As immunotherapy is increasingly used in the treatment of gastric cancer, it is necessary for gastric cancer patients to increase their knowledge of this new therapy. One of the things that patients need to know is what to do before and after immunotherapy.
Cooperate to complete a comprehensive evaluation
Before starting immunotherapy, in addition to the tests that patients with gastric cancer typically undergo, doctors typically assess the likelihood that patients may experience immune-related adverse events (irAE). Specifically, the assessment includes medical and family history, general condition, and the presence of immune diseases.
It is important to note that if a patient has had an autoimmune disease or is being treated for an autoimmune disease, there may be a worsening of the pre-existing immune disease after receiving immunotherapy. Therefore, patients should inform their physicians in advance if these conditions exist.
Be alert for immune-related adverse events
Physicians will inform about potential adverse effects of immunotherapy prior to treatment. In general, adverse events occur early, within a few weeks to 3 months after the start of immunotherapy in most patients, and in some patients up to 1 year after the end of treatment.
Common adverse reactions to immunotherapy include immune-related skin toxicity (rash, pruritus, and vitiligo), immune-related endocrine disorders (thyroid disease, pituitary inflammation, type 1 diabetes), immune-related hepatotoxicity, gastrointestinal and hepatic toxicity, and immune-related pneumonia. Some other less common ones include neurotoxicity, cardiotoxicity, rheumatism, nephrotoxicity, ocular toxicity, hematologic toxicity, and graft rejection.
In the event of an adverse event, the patient should immediately inform the healthcare provider so that the physician can take prompt action to prevent deterioration. In many cases, especially after a serious adverse event, physicians typically discontinue immunotherapy and use immunosuppressive or immunomodulatory agents to control the adverse reaction.
It is important for patients to learn as much as possible about the precautions to take before receiving immunotherapy as a new oncology treatment, and to monitor their changes during treatment.