Immunotherapy vs Chemotherapy

March 27, 2024
Immunotherapy vs Chemotherapy

Cancer treatment can be overwhelming, especially when faced with the choice between immunotherapy and chemotherapy. These two treatments represent the forefront of the fight against cancer, each with its unique approach and implications for patients. Below, we talk about what these treatments really are, and discuss the main differences between them.

Understanding Cancer Treatment

When we talk about treating cancer, we're really talking about a few different approaches aimed at doing one thing: getting rid of cancer or keeping it under control. The main ways to tackle cancer include surgery, where doctors remove cancer physically; radiation therapy, which uses high-energy particles to kill cancer cells; chemotherapy, a type of medication that targets fast-growing cancer cells; immunotherapy, which boosts your body's natural defenses to fight cancer; and targeted therapy, which focuses on specific parts of cancer cells to stop them from growing.

Each treatment has its place, and what works for one person might not work for another. It often depends on the type of cancer, how advanced it is, and the health of the person with cancer. For example, surgery might be the best option for removing a tumor if it's in one place and hasn't spread. But if cancer has spread or is in a tricky spot, doctors might recommend chemotherapy or radiation to shrink it or kill the cancer cells.

Chemotherapy has been a go-to treatment for a long time, dating back to the 1940s. It's been a game-changer for many cancers, offering a way to control the disease and extend life. The thing with chemotherapy is that it's pretty broad in its approach—it targets cells that grow quickly, which includes cancer cells but also some healthy cells, leading to side effects like feeling tired or hair loss.

In the past few years, there's been a lot of excitement about immunotherapy. Instead of attacking cancer directly, it helps your immune system do a better job of spotting and destroying cancer cells. It's a big deal because it offers a new way to tackle cancer, especially for types of cancer that haven't responded well to other treatments.

And then there's something called precision medicine. This is a newer approach that tailors treatment to the individual. It looks at the genetic makeup of the cancer and the person to find treatments that might be more effective and cause fewer side effects. It's a more personalized way to fight cancer, and while it's not available for all types of cancer yet, it's showing a lot of promise.

What is Chemotherapy?

Chemotherapy, often referred to simply as "chemo," is a type of cancer treatment that uses drugs to destroy cancer cells. Unlike surgery or radiation therapy, which target specific areas, chemotherapy can work throughout your entire body. It's one of the oldest forms of cancer treatment and has been a fundamental part of cancer care for decades.

The main goal of chemotherapy is to stop or slow the growth of cancer cells, which tend to grow and divide much more rapidly than most cells in the body. However, because chemotherapy can also affect healthy cells that divide quickly, such as those in your hair, mouth, and intestines, it can lead to a range of side effects. These might include hair loss, mouth sores, nausea, and fatigue, among others. The intensity and type of side effects vary from person to person and depend on the kind of chemotherapy received.

Chemotherapy is used in various scenarios: It can be the primary treatment to destroy cancer cells, before surgery or radiation therapy to shrink tumors (neoadjuvant chemotherapy), or after other treatments to eliminate any remaining cancer cells (adjuvant chemotherapy). In some cases, it's used to ease symptoms and improve quality of life, even if the cancer is considered incurable.

The decision to use chemotherapy, the combination of drugs, and the treatment's length and frequency depend on the cancer type, its stage, your overall health, and previous cancer treatments. Treatment schedules vary widely; some treatments are given daily, weekly, or monthly, and they can be administered through the vein (intravenously), in pill form, or even directly into the cerebrospinal fluid, organs, or body cavities.

Over the years, research and clinical trials have significantly improved chemotherapy's effectiveness and reduced its side effects. According to a study published by the National Cancer Institute, newer, targeted chemotherapy drugs can more precisely identify and attack cancer cells, sparing healthy cells and reducing side effects compared to traditional chemotherapy drugs.

What is Immunotherapy?

Immunotherapy is another effective approach in the battle against cancer. Unlike traditional methods that directly target cancer cells, such as chemotherapy and radiation, immunotherapy works by empowering your body's immune system to fight cancer.

At its core, immunotherapy enhances the innate power of your immune system to detect and destroy cancer cells. The immune system, a complex network of cells, tissues, and organs, defends your body against infections and diseases. However, cancer cells have a knack for evading immune detection, partly because they originate from our own cells. Immunotherapy aims to overcome this challenge by making cancer cells more visible to the immune system or by boosting the immune system's ability to fight cancer more effectively.

There are several types of immunotherapy, including checkpoint inhibitors, CAR T-cell therapy, monoclonal antibodies, cancer vaccines, and immune system modulators. Each type works in a slightly different way to enhance the immune response against cancer cells.

Checkpoint inhibitors, for example, target molecules on immune cells that need to be activated or deactivated to start an immune response. Cancer cells often exploit these checkpoints to avoid being attacked by the immune system. Drugs known as checkpoint inhibitors can block these molecules, enabling the immune cells to attack cancer cells more effectively. 

CAR T-cell therapy is another innovative form of immunotherapy. It involves collecting a patient's T cells (a type of immune cell) and genetically modifying them in a laboratory to attack cancer cells. The modified T cells are then infused back into the patient. This method has shown promising results, particularly in the treatment of certain types of leukemia and lymphoma.

Then, there are also monoclonal antibodies which are lab-made immune system proteins that can bind to specific targets on cancer cells, marking them for destruction by the immune system. Some monoclonal antibodies are also designed to interfere with cancer cell growth signals, effectively slowing down or stopping the cancer's progression.

While immunotherapy has revolutionized cancer treatment, offering hope to many patients, especially those with cancers previously deemed untreatable, it's not without its challenges. The effectiveness of immunotherapy can vary widely among patients, and some treatments come with potential side effects, ranging from mild flu-like symptoms to more severe autoimmune reactions.

Research into immunotherapy is rapidly evolving, with new studies and clinical trials continuously underway to refine these treatments, discover new targets, and reduce side effects. The potential of immunotherapy in cancer treatment is immense, offering a beacon of hope for many facing this disease.

Comparing Immunotherapy and Chemotherapy

Understanding the differences between immunotherapy and chemotherapy is crucial for anyone navigating cancer treatment options. While both are effective in battling cancer, they operate through distinct mechanisms and have different implications for patients.

  • Mechanism of Action: The fundamental difference lies in how they attack cancer. Chemotherapy directly kills rapidly dividing cells, both cancerous and some healthy cells, which can lead to a wide range of side effects. Immunotherapy, by contrast, boosts or modifies the immune system's natural ability to fight cancer, targeting the disease more precisely and often with a different set of side effects.
  • Side Effects: Due to their differing approaches, the side effects vary significantly. Chemotherapy is known for more common and sometimes severe side effects like hair loss, nausea, and vulnerability to infections. Immunotherapy's side effects often stem from an overly stimulated immune system, leading to autoimmune-like symptoms such as inflammation, fatigue, and skin rash, which are generally less predictable than those from chemotherapy.
  • Specificity: Immunotherapy offers a higher level of specificity in targeting cancer cells, aiming to spare more healthy cells than chemotherapy. This specificity comes from the ability of immunotherapeutic agents to distinguish between cancer cells and healthy cells to a certain extent, based on certain proteins or markers.
  • Effectiveness and Usage: Chemotherapy has a broad application and can be used for various types of cancer at different stages. Immunotherapy's effectiveness is more variable, with certain cancers like melanoma, lung cancer, and certain lymphomas responding better to immunotherapy than others. Not all cancers currently have immunotherapy options, and its usage is often based on specific genetic markers and the cancer's molecular characteristics.
  • Treatment Regimen and Duration: Chemotherapy regimens often follow a set schedule, involving treatment cycles followed by rest periods. Immunotherapy schedules can vary widely depending on the type of immunotherapy, the cancer being treated, and how well the patient is responding to treatment. Some immunotherapy treatments may continue for as long as they remain effective and the patient can tolerate them.
  • Emerging Research and Combinations: There's growing interest in combining chemotherapy and immunotherapy to leverage their strengths. Research is exploring how chemotherapy might help make cancer cells more susceptible to the immune response triggered by immunotherapy. Such combinations might offer synergistic effects, potentially leading to improved outcomes for patients.

The Decision-Making Process

Choosing the right cancer treatment is a critical and often complex decision that involves weighing the benefits and potential side effects of different therapies. This decision-making process is deeply personal and should be informed by a comprehensive understanding of your unique situation, including the type and stage of cancer, overall health, and personal preferences.

The first step in this process often involves gathering as much information as possible about your diagnosis. Understanding the specifics of your cancer, such as its location, stage, and any genetic markers, is crucial. This information can significantly influence which treatments are most likely to be effective. For instance, certain types of immunotherapy are only suitable for cancers with specific characteristics, like the presence of particular proteins.

Consultation with a multidisciplinary team of cancer specialists is another pivotal aspect of the decision-making process. This team may include medical oncologists, surgical oncologists, radiation oncologists, and other healthcare professionals like nurses and social workers. Each specialist can provide insights into the advantages and limitations of different treatment options from their perspective, offering a well-rounded view of possible approaches.

Recent studies and clinical trials should also inform your decision. These can offer the latest insights into the effectiveness of treatments, potential side effects, and emerging options that might be available through clinical trials. For example, ongoing research might reveal that a combination of chemotherapy and immunotherapy offers a higher success rate for a specific cancer type compared to either treatment alone.

Quality of life considerations are also essential in this process. Discuss with your healthcare team how different treatments might affect your day-to-day life, including the management of side effects, treatment schedules, and any changes to personal or professional responsibilities. Some treatments may require frequent hospital visits or have side effects that significantly impact your quality of life, factors that must be weighed against the potential benefits of the treatment.

Apart from this, financial implications can't be overlooked. The cost of cancer treatment can be substantial, and understanding the financial impact, including what is covered by insurance, is an important part of the decision-making process. Many cancer centers have financial counselors who can help navigate these concerns.

Finally, it's important to consider your personal values and goals. Some individuals may prioritize treatments that align with a certain quality of life, while others might be more willing to endure significant side effects for the chance of a better outcome. Open and honest discussions with loved ones and healthcare providers can help clarify these priorities and guide the decision-making process.

The Future of Cancer Treatment

The future of cancer treatment is seeing rapid advancements. As we look ahead, the focus is increasingly on personalization and precision, with treatments tailored to the genetic makeup of both the patient and the tumor. This approach promises not only to improve outcomes but also to minimize side effects by targeting treatments more accurately than ever before.

One of the most exciting areas of development is in the realm of immunotherapy. Researchers are continuously discovering new immune checkpoints and other mechanisms that cancer cells use to evade the immune system. Novel immunotherapies that target these mechanisms are in development, offering hope for more effective treatments with fewer side effects. Additionally, CAR T-cell therapy, which has shown remarkable success in treating certain blood cancers, is being explored for a wider range of cancers, including solid tumors.

The integration of artificial intelligence (AI) and machine learning into cancer research and treatment is another groundbreaking development. AI algorithms can analyze vast amounts of data, from genetic information to imaging scans, helping to predict which treatments will be most effective for individual patients. This could lead to more successful outcomes and a reduction in the trial-and-error approach often associated with cancer treatment.

The concept of combination therapy is also gaining traction. By using multiple treatments simultaneously, such as combining immunotherapy with targeted therapy or chemotherapy, there's potential to overcome resistance that cancer cells often develop. This strategy is being studied extensively in clinical trials and has already shown promise in treating several cancer types.

If you or a loved one are navigating this journey and seeking expert guidance and care, BASS Cancer Center is here to support you every step of the way. With a commitment to providing the best cancer treatment services, our team of dedicated professionals is ready to offer the personalized care and advanced treatment options you deserve. At BASS Cancer Center, we believe in empowering our patients with the knowledge and support necessary to make informed decisions about their treatment plans.

We invite you to reach out and learn more about how we can help you on your path to recovery. Our comprehensive approach ensures that you receive the care tailored to your unique needs, incorporating the latest advancements in cancer treatment. Contact us today to schedule a consultation.