Biological Therapy for Cancer Treatment

What is biological therapy?

Biological therapy is the name for a new, growing group of cancer drugs. These drugs work with your immune system. The immune system is the defense system for the human body. It helps your body fight infections and disease. Biological therapy can help your immune system fight cancer, or it can help lessen side effects from other cancer treatments, such as treatment with drugs that attack cancer cells (chemotherapy). It is also called immunotherapy, biotherapy, biologic therapy, or biological response modifier therapy (BRM).

How does biological therapy fight cancer?

Biological therapy may help the immune system fight cancer:

• By stopping or slowing the growth of cancer cells.
• By making it easier for your immune system to destroy or get rid of cancer cells.
• By keeping cancer from spreading to other parts of the body.

When is biological therapy used?

The treatment for cancer depends on a number of factors, such as the type of cancer and how far it has spread. In some cases, biological therapy is the best treatment choice. Some people need only biological therapy. Others may also have surgery, chemotherapy, or radiation treatment.

How is the treatment given?

Some drugs used for biological therapy are given as pills or shots that you can take at home. Others are given through an IV (into a vein), and you must go to the hospital or clinic for your treatment.

Treatment schedules for biological therapy vary. Sometimes the drugs may be given 1 or more times a day. Or they may be given less often--sometimes once a week, or perhaps just once every month or two. Your provider will tell you how often you will get your treatment and how long you will need to be on it.

What are the names of some types of biological therapy?

Different kinds of drugs may be used for biological therapy--some to fight cancer and some to treat the side effects of other cancer treatments. Many of the substances used for biological therapy occur naturally in the body but can also be made in the lab. Examples of the types of drugs used for treatment are interferons, interleukins, colony-stimulating factors, monoclonal antibodies, and nonspecific immunomodulating agents. Gene therapy is yet another type of biological therapy.

• Interferons can improve the way the immune system acts against cancer cells. Interferons may also act directly on cancer cells by slowing their growth or causing them to act more like normal cells. There are 3 main types of interferons: interferon alpha, interferon beta, and interferon gamma.
• Interleukins, such as interleukin-2 (also called IL-2 or aldesleukin), stimulate the growth and activity of immune cells. These immune cells can then destroy cancer cells.
• Colony-stimulating factors (CSFs) usually do not directly affect tumor cells. Instead, they encourage your body to make more white blood cells, platelets, and red blood cells. This helps counteract the side effects of other cancer treatments. Examples of CSFs are erythropoietin (also called epoetin, Procrit, or Epogen) and interleukin-11 (also called IL-11, oprelvekin, or Neumega).
• Monoclonal antibodies (MOABs or MoABs), such as Rituxan (rituximab) and Herceptin (trastuzumab), are antibodies created in the lab. The antibodies can attach themselves to cancer cells. They may be used to:
  • enhance your immune response to the cancer
  • help stop the growth of cancer cells
  • deliver chemotherapy drugs directly to the cancer.
• Nonspecific immunomodulating agents are another type of drug that helps the immune system work better to fight disease. An example used in cancer treatment is bacillus Calmette-Guérin (BCG).
• Gene therapy is an experimental treatment that involves putting genetic material into your cells to fight disease. For example, a gene may be inserted into an immune cell to help it recognize and attack cancer cells.

What are the side effects?

Just like other forms of cancer treatment, biological therapy sometimes causes side effects. The side effects can vary a lot, depending on the drug and the person receiving it. Possible side effects are:

• rashes or swelling where the medicine is injected
• flulike symptoms such as fever, chills, nausea, vomiting, loss of appetite, tiredness, bone pain, and muscle aches
• low blood pressure.

What are clinical trials?

Ask your healthcare provider about clinical trials. These are studies being done to test new treatments, new medicines, and new combinations of medicines. Research programs sometimes allow you to receive the latest treatments. Ask your provider where the closest clinical trials are (often at universities and participating doctors' offices) and how you can learn more about them. Making an appointment to learn about a clinical trial does not mean you have to take part in the trial. The options, the risks, the costs, and whether your insurance will pay will be explained to you. Then you can decide if you want to join the study.

An important thing to know about cancer clinical trials is that they do not use placebos. Placebos are "blanks," that is, pills or injections that actually contain no medicine. Sometimes people worry that participating in a cancer clinical trial will mean that they receive no treatment. In cancer research new drugs and treatments are compared with known treatments, not with a lack of treatment. Scientists are always looking for better ways to treat cancer.

How should I take care of myself during treatment?

• First, follow your healthcare provider's instructions for your treatment. Always ask questions to make sure you understand the directions. It is often helpful to have a friend or family member go with you to help you remember what is said at visits with your provider. You or your family may want to take notes.
• Be sure to tell your provider about all medicines, vitamins, supplements, and any alternative or complementary therapies you are using. Some of these might interact with your drug treatment and cause more side effects.
• Several doctors may be giving you care: your family healthcare provider, a cancer specialist (oncologist), a radiation oncologist (a doctor who specializes in the use of radiation for treatment), and a surgeon. Help your providers communicate with each other. Always take a list of your current medicines and cancer drugs with you to ALL of your doctor visits, review the list with the doctor, and ask for the list to be included with your medical chart. Also share your test results from one provider's office with your other providers by carrying copies of the results with you.
• Get specific instructions about what to eat and drink and what to avoid.
• Ask if you will need pain medicine and how to take it. If your cancer or your treatment is causing pain, it is usually best to take the pain medicine either on a regular basis or just when the pain is starting. There is usually no need to wait until the pain is severe.
• Let trusted family members and friends help you. Give them specific suggestions for what they can do to help make your life easier--for example, do your grocery shopping, put gas in your car, or babysit so you can take a nap.
• Save your energy for important things and things you enjoy.
• Laughter is the best medicine. Humor helps the immune system work. Read funny books or watch funny movies--whatever makes you laugh.

To learn more about biological therapy, contact your local chapter of the American Cancer Society or call 800-ACS-2345, or the Cancer Information Service at 800-4-CANCER. You may also visit their Web sites at http://www.cancer.org or http://www.cancer.gov.