Chemotherapy vs. Immunotherapy: Uses, Benefits, Side Effects, and More
Medically reviewed by Benjamin Leach, MD
Chemotherapy (chemo) and immunotherapy are two modes of treatment that can be used for various types of cancer. While the treatments can be similar and even used together, they are two different and distinct therapies.
Knowing more about each can help you talk with your treatment team and make decisions about your care. This article will discuss chemotherapy and immunotherapy for cancer, their side effects, costs, and how to cope with treatment.
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What to Know About Chemotherapy
Chemotherapy is the use of medications to help treat or cure cancer.
How Does It Work?
Chemotherapy targets fast-growing cells, which cancer cells are. The drugs work by stopping or slowing down the growth and reproduction of the cancer cells. Chemotherapy can be used to treat cancer and reduce the risk of recurrence. Or, it may be used in a palliative way—to shrink or inhibit the growth of tumors to reduce pain and other effects.
Chemotherapy Delivery
Chemo can be given intravenously (IV, through a line into a vein), taken as a pill orally, given as a shot, used topically, or placed into a bodily cavity or organ.
Chemotherapy usually is given in cycles—periods of treatment followed by a period with no chemotherapy. The period without chemotherapy allows your body to recover. An example of a four-week cycle can be daily chemotherapy for one week, then no chemotherapy for three weeks, then the next cycle may begin.
Side Effects
Side effects of chemotherapy can vary depending on your general health and reactions to medications, the drugs you are taking and their dosages, and your treatment regimen. Not everyone taking the same drugs has the same side effects. Common side effects include:
Fatigue
Infection
Anemia (a low number of healthy red blood cells)
Changes in bowel habits (diarrhea and constipation)
Mouth/tongue/throat issues like sores and trouble swallowing
Peripheral neuropathy (damage to nerves outside the brain and spinal cord)
Changes in appetite
Easy bruising
Weight changes
Chemo brain (temporary changes in memory and thinking processes)
Changes in libido (desire to have sex)
Before you start chemotherapy, talk with your treatment team about the potential side effects and what you can do to help manage them. If you do start experiencing side effects, tell your treatment team about them.
Prices and Where to Get It
The cost of chemotherapy drugs can vary widely, depending on the specific drug and your treatment regimen. It can also depend on where you live—prices in the United States are well over the value-based price (a price linked to the potential benefit of the medication).
If you do not have insurance, meet with the financial office of your treatment center to discuss how much the drugs will be and how much you are expected to pay. Many places have financial aid options that you can apply for to help with costs. If you have insurance, call your insurance company to ask what your out-of-pocket costs will be.
Your healthcare provider prescribes chemotherapy drugs. Intravenous chemotherapy is typically given at a treatment center or hospital. Some types of oral and topical chemotherapy may be taken at home, depending on your healthcare provider’s instructions.
What to Know About Immunotherapy
Immunotherapy, also called biologic therapy, is treatment that uses your immune system to help fight cancer.
How Does It Work?
Immunotherapy helps your immune system fight the cancer in your body. In a healthy person, the immune system fights off abnormal cells, helping to prevent cancer. Sometimes immune cells are seen in and around cancers. These are called tumor-infiltrating lymphocytes (TILs). Cancers with TILs usually have a better prognosis (expected outcome) than those that don’t.
Immunotherapy helps various immune cells work better against cancer cells and help to more effectively destroy them.
Immunotherapy Delivery
Immunotherapy can be given in a variety of ways, depending on the specific drug: orally, topically, intravenously, or directly into an organ, such as the bladder.
The schedule for immunotherapy depends on the type of immunotherapy, type of cancer, cancer stage (how much cancer is in your body and whether it has spread from its original site), and your reaction to treatment. It may be daily, weekly, or monthly.
Depending on the immunotherapy type, it may be given in a cycle to allow a recovery period so your body can respond to the therapy before the next treatment cycle.
Side Effects
When the immune system is boosted to kill cancer cells or abnormal cells, sometimes side effects can occur because the immune system may act against healthy cells and tissues as well. People can have different side effects, depending on their body’s reactions.
Side effects can also vary due to your type of cancer, how advanced it is, the specific drug you’re on and its dosage, and the treatment regimen. Talk with your treatment team about all of the potential side effects of your specific treatment.
Side effects can include:
Reactions at the needle site, including pain, redness, soreness, rash, swelling
Flu-like symptoms, including fever, chills, nausea/vomiting, muscle or joint pain, fatigue, trouble breathing
Swelling and weight gain due to fluid retention
Heart palpitations (a fast, fluttering, or pounding heartbeat)
Infection
Sinus congestion
Organ inflammation
Prices and Where to Get It
Costs of immunotherapy can be very high. Costs over $100,000 are not uncommon. If you do not have health insurance, talk with the financial office at your treatment center about the costs of treatment, your personal costs, and whether there are any financial aid programs that can help you with the treatment.
If you have health insurance, your insurer can talk with you about your personal out-of-pocket costs.
Immunotherapy needs to be prescribed by a treatment team, who then monitors you while taking the treatment.
What Treatment Is Best for You?
The best treatment for you depends on your specific cancer, its stage and features of the cancer, and any biomarkers (biological molecules in your body that can be measured) you might have that indicate that some drugs may be more effective. Your overall health status may also play a role in determining the best treatment for you.
You and your treatment team will meet to discuss treatment options and all of the possible side effects. You have a say, too, in what treatments you prefer after listening to your options and making an informed decision.
Can Chemotherapy and Immunotherapy Be Used Together?
A combination of chemo and immunotherapy, chemoimmunotherapy, can be used for certain types of cancer to improve the treatment effects of both modes of therapy. Whether you may benefit from chemoimmunotherapy depends on specific aspects of your cancer type. Talk with your treatment team about whether this is a viable option for your treatment.
Coping With Side Effects
People react to side effects of chemotherapy and immunotherapy differently. Let your treatment team know about the side effects you’re experiencing, so they can keep track of anything out of the ordinary. They may also have suggestions for minimizing side effects and tips to help you cope.
Measures you can take to help cope with side effects from treatment include:
Take short naps to help with fatigue.
Perform light exercise to help with fatigue (check with your healthcare provider to make sure it’s safe before starting any exercise program).
Stay hydrated.
Ask for help with running errands and with any assistance you might need.
Get anti-nausea medication from your treatment team if this is an issue.
Small meals more often may be easier on your stomach than three big meals.
Ask your healthcare provider about over-the-counter medication for constipation or diarrhea if necessary.
Avoid acidic, spicy, greasy, or salty foods—this can help with nausea as well as mouth sores.
Use a soft toothbrush.
Ask your treatment team when to call about side effects. Sometimes side effects can get worse and require medical attention or intervention. Your healthcare providers can let you know signs to watch out for and when to call them.
Summary
Chemotherapy and immunotherapy are both used in treating cancer. They help to kill cancer cells in different ways, and may be used together in some people. There are side effects to both treatments. It’s important to discuss the potential side effects with your treatment team.
A Word From Verywell
Each person’s cancer treatment can look different, even if they have the same kind of cancer. There are many factors that go into treatment planning. Both chemotherapy and immunotherapy are valid and effective treatment modalities for cancer. Talk with your healthcare team about the treatment options for your specific condition and which ones might be best for where you are right now.
Read the original article on Verywell Health.
