A cancer diagnosis has turned out to be one of the most important life-altering experiences for both patients and their families these days. The vast majority have been left confused and clueless as regards the right approach to follow in the aftermath of a cancer diagnosis. The medical world has moved some fantastic lengths in understanding and handling cancer, with today being dotted with various ways of treatment available. Among all these treatments are chemotherapy and immunotherapy, the former being the most common and wide-ranging treatment and both of which were found to have been effective as a way in the fight against cancer, however, fundamentally they work differently. Knowing the difference between chemotherapy and immunotherapy, along with knowing about their benefitting and side effects, will help in determining which treatment would be best for the patient or loved ones.
This is an all-around guide to take you through chemotherapy and immunotherapy procedures and what difference these forms might make between each other concerning, with your kind and the phase of cancer, you would consider what suits best for you. We shall present the progresses that these methods of treatment receive alongside how time itself molds them.
What is Chemotherapy?
Chemotherapy, commonly known as “chemo,” is cancer treatment typically taken for years. Chemotherapy can be described as the way systemic medication occurs using strong drugs, aimed at rapidly proliferating cancerous cells then followed by the elimination of such cells. Most people think chemotherapy relates to a general approach towards treating cancers. Chemotherapy, however, may be applied to the treatment of several autoimmune diseases aside from a plethora of diseases. It normally performs its duty through the elimination of cancerous cells or arresting multiplication of division in those cancerous cells. The chemotherapy drugs work on the mechanism whereby the cancerous cell produces or multiplies DNA in itself; these drugs would do harm to the cellular formation resulting in cellular death. Since their doubling time is highly increased and also doubles in higher velocity rates compared to normal human beings, such chemotherapy drugs kill them easily and selectively. It does not selectively target only cancer cells, though. It affects all the cells that reproduce faster in the healthy parts of the body as well, which is the primary cause of the various side effects experienced when undergoing chemotherapy.
Common Chemotherapy Drugs
There are numerous chemotherapy drugs, and most can be used together for the treatment of almost every type of cancer. Some of the more commonly used ones are as follows:
- Alkylating Agents. These agents will chemically modify the DNA of the cancerous cells, so they will not multiply and grow. Examples include cyclophosphamide and ifosfamide.
- Antimetabolites: It closely resembles the physiologic product of the cell and acts in such a manner that it impairs its capability to produce those proteins and molecules which it depends upon in order to carry out the events of cell division. Examples are methotrexate and 5-fluorouracil.
- Antitumor antibiotics: The antibiotic doxorubicin inhibits the ability of the cancer cells to make duplicate copies of its DNA by inhibiting its cell machinery.
- Topoisomerase inhibitors: The topoisomerase inhibitors target the enzymes that work as DNA replication. The list includes irinotecan, topotecan
- Mitotic inhibitors: These might inhibit the processes of cancer becoming cells through changes in the nature of the process of the cell division, such as a mitotic taxane: paclitaxel and docetaxel etc. The formulation comes in intravenous form, oral through pills; however some ovarian can require drugs administration directly into the abdominal cavity. Administration is type and condition that a person gets from his/ her sickness considered.
Challenges and Side Effects of Chemotherapy
Although chemotherapy has its effectiveness in reducing the size of tumors and even controlling the development of tumors, it has its own disadvantage. One of the major disadvantages of chemotherapy is that this method cannot differentiate between the cells that are cancerous and non-cancerous. This aspect contributes to a number of side effects brought about by chemotherapy, especially on rapid-growing healthy cells that include hair, digestive system, and bone marrow. Common side effects include:
- Hair loss: It is very apparent; all of the rapidly dividing cells are destroyed, including those of hair follicles.
- Nausea and vomiting: Almost every anticancer medication causes nausea; this is why anticancer patients all receive some anticancer medication designed to reduce such side effects as nausea.
- Fatigue: Much energy is killed by chemotherapy.
- Diarrhea or constipation: Chemotherapy may act on the stomach and could therefore induce diarrhea or constipation.
- Risk of infection: The chemotherapy is also said to suppress the production of white blood cells in the bone marrow, thus immunizing patients and putting them in more vulnerable risks from infection.
- Lower Blood Counts: The chemotherapy causes the red and white blood cell deficiency and that of platelet as well; therefore, these elements cause anemia, easy bruising or bleeding, and prone to other infections. While these side effects are very challenging, most of them are transient and tend to resolve once the course of treatment is completed. Some will have significant side effects that last for long periods, so close follow-up and management will be needed.
What is Immunotherapy?
It is a better and more targeted form of cancer treatment because it uses the body’s own immune system in the identification and killing of cancerous cells. However, it is not chemotherapy as it does not implement the strategy of targeting cancerous cells. Immunotherapy “teaches” the immune system how to recognize and destroy defective cells. Immunotherapy actually maximizes the body’s own natural defense mechanisms against abnormal and mutated cells.
It has freakish behavior as if a cancer cell will be sending some signals making it look “normal” or even “healthy.” Thus, the immune system would not react to it. Immunotherapy works on blocking or reversing those signals to enable the immune system to once again recognize the cancer cells. In many instances, it’s known by the term “immune checkpoint inhibition,” since it is merely the removal of brakes placed by the cancer cells on the immune system.
Types of Immunotherapy
Immunotherapy is delivered in various forms and changes with the types of cancer and patient reactions. Some of the significant types of immunotherapy are as follows:
- Checkpoint Inhibitors: The drugs fundamentally inhibit signals that cancer cells use to protect themselves from immune attacks. They allow T-cells to destroy and attack the cancer cells through the immune cells. Examples include pembrolizumab (Keytruda) and nivolumab (Opdivo).
- Monoclonal Antibodies: These are artificially created drugs which can bind onto specific proteins made by cancer cells. They sometimes mark the cancer cells for destruction and at other times let your immune system run loose. Examples include: Herceptin to treat breast cancers.
- Cytokine Therapy: These are proteins, which control the activities of the immune cells. Cytokine therapy is applied for the boosting ability of the immune system towards targeting the cancer. Among them are the interleukin-2 (IL-2) and interferons have been used to treat cancer patients.
- Cancer Vaccines: These are vaccines produced to enhance the immunity system in the detection and eradication of cancerous cells. The vaccines are produced to counter diseases and not cancers. An example of the vaccines is that of the cervical cancer, known as the HPV vaccine, while Provenge vaccine is used to counter prostate cancer.
- CAR-T Cell Therapy. In this method, T-cells are obtained from a patient’s blood and are genetically modified so that it can identify and differentiate cancer very well. The genetically modified cells are then infused into one’s body with the killing effect on more of the cancerous cells.
Immunotherapy-Amenities-Low side effects and sequelae
In many aspects, there are several advantages of immunotherapy over other forms of treatments. It is non-invasive because it only specifically acts upon cancerous cells, which makes its interference with most of the body’s cells less significant. This is what makes it relatively have fewer side effects compared to chemotherapy, which is usually debilitating and has a high rate of side effect occurrences.
However, since it actually does activate the immune system, there is some effect on account of immune-related side effects. These generally include:
- Organ inflammations: This may involve the liver, the lungs, or the intestines that are prone to developing more complicated complications unless it is controlled properly.
- Skin reactions: These lead to the development of rashes, itchiness, among other skin conditions.
- Flu-like symptoms: Some of the most common side effects include fever, chills, and weakness that present in the early phase of treatment.
- Endocrine disorders: In a few cases, the treatment alters the function of hormone-releasing glands and results in conditions such as thyroid malfunction or adrenal insufficiency.
- Colitis or diarrhea: Intestine inflammation leads to some serious gastrointestinal conditions, including colitis, diarrhea, and abdominal pain. Being devoid of side effects, immunotherapy has emerged to be the breakout treatment in numerous cancers, and it is increasingly being used for patients who cannot respond to chemotherapy.
Immunotherapy has gone pretty impressive on many cancers: melanoma, lung carcinoma, and certain lymphomas.
Chemotherapy vs. Immunotherapy: Major Differences
While chemotherapy and immunotherapy have been highly powerful cancer killers, their working mechanism, side effect, and performance are different among various types of cancers.
Working Mechanism
- Chemotherapy: It directly acts on the cancerous cells to destroy them or inhibit the proliferation of those cells.
- Immunotherapy: It either boosts or modifies the immune system such that it could learn to identify the cancerous cells and destroy them.
Side Effects:
- Chemotherapy generally has systemic side effects and rapid onset side effects such as hair loss, nausea, drowsiness, and weakness as it affects the rapidly replicating cancerous as well as non-cancerous cells.
- Immunotherapy tends to present late and immunologically related side effects such as inflammation and fever. Tend to occur less frequently and relatively much minor in nature.
Chemotherapy Effectiveness
- Chemotherapy has proven very effective against an immense range of cancers, thus them often reduced so that the tumors may be much accessible to a surgeon or even killing any leftover cancer cells left with the spreading in the surgery after.
- Immunotherapy has been used with good reactions in cancers, which are insensitive to chemotherapy as a form of treatment, especially melanoma and certain types of lung cancer. There are specified forms of leukemia and lymphomas.
Treatment span:
- Chemotherapy is administered over cycles, alternated with weeks of rest time. The periods are continued over a specific span of weeks or months.
- Immunotherapy is one of the slower-moving medicines, and it will continue to fight the disease far after the cancer treatment because of the fact that the immune system will “remember” the presence of cancer cells.
Types of Cancer Treatment
- Chemotherapy is prescribed as a treatment for the following types of cancers: breast cancer, leukemia, lymphoma, ovarian cancer, and many more.
- Immunotherapy treatments, specifically immunotherapy, work the best on melanoma, non-small cell lung cancer, and numerous kinds of kidney and bladder cancer.
How to Choose the Right Treatment for You
It is chemotherapy or immunotherapy, depending on the type of cancer, the stage of the cancer, the patient’s overall health, and what side effects he can tolerate. The point being, each one of the cancer is unique from patient to another, and hence, what worked for one did not work out for another one.
A discussion with your oncologist based on the type of cancer, biomarkers, and the present health condition will guide him or her in making the proper choice of therapy. For some types of cancers, the best therapy is chemotherapy; for others, immunotherapy; and for some, the combination of both seems to be preferred for a better shot.
Frequently Asked Questions (FAQs)
You would know chemotherapy or immunotherapy was working in a patient through running imaging tests and taking blood for tests. Most of the tracking will be done with a CT scan, MRI, or PET scan regarding growing sizes of the tumors, whether new growth is being found or how well it is responding.
Chemotherapy works faster compared to immunotherapy
The effect wherein chemotherapy is distinguished from the result is obtained after a few weeks of time. Immunotherapy requires some amount of time before its appearance and has the prospect of producing longer-term results.
Can chemotherapy and immunotherapy be used together?
Sometimes, even chemotherapy and immunotherapy are combined to increase the impact from both the treatments. Combining them can be a more effective way of fighting the cancer.
Is it always successful?
No, the therapy works for all the patients or even for all sorts of cancer diseases. Immunotherapy, however, has proved to be highly successful in a few categories of cancers including melanoma and non-small cell lung cancer; the trend, however, continues.
Conclusion: Choice of Right Therapy
This is the compromise most patients with cancer get caught between when it comes to chemotherapy and immunotherapy. Both have their respective strengths and weaknesses. For instance, because of the nature of the cancer as well as general health, one might find himself or herself picking what might fit the bill on the basis of side effects that might arise, which then forms a decision according to the word of an oncologist who happens to know this treatment.
If any patient would consider chemotherapy or immunotherapy, then they should ask questions and obtain a second opinion, if needed. Such approaches should elaborate the possible risks and benefits of each approach. Treatment of cancer must be directed ideally at achieving the best possible result with the fewest side effects and maximizing quality of life.
If you are in India, then visiting a prominent oncologist like Dr. Vikesh Shah will help you out quite a lot. He has some good experience with chemotherapy and immunotherapy; he will guide you on which will suit the case.
Contact us today and book a consultation to start to make sense of the treatment options open to you. With the right care, the battle against cancer can be fought with hope and optimism.