Adverse reactions to immunotherapy: “Warriors” occasionally have “little emotions”

Author: Yu Xiaolei, Affiliated Hospital of Chengde Medical College

Reviewer: Hu Chanchan, Chief Physician, Affiliated Hospital of Chengde Medical College

Immunotherapy, a major breakthrough in cancer treatment, activates the body's own immune system to identify and attack cancer cells. However, this powerful treatment may also trigger a series of adverse reactions that can involve multiple organs or systems throughout the body, ranging from common mild reactions to rare severe reactions.

1. Adverse reactions caused by immunotherapy

1. Skin reactions: including rash, itching, erythema, dryness and desquamation, etc. These skin symptoms may appear anywhere on the body and may be accompanied by pain or discomfort.

Figure 1 Copyright image, no permission to reprint

2. Gastrointestinal reactions: mainly manifested as diarrhea, nausea, vomiting and abdominal pain, etc. These reactions may be related to the direct impact of immunotherapy on the gastrointestinal mucosa.

3. Fatigue and weakness: Immunotherapy may cause cancer patients to feel extremely tired and weak, which may affect their daily life. Patients should ensure adequate rest and sleep and avoid overwork.

4. Fever and chills: These symptoms may be normal physiological reactions after the immune system of cancer patients is activated, but they may also indicate the occurrence of complications such as infection. Patients should closely monitor changes in body temperature and seek medical attention immediately if abnormalities are found to eliminate potential risks.

5. Endocrine system reaction: Immunotherapy may interfere with the normal function of the endocrine glands of cancer patients, leading to abnormal thyroid function, hypopituitarism, etc. Once it occurs, it may have a serious impact on the patient's quality of life. Therefore, patients should monitor their endocrine indicators regularly. Once abnormalities are found, they should seek medical attention and take appropriate measures in a timely manner.

6. Liver toxicity: Immunotherapy may cause liver toxicity, which manifests as elevated transaminases, jaundice and other symptoms. The liver is an important organ for drug metabolism and is easily damaged by immunotherapy drugs. Patients should maintain an active and healthy lifestyle, avoid drinking alcohol, and use drugs that may burden the liver or have significant adverse reactions with caution. At the same time, it is also crucial to monitor liver function regularly so that any potential liver problems can be detected and treated in a timely manner.

Figure 2 Copyright image, no permission to reprint

7. Pulmonary reactions: Immunotherapy may cause pulmonary reactions including interstitial pneumonia and pulmonary fibrosis. These reactions may cause patients to experience symptoms such as dyspnea and cough. Patients should pay close attention to changes in lung symptoms. Once abnormalities are found, they should seek medical attention and undergo appropriate imaging examinations in a timely manner to confirm the diagnosis and take appropriate treatment measures.

Figure 3 Copyright image, no permission to reprint

8. Nervous system reactions: Immunotherapy may also cause reactions in the nervous system, such as headaches, dizziness, paresthesia, etc. This may be related to the direct or indirect effects of immunotherapy on the nervous system. In order to alleviate these symptoms, patients should try to maintain emotional stability and avoid excessive fatigue and mood swings. At the same time, patients should strictly follow the doctor's instructions for necessary examinations and treatments to ensure the health of the nervous system.

2. Time of onset of adverse reactions

Adverse reactions associated with immunotherapy may occur at any time after the start of treatment, including during treatment and for a period of time after the end of treatment. Most adverse reactions occur within weeks to months after the start of treatment, but some patients may not experience adverse reactions until after the end of treatment. Therefore, cancer patients need to remain vigilant throughout the immunotherapy process and strictly follow the guidance of medical staff for self-monitoring and care to ensure that any possible adverse reactions are detected and treated in a timely manner.

3. Self-care guide for adverse reactions

1. Skin care

Keep your skin clean and moisturized daily and use alcohol-free, non-irritating moisturizing products.

When going out, please take sun protection measures such as wearing a sun hat, using a parasol, and applying sunscreen.

Wear soft, loose-fitting, cotton clothing to reduce friction against your skin.

Avoid scratching your skin. If itching or redness occurs, try applying a cold compress or patting the skin to relieve the symptoms.

Trim your nails regularly to avoid scratching your skin due to unbearable itching or unconsciousness.

If you experience severe skin reactions, please seek medical attention immediately and use oral and topical medications as directed by your doctor.

2. Gastrointestinal care

Keep the skin around the anus clean and dry to prevent damage and infection.

Increase your fluid intake to prevent dehydration, especially if diarrhea is severe.

Adjust your diet and avoid greasy, spicy and other irritating foods.

Monitor your weight and bowel movements, and seek medical attention promptly if any abnormalities are found.

You can try soothing treatments such as massage and acupuncture to relieve gastrointestinal discomfort.

3. Other system care

For possible adverse reactions to the endocrine system, liver, lungs and nervous system, patients should strictly follow the professional guidance of medical staff and undergo regular examinations and treatment. At the same time, maintaining a healthy lifestyle, such as regular work and rest, and a balanced diet, can also help reduce the occurrence and severity of adverse reactions.

In short, immunotherapy brings new hope for cancer patients, but its accompanying adverse reactions should not be ignored. During treatment, patients should fully understand the possible adverse reactions and their treatment methods, and perform self-care and monitoring under the guidance of medical staff. Through scientific and reasonable nursing measures and a positive attitude towards life, patients can better cope with the challenges of treatment and improve their quality of life.