HJAR May/Jun 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2020 51 Rhonda Gentry, MD Medical Director of Medical Oncology CARTI, Inc. Immunotherapy, however, actually revs up the immune system in such a way that it allows it to identify and kill the cancer cells, while causing minimal effects on normal healthy tissues. Gives Treatment Options to Those Who Would Otherwise Not be Candidates for Treatment Since immunotherapy is generally less toxic than chemotherapy, some patient populations who were previously unable to tolerate chemotherapy are able to tolerate immunotherapy. These can include elderly patients and those with certain comorbidi- ties, including cardiac issues or organ dys- function. Additionally, for patients who have found chemotherapy is no longer effective in treating their particular cancer, immu- notherapy may give them another option. Reduces Side Effects While immunotherapy may cause side effects, they are often drastically less than those that we typically see in patients who undergo chemotherapy. Patients often feel so well on treatment they worry it may be in- effective because they expect cancer care to come with a long list of negative side effects. The side effects that are seen with immu- notherapy occur when we rev up the im- mune system too much, and it begins to see healthy normal tissues as the enemy, and carries out a reaction against them. For ex- ample, if the lungs are inappropriately seen as foreign, it causes autoimmune pneumo- nitis, which can be severe if not recognized quickly and treated with steroids to calm the immune system. Similarly, the colon, thy- roid, and adrenal glands can be common sites of autoimmune toxicity from immune therapies. It is impossible to predict which patients will have side effects at the initiation of ther- apy, regardless of symptoms they may have had in the past. Subsequently, all patients are monitored closely and treated at the first sign of toxicity. Because patients with autoimmune problems such as psoriasis, lupus, or rheumatoid arthritis are already afflicted with an overactive immune sys- tem, these patients are often not able to rou- tinely receive immune therapies for cancer treatment. Easier Treatment Experience Because of the reduced number of side ef- fects, we do not have to routinely administer pre-medications when a patient receives an immunotherapy infusion. With fewer pre- treatment drugs, patients undergo shorter infusion times, making their entire experi- ence easier. Extends and Increases Quality of Life Most importantly, we find that patients who respond well to immunotherapy are living longer, and experiencing a better qual- ity of life. While we are still in the relatively early stages of truly understanding immunother- apy as a cancer treatment, the changes that have occurred both on a molecular level and in the lives of our patients give us hope for a revolutionary shift in the way we can de- liver front line cancer care. With additional research and refinement, the possibilities are endless for our ability to deliver personal- ized cancer care. n Rhonda Gentry, MD joined CARTI’smedical team in 2008.Today, she leads a teamof 15medical oncolo- gists as the medical director of the medical oncol- ogy department. Dr. Gentry treats patients at the CARTI Cancer Center in Little Rock. She completed a fellowship in hematology/oncology, a residency in internal medicine, and received a medical degree from the University ofArkansas for Medical Sciences in Little Rock. “The goal of immunotherapy is to utilize the body’s own immune system, or “army”, to fight the enemy.”