Renal cell carcinoma is just another term for kidney cancer. Although we don’t hear much about this type of cancer, it is among the 10 most common cancers that occur in men and women. Just like other cancer types, chemotherapy is not too much of an effective treatment for kidney cancer.
Kidney cancer is tricky to treat as it cannot be removed by surgery. Of the treatment options that are available, today we discuss immunotherapy for kidney cancer.1
What Is Immunotherapy?
Immunotherapy is a treatment that uses the body’s immune system to fight the spreading cancer cells. Cancer cells are not recognized by the body’s immune system as a foreign invader as they are quite similar to the normal body cells. However, they do not function like normal body cells. They frequently change or “mutate” to escape from the immune system. Immunotherapy uses medications to bring this to the notice of the immune system so that it can locate and destroy the cells.
The immune system is the body’s police force. When foreign invaders like viruses, bacteria, or any other disease-causing microorganisms enter the body, the immune system is alerted and gets its officers to get rid of them. Lymph nodes, present in most parts of the immune system, and white blood cells like T cells fight infections and cancers.
Immunotherapies uses these three general categories to boost the immune system:2
- Checkpoint inhibitors: These disrupt the signals that allow the cancer cells to hide from the attack of the immune system.
- Cytokines: These are protein molecules that help regulate and direct the immune system.
- Cancer vaccines: These treat and prevent cancer by targeting the immune system.
How Immunotherapy Fights Kidney Cancer
Immunotherapy uses cytokines and checkpoint inhibitors to treat kidney cancer. Let’s examine these elaborately.3
1. Cytokines
Cytokines are man-made protein molecules that activate the immune system and cause the kidney cancer cells to shrink to a small extent. The two most common cytokines used for treating kidney cancer are interleukin-2 (IL-2) and interferon-alpha.
Interleukin-2 (IL-2)
Only a very small percentage of kidney cancer patients responds to this cytokine. But it is the only therapy that results in long-lasting responses. Only doctors who are specialized to use cytokines are allowed to treat patients with the required dose of IL-2. High doses can shrink the cancer cells in the kidneys, but this comes with a few serious side effects. Due to this reason, doctors use it only on patients who are relatively healthier to withstand the side effects, which include the following:
- Extreme fatigue
- High fever and chills
- Diarrhea or abdominal pain
- Trouble breathing
- Low blood pressure
- Rapid heartbeat
- Mental changes
- Fluid buildup in the lungs
- Intestinal bleeding
- Heart attacks
- Kidney damage
Interferon-Alfa
This cytokine is not as effective when used on its own. Therefore, most doctors use it in combination with other targeted drugs to increase its efficiency in the treatment of kidney cancers. It is usually given as an injection under the skin (subcutaneous) and the patient is treated at least three times a week. The common side effects of this cytokine include:
- Fever
- Chills
- Muscle aches
- Fatigue
- Nausea
2. Immune Checkpoint Inhibitors
It is essential for the immune system to prevent itself from attacking normal cells. To allow this to happen, it uses certain “checkpoints” which are molecules in the immune cells to be turned on (off) to start an immune response. Cancer cells, sometimes, use these checkpoints to protect themselves from the attack of the immune system. Nivolumab (Opdivo) is an example of a checkpoint inhibitor that increases the immune system’s response against cancer cells and slows down their growth. This drug is used as an intravenous (IV) infusion, usually twice a week.
Immune checkpoint inhibitors also have possible side effects such as the following:
- Fatigue
- A cough
- Nausea
- Itching
- Skin rash
- Joint pain
- Loss of appetite
- Constipation
- Diarrhea
Precautionary Measures For Immunotherapy
Before you begin any new treatment, it is important to discuss all the possible reactions of the body’s immune system and the side effects caused by the drugs. It is always better to be prepared than to be unaware of the changes that may occur in your body. It may help to discuss the following points with your doctor before going ahead with immunotherapy:
- The number and duration of the treatment sessions
- The type of medications (pills or intravenous)
- Possible side effects
- Possible interactions with existing medications or treatments
- Activities to avoid during the treatment period
- Efficacy of the treatment
Immunotherapy has been proven to be effective in the treatment of kidney cancer and advanced kidney cancer, a disease that cannot be corrected through surgery. Be aware of your choices and go into any therapy with complete knowledge.
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