligns with their health needs and lifestyle.

Key Takeaways

• Hormonal therapy targets cancer growth by blocking or reducing hormones that fuel cancer cells.
• It is commonly used in breast and prostate cancers but may be considered for other hormone-sensitive cancers.
• Administration can be oral, injectable, implanted, or surgical, depending on the case.
• Side effects are typically related to changes in hormone levels, including hot flashes, fatigue, mood changes, and sexual side effects.
• Careful discussion with an oncologist is essential to balance treatment benefits and potential side effects.