A Patient’s Guide to Cancer Immunotherapy
What You
Need to Know
Hearing the words “You have cancer” can feel overwhelming. You may feel scared, confused, or uncertain about what comes next. These feelings are not unexpected — and you are not alone. You don’t have to become an expert overnight.
Every cancer journey is different, and there are more treatment options than ever before. This guide from the Cancer Research Institute (CRI) is designed to help you understand a treatment option called immunotherapy, how it may fit into your cancer treatment plan, and what questions you may want to ask your health care team along the way.
Take the Next Step with Confidence
Patient’s
Perspective
Brendan Connors
Melanoma Survivor
My name is Brendan Connors, and I’m a stage 4 metastatic melanoma survivor. I was diagnosed in 2011, when treatment options were limited and uncertain.
I was fortunate to get into two immunotherapy clinical trials: first at the National Institutes of Health (NIH) and the National Cancer Institute (NCI), where I started on interleukin-2 (IL-2), and later at Memorial Sloan Kettering Cancer Center, where I received a combination of ipilimumab (Yervoy®) and nivolumab (Opdivo®). I’ve been cancer-free since completing treatment.
When I was diagnosed at 27, I didn’t even know how cancer staging worked. So when my doctor said “stage 4 metastatic” and explained that it meant the cancer had spread from its original area, it was a lot to process; I felt overwhelmed.
At the time, these immunotherapies were still being studied, and there were many unknowns. My doctors didn’t always have clear answers about timelines or what I should expect. But by participating in clinical trials, I was helping build that knowledge in real time. I was always willing to provide additional samples and data, because I understood it could help future patients with melanoma or other types of cancers.
One message I want to share is this: you are not alone. There is a community of patients, care teams, and clinicians to help and support you, and scientists are working toward better outcomes. It’s going to sound cliché, but stay positive. I wore a Superman shirt to treatment. That mindset? It matters.
Getting a Diagnosis
What is Cancer?
What is cancer?
Cancer is a disease that begins when cells grow and divide in an uncontrolled way. These abnormal cells can form a tumor, invade nearby tissues, or spread to other parts of your body.
There are many types of cancer, and each can behave differently. Your diagnosis may include information about where the cancer started, whether it has spread, and if it has specific features that can help guide treatment decisions.
What does staging mean?
Staging describes how advanced a cancer is. It may be based on the size of the tumor, whether cancer has spread to nearby lymph nodes, and whether it has spread to other parts of your body.
Understanding the stage of the cancer can help your health care team recommend treatment options, including whether immunotherapy may be appropriate.
Why does tumor testing matter?
Tests such as a biopsy, imaging scans, and biomarker or genetic testing can provide important information about the cancer. These results can help your health care team understand how the cancer may behave and whether certain treatments, including immunotherapy, are more likely to work.
Making a Decision
Understanding
Immunotherapy
More than 40 immunotherapies have been approved to treat more than 35 different types of cancer. Learning which immunotherapies are available for your cancer can help you talk with your care team about the treatments that may fit your specific situation.
What are the main types of cancer treatment?
There are several types of cancer treatments, and each works in a different way. Many patients will receive a combination of treatment types, such as surgery, radiation, chemotherapy, or immunotherapy.
- Surgery removes tumors or cancerous tissues and is often used when cancer is localized, or has not spread.
- Radiation uses targeted energy to damage cancer cells and can be delivered outside or inside your body.
- Chemotherapy uses drugs to kill fast-growing cells, including cancer cells, and can be given through an IV (intravenous), injection, or as a pill.
- Immunotherapy helps your immune system recognize and attack cancer and may be delivered through an IV, injection, topical treatment, or oral medication.
What is immunotherapy, and how does it work?
Immunotherapy uses your body’s own immune system to help detect and fight cancer. Your immune system can recognize abnormal cells and adapt over time — but cancer can sometimes evade detection.
Immunotherapy helps restore or strengthen your immune response. Some immunotherapies provide additional tools (like antibodies or proteins), while others help remove barriers that prevent immune cells from attacking cancer. Immunotherapy is sometimes also called immuno-oncology.
What types of cancers can immunotherapy treat?
Immunotherapies are used to treat more than 35 different types of cancers, including melanoma, lung, colorectal, bladder, and many blood cancers. As of 2025, the U.S. Food and Drug Administration (FDA) has approved more than 40 immunotherapies, and there are ongoing clinical trials for nearly every type of cancer.
What types of immunotherapy treatments are available?
There are several types of immunotherapies, and each works in a different way:
| Immunotherapy types | How they work with your immune system | What types of cancer they treat |
|---|---|---|
| Immune checkpoint inhibitor (ICI) | ICIs help your immune system recognize and attack cancer cells. They block proteins called checkpoints that can stop your immune cells from responding to cancer. | ICIs are approved for many cancer types, including melanoma, lung, bladder, kidney, head and neck, colorectal, liver, and some blood cancers. |
| Bispecific antibody | Bispecific antibodies are designed to attach to two targets at the same time. One part may bind to a cancer cell while the other may connect to an immune cell, bringing them close enough for the immune cell to attack. | Bispecific antibodies are approved for some blood cancers, including leukemia, lymphoma, and multiple myeloma, as well as a small number of solid tumors. |
| Cell and gene therapy | Cell and gene therapies strengthen or reprogram your immune system to fight cancer. They work by modifying immune cells or genes either inside your body or in the laboratory so immune cells can better find and attack cancer. | Cell and gene therapies are most often used for blood cancers such as leukemia, lymphoma, and multiple myeloma. Some are also approved for certain solid tumors, including bladder, melanoma, and sarcoma. |
| Non-ICI immunomodulator | Non-ICI immunomodulators boost or adjust immune system activity. Some help immune cells grow, while others strengthen immune signaling so your body can mount a stronger response. | Non-ICI immunomodulators may be used for certain skin cancers, bladder cancer, kidney cancer, melanoma, leukemia, and lymphoma. |
| Oncolytic virus therapy | Oncolytic viruses are modified viruses that infect and destroy tumor cells. As cancer cells break apart, they may also help alert your immune system to attack cancer. | Only one oncolytic virus therapy as been approved for cancer treatment (melanoma). It uses a modified herpes simplex virus (HSV) that infects cancer cells and promotes their destruction. |
| Cancer vaccine | Cancer vaccines help train your immune system to recognize and attack cells with cancer-related markers. Some vaccines help prevent cancer, while others are used to treat existing cancer. | Only two vaccines have been approved: a bladder cancer vaccine that uses weakened bacteria and a prostate cancer vaccine made of your own stimulated immune cells. |
What tests are needed before starting immunotherapy?
Your health care team considers many factors, including cancer stage, overall health, and prior treatments, before recommending a treatment plan. Your doctor may also order imaging scans, a biopsy, or further lab testing, such as biomarker or genetic testing, to see if the cancer has certain features or unique characteristics. In some cases, these results can determine whether immunotherapy is likely to be effective or whether another option may be a better fit.
How much does immunotherapy cost, and will my insurance cover it?
Immunotherapy can be expensive, often ranging from $100,000-$200,000 or more per year. Many insurance plans, including Medicare and Medicaid, cover FDA-approved treatments. If you’re uninsured or underinsured, you can ask your health care team about financial aid, treatment assistance programs, or clinical trials.
Can immunotherapy cure cancer?
Immunotherapy is a very effective treatment for many patients, but it doesn’t always work for everyone. For some people, immunotherapy can lead to long-term remission, while for others, it may help control cancer or extend survival. Your doctor can help you better understand what to expect in your situation.
what to Expect
Starting
Treatment
How is immunotherapy given?
Immunotherapy is often given through an IV in a doctor’s office, outpatient clinic, hospital, or cancer center. Treatment schedules and duration vary but are often scheduled every two to six weeks and last about 30 minutes to a few hours.
Immunotherapies can also come in the form of pills, topical creams that are applied to your skin, or be given directly into your bladder (intravesical). Your health care team will talk with you about what to expect during treatment visits.
What are the possible side effects of immunotherapy?
Immunotherapy side effects are different from other cancer treatments. They can appear early, within days of starting treatment, but they usually develop several weeks or months later. The most common ones are fatigue and skin reactions, including rash, itchiness, and redness, particularly at an injection site. Some patients may experience diarrhea, flu-like symptoms, and mouth sores.
More serious side effects (caused by an overactive immune response) are less common but can affect organs such as the colon, liver, lungs, or hormone-producing glands. It’s important to let your health care team know about any new or worsening side effects.
How will I know if treatment is working?
Your health care team will monitor your progress through regular follow-up visits, which may include imaging scans (such as CT or MRI), blood tests, and sometimes scopes or biopsies. Immunotherapy may take longer to show results than other treatments. In some cases, tumors may initially appear larger before shrinking.
Your doctor will look at scan results alongside lab findings and ask how you’re feeling overall to determine whether treatment is helping. They’ll also explain what “response” means in your specific situation and how often you’ll be monitored.
How long will I need to stay on immunotherapy?
The length of time you will receive immunotherapy depends on the type of cancer you have, the specific immunotherapy your doctor prescribes, and your care plan. Some people receive treatment for a few months, while others continue for a year or longer. In some cases, benefits may last even after treatment ends because the immune system can “remember” cancer cells.
How will getting immunotherapy affect my daily life?
You may be able to maintain daily routines, including work and exercise, during treatment, though your energy levels may fluctuate. It is generally important to stay hydrated and eat a balanced diet, stay as physically active as you are able, avoid alcohol and smoking, manage stress (such as through yoga, mindfulness, or support groups), and get plenty of rest.
Looking and Living Forward
Post-Treatment
Support
What ongoing care will I need?
After treatment, you’ll continue to have regular checkups with your health care team to monitor for recurrence and manage any long-term side effects. Follow-up care may include physical exams, blood tests, imaging scans, and conversations about how you’re feeling physically and emotionally.
What if immunotherapy doesn’t work or the cancer comes back?
Not everyone responds to immunotherapy, and you may feel discouraged if the results aren’t what you hoped for. If the treatment isn’t effective or the cancer returns, your doctor may recommend a different therapy, a combination approach, or a clinical trial.
What are clinical trials, and how do they work?
Clinical trials are carefully monitored research studies that test new treatments. They may offer access to promising therapies that are not yet approved by the FDA. You can talk with your health care team about clinical trials or use tools like CRI’s Clinical Trial Finder to explore options that may be a good fit.
Where can I find support from others who have had immunotherapy?
Connecting with other people who have had immunotherapy can help you feel more supported. You can explore personal stories from patients and survivors treated with immunotherapy.
Organizations such as the American Cancer Society, Cancer Care, and Cancer Support Community also offer additional educational resources, support communities, and patient and caregiver programs.
What comes next?
Cancer treatment is a journey that looks different for everyone. Advances in immunotherapy are changing what’s possible, helping many patients live longer and with a better quality of life.
Decisions about treatment are personal. Staying informed, asking questions, and working closely with your care team can help you make choices that are right for you.
Progress continues every day — and with it, new possibilities.
conversational cues
10 Questions to Ask Your Doctor
Being diagnosed with cancer can feel overwhelming, and understanding your treatment options can make a meaningful difference. Asking questions can help you take an active role in your care, make informed decisions, and feel more prepared for conversations with your health care team.
Here are 10 questions you may want to ask your doctor:
1
What type and stage of cancer do I have?
2
Is immunotherapy a recommended option for me right now?
3
Do I need additional biomarker or genetic testing to guide treatment or trials?
4
What are the benefits and risks of immunotherapy compared to other treatments like chemotherapy or radiation?
5
Will I receive immunotherapy alone or combined with other treatments?
6
What side effects should I expect, and when should I call you?
7
How will we know if the treatment is working, and how often will we monitor my progress?
8
Are there clinical trials that I should consider now or in the future?
9
What are the costs of treatment(s), and is it covered by my insurance?
10
What support resources are available for me and my family?
Continue Your Immunotherapy Journey
Review Patient Resources
Find trusted answers about cancer immunotherapy, treatment options, explanations for medical terms, and more.
Find Immunotherapy Clinical Trials
Explore immunotherapy clinical trials and learn how participation works, with support from CRI’s Clinical Trial Navigators.
Explore Patient Journeys
Hear directly from patients and survivors who have received immunotherapy and learn how they navigated diagnosis, treatment, and decision-making.
Keep Up-To-Date with Educational Programs & Ongoing Research
Stay informed through CRI’s patient-focused educational programs, webinars, and research.
Acknowledgements
We extend our sincere gratitude to the CRI ImmunoAdvocates, a group of patients treated with immunotherapy, who generously shared their experiences, insights, and time to help shape this guide. By telling your stories and offering your perspectives, you’ve helped ensure that people newly diagnosed with cancer feel seen, supported, and empowered as they begin their immunotherapy journey.
Disclaimer: This information is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk with your health care team about questions or decisions related to your care.