10 Questions to Ask Your Doctor About Immunotherapy

Immunotherapy drugs are now standard care for some cancers. Here are 10 questions to ask your doctor, plus information that can help you have a better conversation about immunotherapy. 

1. How does immunotherapy work?

It uses your immune system to fight cancer. It can help your body attack cancer cells and give your immune system what it needs to help it kill them.

Immunotherapy doesn’t work for all types of cancer. But doctors and researchers are still hard at work to create different kinds of medications and figure out which types of cancers they fight and which people might benefit from them.

2. Is it safe?

In some cases, immunotherapy may be safer than chemotherapy and radiation. But like all cancer treatments, it has serious risks. The most common side effects are skin reactions at the needle site. Other side effects include flu-like symptoms. Immunotherapies may also cause severe or even fatal allergic reactions.

3. How is a clinical trial for immunotherapy different from other treatment?

Many of these medications are still in the research phase. That means the FDA hasn’t approved them yet. So to get these medications, you have to take part in a clinical trial.

Before doctors can prescribe a drug, it must be tested on volunteers. That helps researchers figure out how well a medication or combination of medications works, and who it’s best for. If the medication works during the clinical trial, the FDA will consider approving it for the disease it was tested on.

4. Should I join a clinical trial?

Only you and your doctor can decide if that's right for you. Before you enroll, you’ll want to find out:

  • The benefits of receiving an immunotherapy drug
  • The risks of the medication(s) you’re considering
  • Who you’ll be working with. You may need to work with doctors who aren’t members of your original cancer care team.
  • How long you’ll have treatment. Most clinical trials only run for a set period of time.
  • What happens if the clinical trial is stopped, or if you need to stop treatment early
  • The cost of treatment, including whether your health insurance will cover it

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5. What happens during treatment?

Immunotherapy is a lot like other forms of cancer treatment. You’ll go a doctor’s office or hospital. Depending on your medication, it may be:

  • Intravenous (IV): It will be put into a vein through an IV.
  • Oral: It comes in a pill or capsule you swallow.
  • Topical: It’s a cream you rub onto your skin.
  • Intravesical: It goes directly into your bladder.

Depending on the type of immunotherapy, you may get treatment every day, week, or month. You may have times where you don’t take medication. This gives your body a break as you get ready for the next cycle.

6. How long does it take to work?

Immunotherapy can take longer to work than other cancer treatments. And it may do more to extend your life than cure your cancer. That’s why it’s best to talk to your doctor about what you can expect from the type you’re considering, and to be clear on all your treatment choices before you make a decision.

7. What if immunotherapy doesn’t work?

Your doctor and medical team will watch your health closely during treatment. If it doesn’t lead to the results you and your doctor were hoping for, your medical team will work together to find other options. That may involve different forms of immunotherapy or traditional cancer treatments like chemotherapy.

8. Can immunotherapy be combined with other treatments?

Sometimes. Usually, it's used after chemotherapy or radiation. In many cases, this is because those didn’t work. For certain forms of tough-to-treat or advanced cancers, like metastatic squamous cell carcinoma, your doctor may recommend immunotherapy as a first or early treatment.

Immunotherapy can sometimes be paired with traditional treatments. This is called combination therapy. It may include chemotherapy and immunotherapy, or it could involve immunotherapy and other forms of targeted therapy. It might even mix two types of immunotherapy. As part of your overall cancer treatment, your doctor may recommend other steps, like surgery or radiation.

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9. Could I be turned down for immunotherapy?

Several forms are already approved to treat cancer. That means doctors can recommend them right away. But many are in the experimental stage. That means researchers and doctors don’t know for sure that they’re better than traditional cancer treatments. That’s why doctors have an ethical and legal requirement to recommend other standard methods like chemotherapy and surgery first, before they suggest you try a clinical trial. You could be rejected from a clinical trial for immunotherapy if you haven’t tried traditional treatment first.

Still, some clinical trials are open to people with advanced forms of cancer. Others will let you get immunotherapy medication along with traditional treatment.

If you have certain medical conditions, like an autoimmune disease, have an infection, or have a short life expectancy, you may not be a good fit for an immunotherapy clinical trial.

10. Can immunotherapy prevent cancer from coming back?

Sometimes. Everyone is different. But researchers have found that some forms of immunotherapy prevent certain types of cancer (like advanced ovarian cancer) from coming back longer than other treatments.

Researchers are working on immunotherapy vaccines that may help prevent other forms of cancer, like breast cancer, from returning.

WebMD Medical Reference Reviewed by Neha Pathak, MD on February 23, 2019

Sources

SOURCES:

Milan Radovich, PhD, medical co-director, Indiana University/IU Health Precision Genomics Program, Indianapolis.

American Cancer Society: "Clinical Trials: What You Need to Know," "What is Cancer Immunotherapy?"

Cancer Research Institute: "Cancer Immunotherapy: Should You Participate?" "Head and Neck Cancer."

FDA: "Step 3: Clinical Research."

Elizabeth A. McGlynn, PhD, vice president, Kaiser Permanente Research, Oakland, CA.

National Cancer Institute: "Immunotherapy,” "Targeted Cancer Therapies."

University of Texas M.D. Anderson Cancer Center: "Immunotherapy," "Review Highlights Potential of Cancer Immunotherapy Plus Targeted Therapy."

Society of Gynecologic Oncology.

Fred Hutchinson Cancer Research Center: "6 Questions in Cancer Immunotherapy.”

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