Immunotherapy for cancer patients. Hope or Hype?
For past few months i receive lot of queries about immunotherapy from patients and i always think what to answer. Is it hope or hype? I go to my chamber every time and keep thinking is this the only hope for patients suffering from stage four malignancies . Unfortunately these days one would see lot of people claiming they have immunotherapy and they are healers. Is it so? Immunotherapy has evolved a lot for past one year and is very costly. What my experience is only few patients benefit from it and we have to select these patients and that is not an easy job to do.We hear stories that immunotherapy does magic .
Today i was sitting in my cabin and this elderly male suffering from lung cancer came to see me in OPD to show his Scan and after seeing his scan i started smiling. Reason for smile was that my heart was filled with joy because this was his i think 8th scan and his disease was responding for last 2 years. He comes walking to OPD and attends all family functions and goes for morning walk everyday . He is enjoying his life without any side effects of chemotherapy. Other patient i treat is also elderly gentleman suffering from stage four bladder cancer and is disease free from last one year and now he has started working in office. He always keeps insisting on stopping treatment but i keep persuading him not to stop because disease will eventually come back some day and till then he should get full benefit from immunotherapy. But not my every patient responded . For some of my patients immunotherapy did not work.
Till date we donot have any tools for predicting response to immunotherapy but they are evolving and i have started using these predictive biomarkers . Immunotherapy does not work in every cancer. There are few cancers where it works very good and for some cancers it does not work at all, so patients have to selected with lot of caution. Good thing about immunotherapy is that it can be given in daycare. It is one hour infusion and patients can continue their work without taking leave from work .
Last week one patient gall bladder cancer came to consult me and wanted immunotherapy and i had to refuse and had to explain him for one hour that immunotherapy does not work for gall bladder cancer and he went to other hospital and received 6 cycles but it did not work on him . Only around 30% people respond to immunotherapy, 70% do not. We are in the initial stage of development of immunotherapy and with time we will get more answers to our questions. One size did not fir all. Lot of questions remain unanswered and hope soon we will find answer to these questions. And i will keep updating you about new developments. My next blog will be about a patient who is fighting cancer for last four years . Till then good bye and take care.
Dr Abbas Waseem