- Emotional & Physical Effects
- Anemia and Cancer
- Appetite Changes
- Bleeding and Bruising
- Blood Clots and Anticoagulants
- Body Image
- Bone Health
- Bowel Management
- Cancer Pain Management
- CAR T-cell Therapy Side Effects
- Chemobrain
- Chemotherapy Treatment Side Effects
- Constipation
- Dehydration
- Diabetes Management
- Fatigue
- Hair Loss
- Heart Health
- Immune Checkpoint Inhibitor Side Effects
- Immunotherapy Treatment Side Effects
- Infections
- Lymphedema
- Managing Medications
- Mouth Sores from Chemotherapy
- Nausea
- Neutropenia
- Peripheral Neuropathy
- Pulmonary Embolism and Cancer
- Radiation Fibrosis
- Sexuality and Cancer
- Skin and Nail Changes
- Sleep Loss
- Stem Cell Transplant Treatment Side Effects
- Stress Reduction
- Targeted Therapy Side Effects
- Weight Loss
Immunotherapy Treatment Side Effects
Immunotherapy helps the immune system find and attack cancer cells more effectively. Cancer can sometimes hide from the immune system or stop it from working properly. Immunotherapy works by blocking those signals or by boosting the immune system's ability to fight the disease. Some treatments, like immune checkpoint inhibitors, take the "brakes" off immune cells, while others, like CAR T-cell therapy, train the immune system to target cancer directly. This gives the body a better chance to destroy cancer cells.
While immunotherapy can be highly effective, it may also cause side effects, especially because it stimulates the immune system, which can sometimes attack healthy tissues as well as cancer cells.
Common skin reactions from immunotherapy
Skin toxicities are among the most common side effects of immunotherapy. They can range from mild to serious and may appear within weeks of starting treatment, or even months later.
Most common skin side effects:
- Rash: Often appears as small red bumps or rough patches and may be itchy.
- Dry or itchy skin (pruritus): Skin may become flaky, cracked or rough.
- Skin discoloration, including loss of pigmentation
- Photosensitivity (increased sensitivity to sunlight)
- Peeling or blistering skin (in more severe cases)
Less common but serious skin reactions:
- Stevens-Johnson syndrome, a rare disorder of the skin and mucous membranes
- Toxic epidermal necrolysis, a life-threatening skin disorder characterized by blistering and peeling of the skin
- Bullous pemphigoid, an autoimmune blistering disorder
Contact your care team if you experience painful blisters, open sores, fever or skin that begins to peel.
Tips for protecting your skin during immunotherapy
- Use gentle, fragrance-free soaps and moisturizers
- Avoid hot showers, which can dry out skin
- Wear broad-spectrum sunscreen daily (SPF 30 or higher)
- Stay hydrated and avoid scratching irritated areas
- Choose loose, breathable clothing
Other side effects of immunotherapy
In addition to skin reactions, immunotherapy may cause side effects in other parts of the body due to immune system activation.
These side effects include:
- Diarrhea
- Fatigue (feeling tired or weak is very common)
- Fever or chills
- Loss of appetite
- Nausea or vomiting
- Joint or muscle pain
- Headaches
- Immune-related inflammation
In some cases, the immune system may attack healthy organs. These side effects are rare but can be serious if not treated early:
- Colitis (inflammation of the colon): diarrhea, abdominal pain
- Pneumonitis (inflammation of the lungs): cough, shortness of breath
- Hepatitis (inflammation of the liver): yellowing of the skin or eyes, abnormal liver tests
- Endocrinopathies (hormone issues): fatigue, weight changes, dizziness, or mood swings from inflammation in glands like the thyroid, pituitary or adrenal glands
- Nephritis (inflammation of the kidneys): changes in urination, swelling in hands or feet
If any of these symptoms develop, it’s important to notify your care team right away. Early treatment can help prevent serious complications.
How are immunotherapy side effects treated?
Treatment depends on the type and severity of the reaction:
- Topical corticosteroids for mild rashes or itching
- Oral steroids or immunosuppressants for more severe reactions
- Antihistamines to help relieve itching
- Hormone replacement therapy if the glands are affected
- Moisturizers and gentle skin care to protect the skin
In some cases, immunotherapy may need to be paused or stopped if side effects become too severe.
When to call your doctor
Call your doctor or care team if you notice:
- A sudden or spreading rash
- Severe itching
- Blisters or peeling skin
- Painful sores or ulcers, especially in the mouth or genital area
- Fever or feeling unwell
- Diarrhea
- Coughing or trouble breathing
- Yellowing of the skin or eyes
- New or worsening fatigue, confusion or mood changes
Immune-related side effects can be frustrating, but most are manageable, and some may even indicate that the immune system is actively responding to treatment. Your care team may adjust your treatment, prescribe medications or refer you to specialists to manage side effects.
During immunotherapy, some patients may feel like they’re having an allergic reaction. However, these symptoms are typically not due to an actual allergy. Most patients can safely continue treatment while we manage the side effects.
At MD Anderson Cancer Center, our multidisciplinary team includes oncologists, dermatologists, endocrinologists and other supportive care specialists who work together to support you throughout your immunotherapy treatment.
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