Cancer is a complex disease, often requiring sophisticated treatment. Modern oncology frequently employs two prominent strategies: chemotherapy and immunotherapy. Understanding these distinct yet complementary treatments is valuable for patients and their families. This article provides an overview of how these therapies work individually and how their combined application is shaping current cancer care.
How Chemotherapy Works
Chemotherapy uses powerful drugs to target and eliminate rapidly dividing cells. Cancer cells proliferate uncontrollably, making them susceptible to these medications. The drugs damage the genetic material of these fast-growing cells, disrupting their ability to grow and multiply. Different chemotherapy drugs achieve this by directly damaging DNA, interfering with cell division, or disrupting building blocks for DNA and RNA synthesis.
Since chemotherapy drugs circulate throughout the body, they can reach cancer cells that may have spread beyond the original tumor site. While highly effective against cancer cells, these drugs can also affect healthy cells that divide quickly, such as those in hair follicles, bone marrow, and the digestive tract. This non-specific action accounts for many common side effects. Chemotherapy is commonly administered intravenously or orally.
How Immunotherapy Works
Immunotherapy harnesses the body’s own immune system to combat cancer cells. Unlike chemotherapy, which directly attacks cancer cells, immunotherapy empowers the immune system to recognize and destroy them. This method is more targeted, leveraging the immune system’s ability to differentiate between healthy and abnormal cells.
One type of immunotherapy involves immune checkpoint inhibitors, which “release the brakes” on the immune system. Cancer cells can evade immune detection by activating checkpoints that suppress immune responses. These inhibitors block such checkpoints, allowing immune cells, particularly T-cells, to recognize and attack the cancer more effectively. Another form is CAR T-cell therapy, where a patient’s T-cells are re-engineered to target cancer cells and then infused back into the patient. Immunotherapy is administered intravenously, though subcutaneous injections are also used for certain agents.
Combining Immunotherapy and Chemotherapy
Combining immunotherapy and chemotherapy leverages the unique strengths of each modality. Chemotherapy can reduce tumor size and potentially make cancer cells more vulnerable, while immunotherapy enhances the body’s long-term immune response against remaining cancer cells. Chemotherapy might also cause cancer cells to release signals that make them more recognizable to the immune system, setting the stage for immunotherapy to be more effective.
This combined strategy can also help prevent cancer recurrence by enabling the immune system to maintain surveillance for residual cancer cells after initial reduction by chemotherapy. For instance, in certain lung cancers, melanoma, and some gastrointestinal cancers, the combination has shown improved patient outcomes. The specific regimen is carefully chosen by oncologists based on the patient’s cancer type, stage, and overall health. The integration of these treatments aims to achieve a more comprehensive and durable response against the disease.
Navigating Cancer Treatment
Undergoing cancer treatment requires a comprehensive and supportive approach. Patients benefit from a multidisciplinary care team, including oncologists, nurses, social workers, and other specialists, all working together to manage various aspects of care. Open communication with healthcare providers is important, allowing patients to understand their treatment plan, potential side effects, and any adjustments needed.
Supportive care helps manage the patient experience, addressing symptoms and treatment-related side effects. Common side effects, which vary among individuals and treatment types, can include fatigue, nausea, and hair loss from chemotherapy, or flu-like symptoms and skin rashes from immunotherapy. The focus remains on maintaining the patient’s quality of life throughout the treatment journey.