Immunotherapy

Immunotherapy treats cancer by working on your immune system instead of on the tumour cells directly. The commonest group, the checkpoint inhibitors, block a signal that some tumours use to switch off the immune cells that would otherwise attack them.

It is not offered for every cancer. Your oncologist decides from the cancer type and from tests run on the biopsy sample, such as PD-L1 staining or mismatch repair status, and it is often combined with chemotherapy.

Response varies a great deal between patients. Some tumours shrink and stay controlled for a long time, others do not respond at all, and scans every two to three months show which is happening for you.

Treatment is given as a drip into a vein through a cannula or a port. Each visit takes about thirty to sixty minutes for the drip itself, plus the time to check your blood results and see the doctor beforehand.

You stay in the Day Care unit for a short observation period afterwards and go home the same day. There is no anaesthetic, nothing to fast for, and you can drive yourself.

Cycles repeat every two to six weeks depending on the drug your oncologist has chosen, and treatment continues while it is working and you are tolerating it.

Most people carry on working between cycles. Immunotherapy does not usually cause the hair loss or the low blood counts that chemotherapy does, so the day after a session often feels ordinary. Tiredness is the commonest complaint and builds over months.

Tell your team quickly about a new cough, breathlessness, diarrhoea lasting more than a day, a rash, or unusual fatigue. These can be the first sign of an immune side effect, and they are far easier to settle when treated early. Go to an emergency department if you become breathless at rest or cannot keep fluids down.