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Kuala Lumpur, Feb 2: This year, World Cancer Day falls on Feb 4 and is celebrated to raise awareness surrounding cancer in its many forms, effects, as well as treatments and recovery. Cancer-fighting technology have improved in leaps and bounds in recent years, and one newer technology that has been known to be effective in treating cancer is Immunotherapy that has also reached Malaysian shores.
Immunotherapy is unique in the way that it uses the body’s own immune system to fight cancer. Consultant Clinical Oncologist from Sunway Medical Centre Velocity (SMCV), Dr Hafizah Zaharah Ahmad explains that the immune system is like the police force of our bodies – it is designed to protect the body against infection, illness and disease.
It can also protect us from the development of cancer.
Normally, it can detect and destroy faulty or mutated cells in the body and eliminates them before they become a significant threat.
However, cancer can still develop when the immune system is not strong enough to kill cancer cells, or when the cancer cells hide from the immune system (cancer cells have the ability to camouflage and resemble normal cells).
What makes immunotherapy different?
Immunotherapy as a cancer treatment is more targeted. Immunotherapy treats patients by acting on their immune system.
“Immunotherapy uses the immune system to fight cancer. Immunotherapy can boost or change how the immune system works so it can recognise and kill cancer cells,” Dr Hafizah explains.
As cancer cells start in normal cells, the immune system does not always recognise them as a threat. These cancer cells can push a ‘brake’ button on the immune cells, so the immune ystem would not attack them. Checkpoint inhibitors (a type of immunotherapy) take the ‘brakes’ off the immune system which helps it recognise and attack the cancer cells.
She adds that various immunotherapy agents are given as an infusion into a vein (IV) typically once every two, three or four weeks and can be given by itself, or in combination with targeted therapy or chemotherapy.
For advanced stage cancer, immunotherapy treatment generally is given for two years, alongside close monitoring.
Ensuring patients are on the right track
Although immunotherapy may seem like the light at the end of the tunnel for cancer patients, Dr Hafizah warns that not all cancers will respond well to the treatment.
Before embarking on immunotherapy, patients have to first undergo a specific biomarker test such as the PD-L1 test that will need to be carried out on a cancer specimen to ensure that the patient will respond to the treatment. Immunotherapy can be used as a treatment for various cancers including non-small cell lung cancer, triple negative breast cancer, head and neck cancer, cervical cancer, gastric cancer, oesophageal cancer, bladder cancer, melanoma, liver cancer, renal cell carcinoma, endometrial cancer and colon cancer.
Dr Hafizah shares her experience with patients who have responded well to immunotherapy, which include a patient she treated two years ago with advanced malignant melanoma (a type of skin cancer) that had spread and was resistant to chemotherapy.
However, after undergoing immunotherapy the patient has remained in complete remission until now.
“Another patient that is currently undergoing immunotherapy treatment under my care is a gentleman with stage 4 colon cancer. A biomarker test was done on the cancer specimen and confirmed to be suitable for immunotherapy. His latest imaging showed near complete resolution of the cancer. However, not all patients are suitable for immunotherapy. As mentioned earlier, a special biomarker test needs to be done before determining the suitability of this treatment,” Dr Hafizah notes.
Side effects, symptoms and allergies
As with any form of treatment, immunotherapy also presents its own sets of side effects.
“Generally, the treatment is well tolerated, with possible side effects such as feeling tired, skin rash, or muscle or joint pain.
“Although rare, some patients could also exhibit allergic reactions including dizziness, fast heart rate, face swelling or breathing problems. Signs of autoimmune reactions which can cause serious problems may occur in the lungs, intestines, liver, hormone-making glands, kidneys, skin, or other. Examples of symptoms to look out for are diarrhoea, severe abdominal pain, worsening cough, shortness of breath or difficulty in breathing,” Dr Hafizah adds.
Each patient will have their own cancer journeys, but Dr Hafizah assures that cancer research has pushed cancer treatment to new frontiers, leading to higher cancer control rates or cure rates.
She recommends taking on medical insurance to manage the rising cost of treatment – and that each patient should consult their trusted doctors to find the best possible treatment option when faced with a cancer diagnosis.
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