Immunotherapy drugs save lives, but risks can be deadly
A powerful new way to fight cancer is starting to appear in clinics large and small.
It’s called immunotherapy. And if there ever was a medical moonshot, this is it. It can give the immune system the power to stomp out even the most deadly and untreatable cancers.
Certainly the promise of such a game-changing therapy is exciting.
But it doesn’t come without a catch.
Any cancer patient who’s receiving immunotherapy needs to know that this superhero treatment can deliver miracles, but also involves a lot of risk.
‘Playing with fire’
Cancer doesn’t play fair.
It knows how to trick the immune system into not attacking. When researchers discovered this many years ago, they started figuring out how to unleash the immune response so the body could finally conquer cancer on its own terms.
And now that knowledge is being put into action.
Doctors are getting amazing results with various immunotherapy drugs, sometimes doubling up on drugs to quickly and completely shut down advanced cancers that have already spread.
As you can guess, this kind of miracle work comes with a staggering price tag. Some treatments can run more than a quarter million dollars per year.
No matter what the price, who would turn down a chance of going from certain death to being cancer-free?
If the story ended there, of course, it would be a very happy ending. Sure, patients might land in some serious debt, but they would be around to enjoy more Christmases, birthdays, and summer vacations.
Unfortunately for many patients, that’s not the case.
As oncologist Dr. John Timmerman put it, “We are playing with fire.”
While we’ve heard some of the success stories, such as Jimmy Carter’s miraculous cancer cure (he also received surgery and radiation), as Dr. Timmerman said, we haven’t heard much about “the collateral damage.”
The fact is that this lifesaver can also turn into a savage monster. When you set the immune system free to attack, sometimes it just won’t stop.
When that happens, major organs can get trampled, and the damage can be sudden and severe.
In a case reported in The New York Times, immunotherapy “melted away” one woman’s cancer. But just a few weeks after getting this good news, she came down with flu-like symptoms that sent her to the ER, where she died of an acute inflammatory response.
In another case, doctors used two immunotherapy drugs to stop a man’s melanoma dead in its tracks. But just a few weeks after his treatments, he began running a high fever, his blood pressure dropped, his blood sugar soared, and his kidneys stopped functioning as he slipped in and out of consciousness.
After three weeks in the hospital the man survived, but his immune system had blown out his pancreas, causing acute-onset diabetes.
These severe reactions can flare up more than half the time when two immunotherapy drugs are combined. But single drugs can also set off brutal, life-threatening side effects.
Right now, this looks like it happens in about 20 to 30 percent of cases, but that number might go even higher. It’s hard to predict because researchers have focused on the cancer-killing effects of these drugs, paying much less attention to the risks.
Experts are saying a major problem is that too many medical professionals – including ER doctors – just aren’t aware of how side effects can spiral out of control so quickly.
It’s vital that doctors who prescribe these drugs make sure their patients know the warning signs and the power these meds can unleash. And if side effects do occur, as Dr. Timmerman said, they have to be managed “hour by hour, minute by minute.”
If immunotherapy shows us anything, it’s that moonshots can work. But they work most successfully when mission control watches over patients very, very carefully.
“Immune system unleashed by cancer therapies, can attack organs” Matt Richtel, December 3, 2016, The New York Times, nytimes.com
