The war on cancer is now looking within the patient's arsenal of weapons: genes, molecules, and the immune system. The conventional regimen of surgery-radiotherapy-chemotherapy is slowly but surely giving way to targeted, personalized treatments and more intricate diagnostic tools. Combination therapies to keep cancers in check are being worked upon.
The emerging field of immunotherapy harnesses the immune system's power to fight diseases. Immunotherapy has recently shown impressive results in the treatment of multiple cancers. Introducing a class of drugs called checkpoint inhibitors has dramatically improved therapeutic options. People with melanoma, lung, kidney, bladder, leukemia, and other cancers may benefit from these drugs.
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How Much Does Immunotherapy Cost in India?
Immunotherapy costs USD 3600 to USD 4400 in India. The overall cost of the procedure depends on factors including pre-procedure tests (Blood tests, PET CT, IHC, DNA test on Block, biopsy, etc.), consumables, cost of accommodation, etc.
Types of Immunotherapy
Immune Checkpoint Inhibitors
They activate dormant cells (T-cells) and block proteins that stop the immune system from attacking the cancer cells. In recent years, a range of new drugs has emerged, like CTLA-4 inhibitors, PD-1 inhibitors, and PD-L1 inhibitors, which can activate specific T-cells, depending on the type of cancer. Checkpoint inhibitors treat cancers such as melanoma, skin and lung cancer.
Note: Checkpoint inhibitors boost all the immune cells, not just those targeting cancer. So the overactive T cells can cause possible side effects. Consult your doctor for possible side effects.
Tumor-Infiltrating Lymphocyte (TIL) Therapy
T-cells are powerful white blood cells that fight infections. In this treatment, doctors remove T-cells that have started to attack your tumor. They grow a large batch of these cells, called tumor-infiltrating lymphocytes (TILs), in a lab. They then put these activated fighters back into your body.
Natural Killer (NK) Cell Therapy
These immune cells attack foreign invaders like cancer in your body. Adding CARs to NK cells helps them target the cancer even better.
Passive Immunotherapy
It helps the immune system act directly against cancer. It involves antibodies or other immune system components made outside the body and administered to patients to provide immunity against disease to help fight off cancer.
Monoclonal Antibody (mAb) Therapy
This is the most widely used form of cancer immunotherapy. mAb targets specific proteins in cancer cells or inhibits cancer growth factors. This helps to reduce the rate of growth and proliferation of cancer cells. mAb therapy has been developed for some but not all cancers, and certain cancer cells are more vulnerable than others to mAb interventions.
Types of cancers include Brain cancer, Breast cancer, chronic lymphocytic leukemia, colorectal cancer, head and neck cancers, Hodgkin's lymphoma, Lung cancer, and Melanoma.
Non-specific Immunotherapy
It enhances the body's immune response to fight cancer. Its principle is to boost the immune system, increasing the probability of it attacking cancerous cells. Non-specific immunotherapy includes vaccines usually given with chemotherapy (cancer vaccines).
Oncolytic Virus Therapy
Oncolytic viruses infect and kill cancer cells without harming healthy cells. The FDA has approved one oncolytic virus, talimogene laherparepvec (T-VEC, Imlygic), to treat metastatic melanoma.
Cancer Vaccines
These use your immune system to prevent or treat cancer. Cancer vaccines are made from dead cancer cells, proteins or pieces of proteins from cancer cells, or immune system cells.
Four vaccines are approved to prevent cancer:
- Cervarix, Gardasil, and Gardasil-9 protect against the human papillomavirus (HPV), which is linked to cancers of the cervix, throat, vagina, vulva, anus, and penis.
- Hepatitis B (HBV) vaccine (HEPLISAV-B) protects against HBV infections that can cause liver cancer.
FDA-approved vaccines to treat cancer:
- Sipuleucel-T (Provenge) treats advanced prostate cancer when hormone therapy doesn't work.
- Talimogene laherparepvec (T-VEC) treats melanoma skin cancer that has spread.
- Bacillus Calmette-Guérin, or BCG, treats early-stage bladder cancer.
How Often You Will Receive Immunotherapy Treatment
The frequency and duration of your immunotherapy treatment depend on the following factors:
- Type and stage of cancer
- Type of immunotherapy
- Body's reaction to treatment
You may receive treatment every day, week, or month. Some Immunotherapies are given in cycles. To know the best course of treatment, speak to our panel of cancer specialists for guidance on proper care and treatment.
How Immunotherapy Is Given?
The different forms of immunotherapy mentioned above can be given in different ways. These include:
- Oral: Immunotherapy is available in pills or capsules that can be swallowed.
- Intravenous (IV): The immunotherapy is administered by injecting a vein.
- Topical: A cream form of immunotherapy is available for treating skin cancer in its earliest stages. Apply the cream directly onto the skin.
- Intravesical: The immunotherapy is administered directly into the bladder.
Which is Safer, Chemotherapy or Immunotherapy?
Chemotherapy and immunotherapy often cause many similar side effects, including:
- High blood pressure
- Fluid buildup (lymphedema), usually in the legs
- Fever or chills
- Pain or weakness
- Headaches
- Rashes or itching
- Fatigue
- Nausea or vomiting
- Diarrhea
- Mouth sores
Other chemotherapy-related side effects may include:
- Weight loss or weight gain
- Hair loss
- Anemia
- Weakened immune system leading to infections
After the initial treatment, the side effects of immunotherapy typically decrease in intensity. For chemotherapy, most side effects subside once treatment is completed. One advantage of chemo is that the side effects appear when the treatment starts, but once you stop the chemo, most of those side effects go away. They are dose-dependent, they're timing-dependent. You may have no side effects when you're using immunotherapy, which would be great. Still, on the other hand, you may have those random idiosyncratic reactions that are autoimmune phenomena that happen to the patient because the immune system was awakened.
Which Hospital is Best for Immunotherapy in India?
- Medanta - The Medicity, Gurgaon: Accredited by NABH and NABL accredited, this is the first hospital in the country that offers Robotic Surgeries in Cardiology, Urology, and Gynaecology. The hospital comprises a well-equipped team highly experienced in treating breast cancer, fibroadenoma, fibrocystic breast, intraductal carcinoma, etc.
- Kokilaben Dhirubhai Ambani Hospital Mumbai: This hospital in India is one of the leading institutions for cancer treatment and has been officially designated as a center for integrated oncology and palliative care by the European Society of Medical Oncology.
- BLK Super Specialty Hospital New Delhi: This is amongst the first hospitals to offer HIPEC (Hyperthermic Intraperitoneal Chemotherapy) Technology in India. It was Asia's first and the world's seventh hospital to introduce Cyber-knife VSI. Besides Cyber-knife, the hospital provides other modern technologies, such as IGRT, Trilogy Tx Linear Accelerator, IMRT, 3D CRT, and high-dose-rate brachytherapy.
- Fortis Memorial Research Institute (FMRI): Accredited by NABH, the hospital is a multi-specialty tertiary care hospital. According to a global study, FMRI is the world's second most technologically advanced hospital. The Institute is the 'Mecca of Healthcare' for the Asia Pacific region.
Conclusion
If you are undergoing immunotherapy treatment, it is essential to understand its mechanism and potential outcomes. Being informed about your treatment can help you better prepare for it and make informed decisions about your care. Healthcare providers may recommend immunotherapy for advanced cancer cases or when traditional treatments have failed.