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Chemotherapy or Immunotherapy: Which is More Effective?

September 3, 2022
Shimon Slavin
cancer immunotherapy

A person with cancer has one wish that trumps all others: to beat cancer and live a long and fulfilling life. Conventional cancer therapies such as surgery, chemotherapy and radiotherapy have proven successful in treating many types of cancer. Unfortunately, they do not always lead to a complete cure for patients, even if remission has been achieved.

When is chemotherapy ineffective?

Treating cancer with a combination of chemotherapy drugs and surgery can be quite effective, and lead to a patient being cured or enter remission. Chemotherapy is often the most efficient way to stop a rapidly-growing or metastatic tumor, and to reduce its size as much as possible.

However, doctors may encounter the following problems when administering chemotherapy.

First, not all types of tumors respond positively to chemotherapy. There are some cancers for which chemotherapy is simply ineffective.

Second, over time, cancer cells may become “resistant” to chemotherapy and stop responding to the drugs.

Third, even if the treatment was successful and the patient went into remission, it is not uncommon for the disease to return. This happens because chemotherapy does not destroy cancer stem cells, from which the tumor develops.

Finally, chemotherapy has many side effects because it destroys healthy cells along with cancer cells. At the same time, the patient’s body may already be so weakened that it cannot tolerate further courses of chemotherapy.

How does immunotherapy work?

The main principle of immunotherapy is to activate the patient’s own immune resources to fight the malignant tumor.

In a healthy body, the immune system successfully recognizes and destroys any cancer cells that result from random mutations. Cancer occurs when the immune system malfunctions for some reason and malignant cells begin to divide actively, forming a tumor.

Modern immunotherapy methods can work along the following lines:

  • Eliminate factors that suppress the patient’s immune system and prevent them from fighting the disease
  • Help the patient’s immune system better recognize malignant cells and destroy them
  • Target and destroy cancerous cells selectively and effectively, without damaging healthy tissue.

Thus, immunotherapy may be most effective in the following cases:

  • After successful conventional treatment, when the disease is in the “minimal residual disease” stage. In this case, immunotherapy can destroy the remaining cancer cells as well as prevent the development of recurrences.
  • In the case of remission, when visual diagnostic methods can’t spot the tumor. A tumor of just 1mm²  may contain millions of malignant cells in. Immunotherapy will destroy these invisible cancer cells, including the cancer stem cells that originally spawned the tumor.
  • When a patient cannot tolerate chemotherapy because of its toxicity to the body, immunotherapy can be prescribed as an effective means to reduce the size of the tumor and the progression of the disease.

Is immunotherapy better than chemo?

Based on the above, it follows that the use of chemotherapy or immunotherapy can be prescribed based on the type of cancer, the stage of the disease, the clinical condition of the patient and the effectiveness of the conventional treatments already used.

Generally, conventional therapies like chemotherapy are used during the initial stage of treatmentIf the type of cancer is known to be resistant to chemotherapy, immunotherapy may be prescribed right away.

Immunotherapy is most effective in the “minimal residual disease” stage, when small tumors need to be destroyed and the insidious disease completely cured.

With large and resistant tumors, immunotherapy can slow the progression of the disease, reduce the size of the tumor, and in some cases even cure the disease. However, the body’s response to immunotherapy in such cases can vary significantly. It is impossible to predict in advance how effective the treatment will be for each individual patient.

Of utmost importance in the choice of treatment is also the patient’s quality of life, which can significantly worsen with chemotherapy, while with immunotherapy patients usually report only minor side effects.

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