It seems cancer has touched nearly every home in some way. Maybe a friend, neighbor or loved one has heard the diagnosis. Although the diagnosis is never good news, there are some reasons for optimism about the chances for continuing to live a long, happy life after the diagnosis.
We’ve made a number of innovative advances in cancer care. Our established cancer treatments — surgery, radiation therapy and chemotherapy — continue to develop new, more effective treatments.
And these three pillars of cancer treatment are being increasingly complemented by immunotherapy.
This relatively new treatment involves harnessing the body’s own immune system to fight cancer. Your immune system defends you against invaders like bacteria, viruses, fungi and parasites. Unfortunately, since cancer cells are your own cells, your immune system doesn’t naturally see the cancer cells as invaders and doesn’t attack them.
One approach to immunotherapy involves engineering a patient’s immune cells to see the cancer cells as invaders and attack them just as they would an infection in a cut finger.
Now, the concept sounds simple, but it’s been the subject of research and clinical trials for years. Every cancer is different and scientists must custom engineer the immune cells to fight a specific cancer.
We call one new approach adoptive cell transfer (ACT). It’s like giving patients a “living drug.” In limited trials, this therapy’s results have been very encouraging and merit further research.
This approach uses the patient’s T-cells — a type of immune cell you already have. Caregivers collect T-cells from the patient’s body in a process that takes about four hours.
The cells are then genetically engineered to produce special chemical receptors on their surface. This takes a few weeks in a lab.
We call these receptors on the T-cells chimeric antigen receptors (CARs). (Don’t worry, you don’t need to remember this.)
The receptors are proteins that allow your T-cells to detect another protein (called an antigen) on cancer tumor cells.
The T-cells with the special receptors are then replicated in the lab by the billions. The replicated T-cells are intravenously added back (infused) into the patient’s blood stream.
When all goes as planned, the T-cells continue to multiply in the body and, guided by the special receptors, the T-cells recognize and kill cancer cells that have the unique cancer antigens on their surfaces.
Doctors are using this approach to treat lymphoma and lymphoid leukemia. These cancer cells have unique surface markers that the modified T-cells will recognize and attack.
We’re also using different forms of immunotherapy to treat kidney and skin cancers.
Immunotherapy is not without the potential for side effects. One that we watch for is what we call cytokine-release syndrome.
When the modified T-cells are returned to the patient, the T-cells release cytokines — chemical messengers that help the T-cells do their jobs. With cytokine-release syndrome, too much cytokine is released into the bloodstream. As a result, the patient can suffer from a high fever and an unsafe blood-pressure drop.
Fortunately, side effects in most patients are mild and can be managed with standard therapies such as steroids.
As mentioned, immunotherapy is still in development. We’ll continue to research it and look for ways to successfully incorporate the therapy in treating additional cancers in both children and adults. Researchers are already looking into therapies for pancreatic and brain cancers.
If you have questions about immunotherapy, visit with your health care professional.
If someone you care about has received a cancer diagnosis, they may benefit from a cancer counseling program with resources and support to reduce the mysteries of the cancer recovery journey.