Advances in cancer treatments have increased the number of cancers treated using immunotherapy. The percentage of patients selected for immune checkpoint inhibitor drugs – a subtype of immunotherapy – has increased from 1.54% in 2011 to 43.63% in 20181. The percentage response of patients to immune checkpoint inhibitor drugs increased from 0.14% to 12.46%. With selection increasing 29 times and response surging by 89 times, immunotherapy is quickly becoming mainstream for cancer patients.
Cancer immunotherapy offers an additional layer of hope to cancer patients, but some oncologists may face a daunting task managing patients’ optimism and the realities surrounding these evolving therapies. This article explores common patient misconceptions about immunotherapy, and looks at how oncologists can be both realistic and hopeful when managing patients who are either inquiring about immunotherapy or who may actually be candidates for it.
Two major immunotherapy misconceptions
The news and social media typically report on immunotherapy clinical trial breakthroughs, but the media may not reveal complete details of novel efficacious immunotherapy drugs. These information gaps could lead cancer patients to have unrealistic expectations about immunotherapy. Here are two major misconceptions some patients may have:
1. Immunotherapy cures cancer
In a 2022 Sermo survey of specialists in our community, 56% of these experts reported that most patients wrongly believe that immunotherapy cures any cancer. These misconceptions could be due to media headlines on the latest cancer immunotherapy drugs that give patients hope.
Some cancer patients may discuss these cancer therapy discoveries with their oncologist with the hopes of getting treated with a new drug. These patients are typically unaware that the apparently efficacious new immunotherapy drugs may not be suitable for them.
“Patients believe immunotherapy can cure cancer into remission and it is safer than chemotherapy with little to no side effects. They also think it can be given at any time, even to every sick patient in the ICU”. A pulmonologist in the Sermo physician community stated in one of our recent surveys.
These patients have these misconceptions because they do not have sufficient information to alter their beliefs. Also, some patients do not consider other indications for selecting an immunotherapy intervention. For instance, an immunotherapy drug may have a potentially life-threatening adverse effect that could make it unfit for a patient.
Therefore, it is critical for oncologists to inform their patients by educating them on the potential risks and limitations of immunotherapy. Oncologists may even dive into the study details that were not published in the media report and explain grey areas clearly. And further, explaining why the preferred conventional treatment may be a better option could also strengthen the doctor-patient relationship and position the physician as being open to different approaches but still ultimately wanting the best option available for a patient’s unique case.
2. Immunotherapy is affordable
Some patients may believe new immunotherapy drugs are affordable and/or covered by insurance. These cancer patients may not understand the degree of financial burden novel cancer treatments entail. In some cases, the average price of a newly launched cancer drug can exceed $100,000 per treatment course2 per patient.
Also, the average age for cancer diagnosis in the United States is 663 years, and the US Census Bureau data reports that the average mean retirement income for retirees aged 65 years and above is $73,228. These figures suggest that the average retiree in the US may not be able to afford the cancer treatments they may hear about in the media.
Hence, it is vital for oncologists to explain these realities to patients, even if they are eligible for cancer immunotherapy. Patients need to clearly understand the financial commitments involved before treatment commences.
How oncologists can manage patient immunotherapy expectations
Oncologists typically encounter patients at various levels of awareness about cancer immunotherapy. Some patients are new to immunotherapy and require more counseling. Others are knowledgeable but need guidance with information gaps. Here are some strategies oncologists can use to manage cancer patients’ immunotherapy expectations.
Provide optimistic and realistic counsel
Educating your patients about specific clinical details of immunotherapy will help them make better decisions. With a sense of hope after several failed chemotherapy treatments, some patients choose immunotherapy without due consideration.
It is necessary for oncologists to discuss the risks and limitations of immunotherapy. Also, a physician can explain the role of genomic testing and meeting eligibility criteria when determining an individual’s suitability for immunotherapy. You can educate your cancer patients on the treatment realities while staying optimistic. Empowering your patients with all the relevant details and immunotherapy facts helps them make a shared decision that could positively impact their health outcome.
Access to updated online resources
Physicians don’t have to do all of the educating in person. Most cancer centers have a website where patients can access quality information about cancer care and their services. Referring them to these sites and other factual research may empower them to learn more. Further, according to a respiratory physician in our community, “The new treatments based on immunotherapy information is coming too fast and needs to be simplified.” This highlights the need for easy-to-understand information on cancer websites.
Cancer websites with updated resources containing reviews of the latest research in cancer therapy will facilitate patients’ self-education. In addition, these review articles may help your patients develop a realistic attitude toward the advances in cancer immunotherapy. Also, consistently publishing updated reviews of the latest cancer research boosts your center’s position as a thought leader on immunotherapy facts.
Use an oncology support team
Globally, there is approximately one oncologist per 100 cancer patients4. This means the average oncologist is busy. However, some patients may have questions or still need help navigating the resource page on websites. That’s why creating and using a dedicated support team can lead to a positive patient experience. For instance, 40% of the oncologists in the latest Sermo community survey reported that they have more than one person in their oncology support team.
Training and retraining members of a team on how to direct patients to resources that answer questions will reduce the time spent answering patients’ questions. It also gives doctors more time to focus on patient care.
Get a physician support team
The average oncologist may not have time to consistently watch the news to stay updated on the latest cancer research breakthrough. Joining a physician community like Sermo can help you stay connected and updated on current cancer treatment advances that may positively affect your patient outcomes. You can also share your learnings and hear from peers about how they handle and overcome specific clinical challenges in cancer care.