What is Biological Therapy for Cancer: Purpose, Procedure, Results, Preparation & Costs in India

Cancer. The word itself can evoke feelings of fear and uncertainty. For many, the conventional treatments like chemotherapy and radiation are the first things that come to mind. But what if there was another way, a way to harness the power of your own body to fight this disease? That's where biological therapy, also known as immunotherapy or biotherapy, comes in. This blog post aims to provide a comprehensive understanding of biological therapy for cancer, specifically tailored for Indian patients and their families. We’ll cover what it is, why it’s used, how it works, what to expect, potential risks, and, importantly, the costs involved in India.

What is Biological Therapy?

Biological therapy is a type of cancer treatment that uses your body's immune system to recognize and destroy cancer cells. Unlike chemotherapy and radiation, which directly target cancer cells but can also damage healthy cells, biological therapy focuses on stimulating and strengthening your immune system. Think of it as training your immune system to identify cancer cells as the enemy and then empowering it to attack and eliminate them.

This approach can involve using substances made by your own body or created in a lab to boost, direct, or restore your immune system's natural defenses. It’s a rapidly evolving field with new therapies constantly being developed and refined.

Why is Biological Therapy Performed?

Biological therapy is used for several key reasons:

Boosting the Immune System: The primary goal is to enhance your immune system's ability to recognize and destroy cancer cells. Cancer cells often have ways of hiding from or suppressing the immune system. Biological therapy helps overcome these defenses.
Slowing or Stopping Cancer Growth: Many biological therapies can prevent or slow the growth of tumors and stop the spread of cancer (metastasis). This can be particularly important in managing advanced cancers.
Fewer Side Effects (Potentially): Compared to treatments like chemotherapy and radiation, biological therapy often has fewer side effects because it targets the immune system specifically, rather than indiscriminately affecting all cells in the body. However, it's important to note that biological therapy can still have side effects, which we'll discuss later.
Effective When Other Treatments Don't Work: Biological therapy may be effective for cancers that don't respond well to traditional treatments like chemotherapy or radiation. It can offer a new avenue of hope for patients facing difficult-to-treat cancers.
Reducing Cancer Recurrence: By training immune cells to recognize and destroy cancer cells, biological therapy can help prevent cancer from returning after initial treatment. This is particularly valuable for cancers with a high risk of recurrence.

Who Needs Biological Therapy?

Biological therapy isn't a one-size-fits-all solution. Your doctor will need to carefully evaluate several factors to determine if it's the right treatment option for you. These factors include:

Type of Cancer: Some cancers respond better to biological therapy than others. For instance, certain types of leukemia, lymphoma, melanoma, and lung cancer have shown promising results with specific biological therapies.
Stage of Cancer: The stage of your cancer (how far it has spread) will influence the potential benefits of biological therapy. It may be used in early stages to prevent recurrence or in advanced stages to control the disease and improve quality of life.
Overall Health: Your overall health status is crucial. Biological therapy may not be suitable for patients with weak immune systems, pre-existing heart conditions, or neurological ailments. Your doctor will assess your medical history and perform necessary tests to determine if you are a good candidate.
Previous Treatments: Your response to previous cancer treatments will also be considered. Biological therapy may be an option if other treatments have failed or if you've experienced severe side effects from them.
Genetic Markers: Increasingly, genetic testing is used to identify specific markers on cancer cells that can predict response to certain biological therapies. This allows for more personalized and targeted treatment.

It's crucial to have an open and honest conversation with your oncologist to understand if biological therapy is the right choice for your specific situation.

Preparation for Biological Therapy (India-Specific Tips)

Preparing for biological therapy involves several steps to ensure you are physically and mentally ready for the treatment. Here are some India-specific tips:

Doctor Assessment and Counseling: The first step is a thorough assessment by your oncologist to determine if biological therapy is appropriate for you. This will involve a detailed review of your medical history, physical examination, and relevant diagnostic tests. You should also receive comprehensive counseling about the potential benefits and side effects of the therapy. Don't hesitate to ask questions and express any concerns you may have.
Pre-Existing Conditions: It's crucial to inform your doctor about any pre-existing conditions you have, such as weak immune systems, heart conditions, or neurological ailments. These conditions may affect your suitability for biological therapy.
Insurance Coverage: Navigating insurance coverage can be complex. Contact your insurance provider early on to understand what portion of the biological therapy costs will be covered under your policy. Some therapies may have limited coverage, so it's important to be prepared financially. Ask your hospital about payment plans or financial assistance programs that may be available.
Gathering Medical Records: Ensure you have all your medical records organized and readily available. This includes previous treatment records, imaging reports, and pathology reports. This information is essential for your oncologist to make informed decisions about your treatment plan. Ayu can help you digitize and organize these records for easy access.
Lifestyle Modifications: Adopting a healthy lifestyle can significantly improve your overall well-being and potentially enhance your response to biological therapy. This includes:
- Diet: Follow a balanced and nutritious diet rich in fruits, vegetables, and whole grains. Avoid processed foods, sugary drinks, and excessive amounts of red meat. Consult a registered dietitian for personalized dietary recommendations.
- Exercise: Engage in regular physical activity, as tolerated. Even moderate exercise, such as walking or yoga, can boost your immune system and improve your energy levels. Consult your doctor before starting any new exercise program.
- Stress Management: Find healthy ways to manage stress, such as meditation, deep breathing exercises, or spending time with loved ones. Chronic stress can weaken your immune system.
- Sleep: Aim for 7-8 hours of quality sleep each night. Adequate sleep is essential for immune function and overall health.
Mental and Emotional Preparation: Dealing with cancer and undergoing treatment can be emotionally challenging. Seek support from family, friends, or a mental health professional. Joining a support group can provide a sense of community and allow you to share your experiences with others facing similar challenges.
Logistics and Accommodation: If you need to travel to a hospital for treatment, plan your travel and accommodation arrangements in advance. Consider factors such as proximity to the hospital, transportation options, and budget. Many hospitals have tie-ups with nearby hotels that offer discounted rates for patients and their families.

Procedure: Step-by-Step

The procedure for biological therapy can vary depending on the type of therapy you are receiving. However, here's a general overview of what you can expect:

Initial Consultation: You'll meet with your oncologist to discuss your treatment plan, including the specific biological therapy you'll be receiving, the dosage, and the frequency of treatment. This is an opportunity to ask any questions you have and address any concerns.
Pre-Treatment Evaluation: Before starting biological therapy, you'll undergo a series of tests to assess your overall health and ensure you are fit for treatment. These tests may include blood tests, urine tests, and imaging scans.
Administration: Biological therapy is often administered intravenously (through a vein) at a hospital or clinic. The infusion process can take anywhere from a few minutes to several hours, depending on the type of therapy. You'll be closely monitored by medical staff during the infusion. Some therapies may be administered subcutaneously (under the skin) or orally (as a pill).
Treatment Schedule: The frequency of treatment (daily, weekly, or monthly) depends on the type and stage of cancer, the specific drug used, and your individual response to treatment. Your oncologist will tailor the treatment schedule to your specific needs.
Monitoring: During treatment, you'll be closely monitored for any side effects. Regular blood tests and imaging scans will be performed to assess your response to the therapy and adjust the treatment plan as needed.
Follow-Up: After completing the prescribed course of biological therapy, you'll continue to have regular follow-up appointments with your oncologist to monitor your progress and detect any signs of recurrence.

Let's look at some specific examples:

CAR T-cell Therapy: This is a more complex process. First, your T-cells (a type of immune cell) are collected from your blood through a process called apheresis. These T-cells are then sent to a lab where they are genetically modified to express a chimeric antigen receptor (CAR) that recognizes a specific protein on cancer cells. The modified CAR T-cells are then multiplied in the lab and infused back into your body. Before the infusion, you may receive chemotherapy to prepare your body. You'll be closely monitored in the hospital for several days or weeks after the infusion for potential side effects, such as cytokine release syndrome (CRS).
Immune Checkpoint Inhibitors: These drugs are typically administered intravenously every 2-3 weeks. The infusion process usually takes about 30-60 minutes. You'll be monitored for any infusion-related reactions.
Therapeutic Antibodies: Similar to immune checkpoint inhibitors, therapeutic antibodies are usually administered intravenously. The infusion time can vary depending on the specific antibody.

Understanding the Results

The success of biological therapy can vary depending on several factors, including the type of cancer, the specific therapy used, the stage of the cancer, and your overall health. It's important to have realistic expectations and understand that biological therapy may not be a cure for all cancers.

Here's what you need to know about understanding the results:

Response Rates: Response rates refer to the percentage of patients who experience a significant reduction in the size of their tumors or complete disappearance of their cancer after treatment. Response rates can vary widely depending on the factors mentioned above.
Progression-Free Survival: Progression-free survival (PFS) measures the length of time during and after treatment that a patient lives with the disease without it getting worse. This is an important indicator of the effectiveness of a cancer treatment.
Overall Survival: Overall survival (OS) measures the length of time that a patient lives after starting treatment. This is considered the gold standard for measuring the effectiveness of a cancer treatment.
Improved Quality of Life: Even if biological therapy doesn't lead to a complete cure, it can still improve your quality of life by controlling the disease, reducing symptoms, and improving your overall well-being.

Success Rates (India-Specific Data):

CAR T-cell Therapy: One study on India's first homegrown CAR-T cell therapy showed a 73% response rate in patients with B-cell leukemia and lymphoma. This is a promising result, especially considering that these patients had failed other treatments.
Targeted Therapy: Targeted therapy success rates can be up to 80% in some cases, compared to around 30% for chemotherapy. However, it's important to note that these rates can vary depending on the specific target and the type of cancer.

Your oncologist will use a combination of imaging scans, blood tests, and physical examinations to assess your response to biological therapy. They will discuss the results with you and explain what they mean in terms of your prognosis and future treatment options.

Risks and Side Effects

While biological therapy often has fewer side effects than chemotherapy or radiation, it's still important to be aware of the potential risks. The side effects can vary depending on the type of therapy, but some common ones include:

Flu-like Symptoms: Chills, fever, muscle aches, weakness, loss of appetite, nausea, vomiting, and diarrhea are common side effects of many biological therapies. These symptoms are usually mild to moderate and can be managed with medications.
Skin Rashes: Skin rashes are another common side effect, especially with immune checkpoint inhibitors. The rashes can range from mild itching to severe blistering.
Bleeding or Bruising Easily: Some biological therapies can affect your blood clotting ability, leading to increased bleeding or bruising.
Low Blood Cell Counts: Biological therapies can sometimes suppress your bone marrow, leading to low blood cell counts (neutropenia, thrombocytopenia, anemia). This can increase your risk of infection, bleeding, and fatigue.
Fatigue: Fatigue is a common side effect of many cancer treatments, including biological therapy. It can be caused by a variety of factors, including the cancer itself, the treatment, and emotional stress.
Cytokine Release Syndrome (CRS): This is a potentially serious side effect that can occur with CAR T-cell therapy and some other immunotherapies. It's caused by the release of large amounts of cytokines (inflammatory proteins) into the bloodstream. Symptoms can include fever, chills, nausea, vomiting, diarrhea, muscle aches, headache, and difficulty breathing. Severe cases of CRS can be life-threatening.
Immune-Related Adverse Events (irAEs): Immune checkpoint inhibitors can sometimes cause the immune system to attack healthy organs and tissues, leading to a variety of immune-related adverse events (irAEs). These can affect virtually any organ in the body, including the skin, gastrointestinal tract, liver, lungs, endocrine glands, and nervous system.

It's important to report any side effects to your doctor immediately. Many side effects can be managed with medications or other supportive care measures. In some cases, it may be necessary to temporarily or permanently stop the biological therapy.

Costs of Biological Therapy in India (₹)

The cost of biological therapy in India can vary widely depending on several factors:

Type of Cancer: Different cancers require different types of biological therapy, which can have varying costs.
Stage of Cancer: The stage of your cancer may influence the duration and intensity of treatment, which can affect the overall cost.
Specific Drugs Used: The specific biological therapy drugs used will have a significant impact on the cost. Some drugs are more expensive than others.
Treatment Duration: The length of your treatment course will also affect the cost.
Hospital: The hospital you choose can influence the cost, as different hospitals have different pricing structures.
Other Factors: Other factors that can affect the cost include the need for hospitalization, supportive care medications, and monitoring tests.

Here's a breakdown of the approximate costs of some common biological therapies in India:

CAR T-cell Therapy: An indigenous CAR T-cell therapy is available in India for around ₹25 lakh (USD 30,000). In comparison, similar therapies in the US, Canada, and the EU can exceed Rs 8.3 crore (USD 1 million). This makes India a more affordable option for patients who are eligible for CAR T-cell therapy.
Targeted Therapy: The cost of targeted therapy can range from ₹50,000 to ₹3,00,000 ($600 to $3,600) per cycle. A complete treatment course may cost between ₹4,00,000 to ₹20,00,000 ($4,800 to $24,000).
Immunotherapy: Immunotherapy can cost approximately INR 4,41,000 - INR 4,55,000 per month for at least two years. This can be a significant financial burden for many patients.

Affordability:

India offers more affordable targeted therapy programs compared to the US and UK, often costing 60-80% less. However, even with these cost savings, biological therapy can still be expensive for many Indian patients.

Cost-Effectiveness:

It's important to consider the cost-effectiveness of biological therapy, especially in the Indian context. Some biological therapies, like pembrolizumab/lenvatinib and nivolumab/ipilimumab for metastatic renal cell carcinoma, may not be cost-effective at their current prices. Sunitinib is considered a more cost-effective option for this condition in India.

Insurance Coverage:

Check with your insurance provider to see if biological therapy is covered under your policy. Many insurance companies in India are now covering some biological therapies, but coverage can vary depending on the policy.

Financial Assistance Programs:

Explore financial assistance programs offered by hospitals, pharmaceutical companies, and non-profit organizations. These programs may provide assistance with the cost of treatment.

How Ayu Helps

Ayu is a medical records app designed to help you manage your health information effectively. Here's how Ayu can assist you during your biological therapy journey:

Centralized Medical Records: Store all your medical records, including doctor's notes, lab results, and imaging reports, in one secure and easily accessible place. This is especially helpful when coordinating care between different doctors and specialists.
Medication Reminders: Set reminders for your medications and appointments to ensure you never miss a dose or a check-up.
Track Symptoms: Monitor your symptoms and side effects and share them with your doctor to help them adjust your treatment plan as needed.
Share Records Securely: Share your medical records securely with your doctors and family members, ensuring everyone is informed about your health status.
Find Doctors and Hospitals: Use Ayu to find reputable oncologists and hospitals in your area that offer biological therapy.

Frequently Asked Questions (FAQ)

Here are some frequently asked questions about biological therapy for cancer:

1. Is biological therapy a cure for cancer?

Biological therapy is not always a cure for cancer, but it can be a valuable treatment option for many patients. It can help to control the disease, reduce symptoms, improve quality of life, and in some cases, lead to long-term remission.

2. How is biological therapy different from chemotherapy?

Biological therapy works by boosting the immune system to fight cancer, while chemotherapy uses drugs to directly kill cancer cells. Biological therapy often has fewer side effects than chemotherapy, but it can still cause side effects.

3. What are the most common side effects of biological therapy?

Common side effects of biological therapy include flu-like symptoms, skin rashes, bleeding or bruising easily, low blood cell counts, and fatigue.

4. How long does biological therapy treatment last?

The duration of biological therapy treatment can vary depending on the type of cancer, the specific therapy used, and your individual response to treatment. Some treatments may last for several months, while others may last for several years.

5. Is biological therapy covered by insurance in India?

Many insurance companies in India are now covering some biological therapies, but coverage can vary depending on the policy. Check with your insurance provider to see if biological therapy is covered under your policy.

6. What should I do if I experience side effects during biological therapy?

Report any side effects to your doctor immediately. Many side effects can be managed with medications or other supportive care measures.

7. Can I continue working during biological therapy?

Whether you can continue working during biological therapy depends on the type of therapy you are receiving and how you are feeling. Some patients are able to continue working with minimal disruption, while others may need to take time off work.

8. Are there any clinical trials for biological therapy in India?

Yes, there are ongoing clinical trials for biological therapy in India. Ask your doctor if you are eligible to participate in a clinical trial.

9. Where can I find more information about biological therapy for cancer in India?

You can find more information about biological therapy for cancer from your oncologist, reputable cancer organizations, and online resources.

10. What questions should I ask my doctor about biological therapy?

Here are some questions you should ask your doctor about biological therapy:

Is biological therapy the right treatment option for me?
What type of biological therapy do you recommend?
What are the potential benefits and risks of this therapy?
What are the possible side effects?
How long will the treatment last?
How will I be monitored during treatment?
What is the cost of the treatment?
Is this therapy covered by my insurance?
Are there any clinical trials that I am eligible for?

Biological therapy is a promising approach to cancer treatment that offers new hope for many patients. By understanding the purpose, procedure, results, risks, and costs involved, you can make informed decisions about your treatment options. Remember to have an open and honest conversation with your doctor to determine if biological therapy is right for you. And remember, Ayu is here to help you manage your medical information and navigate your cancer journey with greater ease.

What is Biological therapy for cancer: Complete Guide for India