How might immunotherapy help the immune system fight cancer?

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There are different types of immunotherapies.  They can all help the immune system in different ways.  Let's take a closer look.  

Tricky cancer cells can escape from detector cells and deactivate fighter cells.  In turn, these cancer cells can continue to survive and grow into a tumor.  Your immune system may need help finding and attacking the tricky cancer cells again.  That's where immunotherapy comes in.

Immunotherapy can help your immune system fight cancer.  However, immunotherapy might also cause your immune system to harm healthy cells.  The way immunotherapy works is different from how other types of cancer treatment work.  For example, chemotherapy acts on fast-growing cells.  This may destroy cancer cells, but may also destroy healthy fast-growing cells, like hair cells.  

Some immunotherapies stop tricky cancer cells from escaping detector cells.  Then, detector cells can become alerted.  Other immunotherapies can help fighter cells stay activated.  The activated fighter cells can then attack cancer cells.  There is research being done to see how new immunotherapies may help your immune system fight cancer.  

What should I expect with chemotherapy?

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Drugs used for chemotherapy come in many different forms.  Some chemotherapy drugs are taken by mouth as pills while others are given into a vein (intravenously) in a doctor's office or clinic.  Patients may receive one chemotherapy drug or a combination of chemotherapy drugs.  

It may take several hours to have chemotherapy at a clinic or hospital.  Depending on the type of chemotherapy, the patient may take medications before the chemotherapy.  These are called premedications and can help stop or reduce certain side effects, such as nausea.  

Chemotherapy treatments are given in cycles.  Different chemotherapy drugs have different cycles.  For example, some chemotherapy drugs are given once a week, while others are given every three weeks.  Patients may not always get the same drug(s) on treatment days.  Patients take breaks between cycles and this may help reduce side effects.  

Possible side effects

Every patient may experience different side effects of chemotherapy drugs and the severity of side effects will vary from person to person.

While possible side effects vary with different chemotherapy drugs, the most common side effects include:

  • Anemia (low red blood cell count)
  • Extreme tiredness
  • Hair loss
  • Increased chance of bruising, bleeding, and infection
  • Nausea and vomiting
  • Neutropenia (low white blood cell count)

Most side effects are temporary and begin to lessen after treatment ends. You may need to take other medications to prevent or ease these side effects.  If side effects are severe, your doctor may temporarily stop or lower the dose of the chemotherapy.  Or your doctor may recommend a different chemotherapy medication.  

What's in my pathology report?


Because every person's cancer is different, it's important to understand your unique diagnosis and tumor biology to help guide your personalized treatment.  To provide specific information about your cancer, your physicians will perform several tests on your tumor tissue.  

Your pathology report is one of the resources that contains information about your tumor, which will help guide your healthcare team in planning the appropriate treatment for you.  Ask your doctor if there are additional tests you should consider to ensure you have the most complete picture of your unique cancer.  

Here is some information about your tumor that is contained in your pathology report:

Stage:  Staging is the assessment of how far the cancer has progressed.  In most cases, the lower the stage, the better the prognosis.  (Stage 0 to Stage IV)

Tumor Size:  The size of the cancer is one of the factors that determines the stage of the breast cancer.  

Margins:  This describes the area at the edge of the specimen being examined by the pathologist.  Positive margins mean that cancer cells are found at the edge of the material removed; negative/not involved/clear margins mean that no cancer cells are found at the outer edge; close margins are neither positive nor negative.  


My primary oncologist prescribed Zofran tabs sublingual (4 mg every 6 hours as needed) but I continue to have symptoms. I have no appetite and losing weight as a result. Are there any other options?


I’m a patient currently being treated with R-CHOP therapy for lymphoma. I have persistent nausea that is incredibly burdensome.

I am very sorry to hear of your current nausea. This is a known side effect of some chemotherapy regimens. Fortunately, we have a lot of experience in managing nausea and numerous options are available to you.

In order to appropriately provide recommendations it is important to briefly review the different kinds of nausea and vomiting to determine the best approach for you. In your specific situation the major types of nausea are most likely acute or delayed chemotherapy-induced nausea/vomiting (CINV) and/or anticipatory nausea/vomiting (ANV). Acute CINV is when nausea occurs within the first 24 hours from receiving chemotherapy. Delayed CINV is when nausea occurs after 24 hours from receiving chemotherapy. Lastly, ANV is a conditioned response where someone has nausea prior to receiving chemotherapy.

Most oncologists consider patients who receive R-CHOP to be moderate to high risk for developing acute or delayed CINV. Thus, I would think this is what you might be experiencing. The standard way to approach this is using Zofran, which you are currently using. I would recommend scheduling your Zofran every 6 hours. You can try taking Zofran 30-60 minutes before you eat a meal, which should decrease your nausea prior to eating. If this does not work then it would be reasonable to use Compazine 10 mg four times a day. You can combine the Compazine at the same time you take Zofran.

If this does not work then I would recommend you contact your local oncologist for further therapeutic options, which may include Ativan, Dexamethasone, Olanzapine, and/or Marinol.

Prior to receiving your next dose of R-CHOP please let your oncologist know about your nausea, as we would like to prevent this from happening again in the future. We are able to prevent this by providing a combination of Emend + Dexamethasone + Olanzapine before, during, and immediately after receiving R-CHOP. Additionally, after completing the course of Emend + Dexamethasone + Olanzapine you can schedule Zofran every 4 hours with or without Compazine over 3-5 days.

Finally, it is important to review all of your medications with your oncologist. We want to ensure you are not taking medications that will create drug-to-drug interactions that could alter your heart rhythm. Your oncologist may ask for you to get an ECG (heart tracing) before taking certain anti-nausea medications to make sure your heart’s rhythm is normal. This information is not intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician prior to making decisions about your treatment.

As an African American male, what are my risks of developing prostate cancer?


This year, the American Cancer Society estimates that nearly 1.5 million Americans will be diagnosed with some form of cancer. Scientific evidence shows that about one-third of those deaths could have been prevented by making lifestyle changes. Smoking, being overweight, lack of exercise, and eating a poor diet — all modifiable risk factors — have been linked to cancer.

Prostate cancer tends to affect older individuals. The median age at diagnosis is 68. Although most of these men die with prostate cancer, not from it, the median age of men who do succumb to the disease is 80. Because many diseases become more prevalent with increasing age, none of this may be particularly surprising.

What may be surprising is that race and ethnicity significantly influence who gets prostate cancer and who dies from it. African American men have, by far, the highest incidence of the disease: they are roughly 1.6 times more likely to develop prostate cancer than whites and 2.6 times more likely than Asian Americans. The gap in mortality rates is even more dramatic — African Americans are more than twice as likely to die of prostate cancer as whites and about five times more likely to die of it than Asian Americans.

Due to this data, many health care professionals agree to be more cautious when screening African American men for prostate cancer. However, over the last several years, controversy has developed as to who to screen and how. This is an ongoing discussion in the cancer communities, and guidelines will likely be shifting over the next several years. For now, we recommend patients engage in a discussion on the pros and cons of screening with their primary care physician. This may involve a blood test or other exam methodologies to examine prostate itself.

Sources: ancer_in_african-american_men_85,P01245