Immunotherapy; A Cancer Breakthrough

One of the biggest scientific discoveries in recent years, produces ‘Extraordinary’ results in Cancer patients.

Efficacy rates normally considered to be “unprecedented in medicine.” the technique is considered a new era for cancer treatment.

T-cell therapy shows promise for treating advanced disease, making Immunotherapy a ‘pillar’ of cancer care.Immunotherapy is a treatment that uses the immune system to work harder or smarter to attack cancer cells thus preventing growth and spreading of the cells.

Immunotherapy is a new dimension of the treatment of cancer with drug. Every day, millions of cancer cells occur in our body. Cells are available in the human’s immune system to defeat the cancer cells. The immune system acts immediately and destroys the cancer cells when it knows them. T-cells (T-lymphocytes) in the immune system fight with them. The T-cells fight against the cancer cells and try to destroy them. However, cancer cells, using their receptors, connect to the T-cells’ receptors and prevent their fight against them. Immunotherapy drugs prevent the T-cells and cancer cells from connection to each other by means of the receptors and allow the T-cells to carry out their missions. The purpose of immunotherapy is to strengthen the immune system, and thus, to let the body itself to defeat cancer.

-What is the difference from chemotherapy?

•Until now, 3 types of drug treatment were applied in respect with cancer. The first of these is the “cytotoxic” chemotherapy that kills the cancer cells (stereotaxic in cancer). The second is the hormonotherapy methods used for breaking the hormone mechanisms in cancer types such as breast and prostate cancers which develop secondary to the hormones. The third is the targeted treatment that has been used for the last 15 years and increasing gradually; the purpose in this treatment method is to block the mechanisms that develop and spread the cancer. The aim of immunotherapy is to strengthen the target, i.e. The immune system, and thus, to let the body itself to defeat cancer.

•They are different from each other as mechanisms. Chemotherapy kills the cells and immunotherapy strengthens the immune system.
•They have different side effects. Side effects such as hair loss, low blood level, nausea, and vomiting observed in chemotherapy are not observed in immunotherapy. Side effects of immunotherapy are the side effects that occur by stimulation of the immune system mostly.
•In order to apply chemotherapy, the patient’s performance should be good and the body should be functioned. Problem secondary to both the disease and chemotherapy should not harm the patient. Immunotherapy is effective also in patients with low performance. It can be provided even to the very exhausted and sluggish patients. It can be effective in them too.

-How is it made?

Immunotherapy drugs are infused from vessels via serum as in chemotherapy. However, it is comfortable than chemotherapy. It does not create any significant problem while it is applied.

-Who is suitable?

Immunotherapy drugs are not used in the early illness periods for now; it is used in patients with spread and metastasis. It can be used in patients in Stage IV. After all, the patient should be in the early period of Stage IV for the good results.

-In which cancer types is it used?

It is in trial period for many cancer types and gives hope. It is the most important drug for malign melanoma cancers. Chemotherapy has almost no efficacy in malign melanoma, however, immunotherapy is very effective. It is used in progressed diseases after chemotherapy as the first choice for the non-small cell lung cancer. Namely, chemotherapy is applied first and then immunotherapy drugs are given as the second choice when the disease is progressed. Its third area of use is renal cancers. Immunotherapy is used as a second choice when the targeted drugs are fail. Fourthly, it is used for lymph cancers (Hodgkin’s Disease).

-In which other cancers is it intended to use?

It gives hope for intestinal, bladder, gastric and breast cancers. It is still in research phase and not used.

-What kinds of side effects does it have?

Immunotherapy causes to side effects in relation with the immune system. These may cause to some symptoms on skin and diarrhea. It can have effects of inflammation of lung (non-germ pneumonia) and on the hormone system. For example, it may have effect on the thyroid gland and cause to slow or fast functioning of it. It may cause to adrenal insufficiency. Insufficiency of the pituitary gland may be observed. It may cause to fatigue and anorexia. Its side effects should be known very well and the patients should be followed up closely.  Therefore, the medical oncologists applying immunotherapy should know when the drug will be discontinued or continued and should take precautions against them when these side effects occur. Not only the medical oncologists, also physicians in other branches such as pulmonology, endocrinology, gastroenterology should know how they will response when any side effect is observed. For example, using cortisone can save life when side effects are observed. Thus, the physician should know when they use cortisone.

-Is it in use in Turkey?

No drug is available in Turkey. Drugs can be supplied by special permissions. Payment problems are experienced. Because drugs are expensive. If immunotherapy drugs are used with proper treatment in the right people, applied with awareness than very successful results can be obtained.

IN BRIEF

-It is used for cancers in Stage IV.
-It strengthens the immune system and allows the body to fight against the disease.
-It is a long-term treatment.
-The purpose is to keep the disease under control. It is used to prevent the progression of disease.
-Responsive patients live for a long time.

In our Medical Oncology Clinic; chemotherapy, target-driven treatments, hormonotherapy are evaluated on patient basis by our experienced and well known medical oncology specialist and the treatment is planned and executed regarding the weight, height, general situation, medical history of the patient.

With ‘Cold Cap Therapy’ we can minimize treatment related hair loss.

In Liv Hospital’s Multidisciplinary Tumor Council, the most appropriate treatment approach is being planned for our patients.

Our department serves with 2 medical oncology specialists, 1 practitioner, 3 chemotherapy nurses, 2 patient admission clerks and 1 department caretaker. While on one hand medical oncology specialists determine the treatment regimen and specifications for the patient, on the other hand other team members are playing an effective role on the quality and the comfort of the treatment. Our chemotherapy medications are being prepared by a specialist team consisting of competent biologists in a special cabin under appropriate sanitary conditions.In 2013, 63.4% of the patients evaluated in our department’s polyclinic have received their chemotherapy treatment as outpatient and 18.3% of the patients have received their treatment as inpatient.In our department, chemotherapy and supportive care is being performed in brain, lung, breast, liver, esophagus, stomach, pancreas, colon, rectum, bone, prostate, head and neck, female genital tumors and their metastasis.

Liv Hospital Medical Oncology Clinic (also known as Liv Cancer Center) serve both outpatient and inpatient treatments. in the Chemotherapy lounge, each cubicle has one chemotherapy chair. 8 chemotherapy cubicles and 2 private treatment rooms are situated in this lounge.

Throughout 2013, nearly 400 cases at in oncology, radiation oncology, pathology, nuclear medicine, radiology and total are discussed in 45 councils and taken into treatment.In our Oncology Clinic, all the oncological treatments are planned and performed by our specialist and experienced physicians within the frame of “Customized Treatment Methods” (tailor-made).Concerns about hair loss after chemotherapy treatment are minimized. Side effects of chemotherapy are minimized by customized treatment methods. “Smart Medicine” (target driven) treatment is used in chemotherapy. This situation has increased the treatment’s chance of success. Rate of post-treatment vomiting has been minimized by target driven medical treatment and customized treatment methods.Chemotherapy medications are being prepared by an experienced and trained team. Rate of chemotherapy medication error throughout 2013 is 0%.Success rate of bloodletting methods have increased to maximum owing to the experienced nurse staff.

A multidisciplinary process is fictionalized in chemotherapy. Our Oncology Clinic is serving in coordination with Pulmonology, Dermatology, Psychology, Cardiology, Radiology and Nuclear Medicine clinics. Each and every patient is provided with dietary and psychological treatment, patients who are considered necessary are directed to other departments. By this means 100% patient satisfaction has been reached.