Vast majority of new cancer treatments do not end up improving survival times and generally come with significant, unpleasant side effects. Of the small minority that are found to be a net benefit, most are just barely worth it: very modest extension of life expectancy with sufficient toxicity that many well-informed patients will nevertheless decline them.
This is not just chemo either; immunotherapies can be brutal.
Its worth saying that some of the side effects of the newer immunotherapies are bizarre, idiosyncratic, and unpleasant, in a different way from chemotherapies. This is definitely good news, but patients undergoing treatment for melanoma are still extremely complex to manage.
Immunotherapies are still immature but far from snake oil at this stage. They routinely achieve miraculous remissions but also lead to many adverse events. For most late stage tumors, chemotherapy will only, at best, increase life expectancy a bit. In my opinion, the choice is obvious.
A line from a passage I remember reading as a medical student, has stuck with me after a decade and a half. It described anticancer therapies as having the effect of "... poisoning patients to the edge of their existence..." It is not my belief that the side effect profile of anti tumor drugs has improved much.
So, yeah. Treatments for cancer can suck just as badly as the disease itself.
all things considered, it's probably far more dangerous than chemo in the sense that it could kill you or seriously and permanently injure you with your first dose depending on your phenotype. at least chemo is a slower process.
but immunotherapies don't kill most people, thankfully. there are also many ways that you could assay the patient to see how they might react to immunotherapy, but i dont know whether these are done clinically or not.
Most of them are awful but only in rare cases do they cause permanent damage beyond what is already happening with the cancer and usually the patient can recover after the treatment is stopped.
Anything that stimulates the immune system runs the risk of increasing its sensitivity too much till it attacks normal cells and at that point, a lot of horrible things can happen ranging from a new mild allergy to neurological disorders like multiple sclerosis to acute organ failure.
Since the point of the therapy is to get immune cells to attack the cancer cells, there's the very real risk of instead targeting the tissue the cancer evolved from.
Well that is the Number One Reason why they are going immuntheraphy the side effects are minor compared to Chemo and Radiation. This is your own body fighting the cancer.
My sister got to move to immunotherapy after years of cancer treatment. It has been very effective.
Anecdotally, I have learned that immortality tends to be effective, and less hard on patients than other types of cancer treatment, but is held off because insurance providers don’t want to pay for it.
That's true, but assuming this specific treatment doesn't reprogram the native immune system, it sounds like the side effects are much shorter and less devastating than the systemic damage of chemo, even if requiring repeated attempts.
Someone close passed away from lung cancer last year. He received immune therapy (keytruda), and while it may work wonders for others, it comes with drawbacks; My main issue was that it takes 4 to 5 treatments (with weeks between each treatment) before you even really know if it worked or not. This is valuable time that could be used to treat the cancer with chemo (which admittedly has way worse side effects than keytruda, but still).
Disappointing to see a complex field summarised in this fashion. For some reason, ill-informed individuals love to adopt extreme views about cancer therapy and air them in public. This is totally irresponsible, and I hope nobody making decisions about cancer therapy reads this. For example:
1. 'Weakening' of the immune system is the wrong idea. Preclinical and clinical studies have shown that there is synergy between the immune system and chemotherapy, and also between the microbiome and chemotherapy. For some cancers, combining modern immunotherapies with other treatments including chemotherapy is likely to be necessary to achieve the best outcomes.
2. Your analogy to medieval blood letting is totally ridiculous. The chemotherapy used today has been carefully studied in randomised controlled trials with many thousands of patients. These patients have been followed up for many years with meticulous documentation of early and late side effects, disease outcomes and patient reported quality of life measures. This information is invaluable to patients who have to make decisions about the pros and cons of cancer therapy.
Is chemotherapy pleasant? Definitely not. Do some people experience terrible side effects that may be permanent and life threatening or even fatal? Yes. But it saves lives, and it comes with a host of supportive therapies designed to make the process as tolerable as it can be.
one dangerous thing is that most conventional cancer drugs cause immunosuppression (usually bone marrow suppression) so if you're taking these cancer vaccines you're going to be forgoing conventional treatments for the duration that you're on the vaccine. But if they have a higher success rate it would obviously be worth it; even if it has the same success rate since the vaccines would likely have less side effects.
Went to a talk about immunotherapy last year, toxicity of these class of therapeutics was way better than the best other available treatment. Sadly still too nascent, but don't forget to ask for it if you can.
Certain invasive cancer treatments can look a lot more effective than they really are, if all cause mortality isn't measured. It's possible to reduce the risk of a patient dying from the particular cancer they have while also lowering their overall life expectancy, since the procedure itself can be extremely harmful.
My wife had stage 4 melanoma. Prior to the newish immunotherapies about 5 years ago, it was a death sentence — 6-9 months life expectancy from diagnosis. Now, it’s 60-70% 5 year survival rate. Unfortunately my wife wasn’t one of them.
In general, these types of cancers spew mets and spread quickly. Many are resistant to chemo, go to the brain (chemo cannot help there) and only respond to high focused radiation like SRS or proton beam.
Immunotherapies essentially suppress checkpoints that cancer cells use to avoid immune response and/or cause your body to target specific checkpoints. I can’t read FT.com, but I believe it’s talking about a targeted therapy that allows your body to control the cancer.
There’s alot of research happening around things like immunotherapy combined with custom versions of Moderna and other vaccines that will significantly improve treatment and save people going through what my wife went through. It’s a good time.
This is not just chemo either; immunotherapies can be brutal.
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