Immunotherapy

Immunotherapy helps the immune system recognise and attack cancer by changing signals that can hold immune cells back.

Many immunotherapies are checkpoint inhibitor drugs. They are given through a vein, and the medicine travels through the bloodstream. Treatment is chosen using the cancer type, stage, tumour tests, previous treatment and your general health.

Before each infusion, the team reviews your health, medicines and recent symptoms. Blood tests may check organs that treatment can affect. The medicine is then infused over a planned period, followed by observation and a schedule for future visits. Some people receive immunotherapy alone; others receive it with chemotherapy, radiotherapy or surgery.

Because the immune system becomes more active, effects may include tiredness, rash, itching, diarrhoea, nausea, cough, joint aches or changes in thyroid function. These can appear during treatment or after it ends.

Contact the oncology team promptly for persistent diarrhoea, severe abdominal pain, yellow skin, dark urine, new breathlessness, chest pain, severe headache, confusion, marked weakness or a rapidly spreading rash. These may signal inflammation of an organ and need assessment.

Immunotherapy can shrink cancer or hold it steady in some people, while others do not benefit. The response depends on tumour biology and the treatment used. Doctors assess symptoms, examination findings and scans, and may continue treatment while the cancer is controlled and side effects remain manageable.

Immune-related effects are different from the usual effects of chemotherapy. Tell every healthcare professional that you receive immunotherapy, including before starting steroids, vaccines or a new medicine.

It may be offered for selected bladder, cervical, bowel, head and neck, kidney, lung, skin, stomach or breast cancers. Tumour testing can help guide the choice, but a test result is only one part of the decision. Your team considers previous therapies, autoimmune conditions, transplant history and other medicines.

The team confirms the treatment plan and checks for conditions that need special care. A nurse places an intravenous line, monitors you during the infusion and explains symptoms to watch for. At later visits, treatment may be delayed or changed if tests or symptoms show that your body needs recovery.

Fatigue may affect activity after treatment, although some people feel little change. Keep a symptom diary and maintain the planned blood tests and reviews. Immune effects can occur after an infusion or after treatment has stopped, so retain the emergency contact instructions.

Inflammation can affect the skin, bowel, lungs, liver, kidneys, hormone glands or nervous system. Early treatment can reduce harm, so do not wait for the next appointment when a new or worsening symptom appears.

Options depend on the cancer and may include surgery, radiotherapy, chemotherapy, targeted therapy or observation. [Chemotherapy](/treatments/systemic-therapy/chemotherapy/) may be used before, after or with another treatment when appropriate.

Choose an oncology service that can provide infusion monitoring and rapid advice about immune-related symptoms. Bring your medicines and records, and ask how urgent concerns are handled outside clinic hours.