Immunotherapy for cancer
A type of cancer treatment that uses medicines to help your own immune system find and attack cancer cells.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It helps your own immune system attack cancer; the most common type is checkpoint inhibitors.
- It helps some people a lot but not everyone, is not used for every cancer, and is not a guaranteed cure.
- It can make the immune system attack healthy organs — these side effects can be serious and need urgent reporting.
- Side effects can appear weeks or even months after treatment, so always tell your team about new symptoms.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can shrink or control some cancers, sometimes for a long time.
Some people with certain active autoimmune conditions or who have had an organ transplant may be at high risk, and immunotherapy may not be safe for them.
You have checks and blood tests, then the infusion. Most people go home the same day and continue normal activities if they feel well.
Written guidance on immune-related side effects and exactly when to seek urgent help.
You have checks and blood tests, then the infusion. Most people go home the same day and continue normal...
You watch for side effects and report new symptoms. Most everyday side effects are mild, but some need prompt...
Scans assess whether the cancer is responding. Sometimes it takes time to see a clear picture.
Treatment continues while it helps and side effects are manageable, with regular blood-test monitoring of organs...
What is immunotherapy for cancer?
Immunotherapy is a group of cancer treatments that work by helping your own immune system recognise and attack cancer cells. The most common type is a group of drugs called immune checkpoint inhibitors (for example pembrolizumab or nivolumab).
Normally the immune system has 'brakes' (checkpoints) that stop it attacking the body's own cells. Some cancers use these brakes to hide. Checkpoint inhibitors release the brakes so the immune system can attack the cancer.
Immunotherapy works very well for some people and some cancers, but not for everyone, and it is not used for every cancer. It is not a guaranteed cure. Whether it can help, and whether the aim is to try to cure the cancer or to control it, depends on your cancer type and situation.
Because it boosts the immune system as a whole, it can cause the immune system to attack healthy parts of the body too. These immune-related side effects can be serious and sometimes need urgent treatment, so reporting symptoms early is very important.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Checkpoint inhibitors (PD-1 / PD-L1)
Drugs such as pembrolizumab, nivolumab, atezolizumab and durvalumab that release the immune system's 'brakes'. The most widely used immunotherapy.
Checkpoint inhibitors (CTLA-4)
Drugs such as ipilimumab that target a different brake. Sometimes combined with a PD-1 drug, which can be more effective but increases the risk of side effects.
Monoclonal antibodies with an immune action
Laboratory-made antibodies that mark cancer cells or trigger immune attack. Some targeted therapies overlap with immunotherapy.
Cell therapies (such as CAR T-cell therapy)
Specialist treatments where immune cells are altered to fight cancer, used for certain blood cancers in specialist centres.
Preparing for your treatment
- Make sure you understand the aim of treatment — to try to cure the cancer, or to control it.
- Tell your team about any autoimmune conditions, previous organ transplant, or steroid/immune-suppressing medicines.
- List all your medicines, supplements and allergies.
- Have baseline blood tests and any scans your team arranges.
- Ask for written information on which side effects to report and how urgently.
- Save the 24-hour contact number for your cancer team or acute oncology service.
- Tell your team if you might be pregnant or are breastfeeding.
What happens
Immunotherapy is usually given as a drip into a vein (an infusion) on a day unit, in repeating cycles every few weeks. Some types are given as an injection under the skin.
Before each treatment you usually have blood tests and a check of how you are feeling and whether you have had side effects. The infusion itself often takes around 30 to 60 minutes, and you can usually go home the same day.
Your team monitors you closely with regular blood tests, because immunotherapy can affect the liver, kidneys, thyroid and other hormone glands. The response to treatment is assessed with scans over weeks to months. Treatment continues as long as it is helping and the side effects are manageable.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Some people with certain active autoimmune conditions or who have had an organ transplant may be at high risk, and immunotherapy may not be safe for them.
- It is not effective for, or approved for, every cancer type.
- People needing long-term high-dose steroids or strong immune-suppressing drugs may not be suitable.
- If you are too unwell to tolerate treatment or to report and manage side effects, it may not be appropriate.
Delay or rearrange if…
- You have an active, uncontrolled infection.
- You have new, unexplained or unstable symptoms that need investigating first.
- Your liver, kidney, thyroid or other blood results are abnormal and need review.
- You are pregnant or might be, as immunotherapy can harm a developing baby.
- An existing immune-related side effect has not yet settled or been controlled.
Alternatives to discuss
- Other cancer treatments such as chemotherapy, targeted therapy, hormone therapy, radiotherapy or surgery, depending on the cancer.
- Best supportive (palliative) care focused on symptoms and quality of life.
- A clinical trial, where suitable.
- Choosing not to have drug treatment, with support either way.
- Standard NHS treatment rather than private treatment.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Can shrink or control some cancers, sometimes for a long time.
- Works well for certain cancers and people, including some advanced cancers.
- Often has different side effects from chemotherapy, which some people tolerate better.
- Usually given as an outpatient, so many people can continue parts of daily life.
- For some cancers, can be used to try to reduce the chance of the cancer coming back after other treatment.
Risks & complications
- Tiredness, which can be significant.
- Skin problems such as rash, dryness or itching.
- Diarrhoea or looser stools.
- Aching joints or muscles, and feeling generally under the weather.
- Inflammation of the bowel (colitis) causing frequent or severe diarrhoea.
- Inflammation of hormone glands such as the thyroid, sometimes needing lifelong hormone replacement.
- Inflammation of the liver, kidneys or lungs (causing cough or breathlessness).
- Infusion reactions during or shortly after treatment.
- Severe inflammation of organs including the lungs, heart, brain or nerves, which can be life-threatening.
- Severe hormone problems, such as adrenal or pituitary gland failure.
- Serious allergic reactions.
The most important point with immunotherapy is that the immune system can attack healthy organs, sometimes seriously, and sometimes weeks or months after treatment. Symptoms can be vague at first. Report any new or worsening symptoms — especially diarrhoea, breathlessness, severe tiredness, yellowing of the skin or eyes, or feeling very unwell — to your cancer team straight away. Early treatment, often with steroids, can prevent serious harm. Tell any healthcare professional you see that you are on immunotherapy.
Published figures to discuss
How well immunotherapy works, and how often serious side effects occur, varies a lot by drug, combination, cancer type and the individual. Combination immunotherapy generally causes more frequent and more severe immune-related side effects than a single drug. Reputable sources avoid quoting single response or survival figures because they differ widely and can mislead. The key safety point is not a precise percentage but that immune-related side effects, though often manageable, can be serious and occasionally life-threatening, and need early recognition.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Immune-related adverse events | Can affect any organ; severity varies | Diarrhoea, rash, breathlessness, hepatitis, endocrine symptoms or severe fatigue can reflect immune toxicity and need urgent reporting. | Guide sourcesClinical context |
| Side effects can occur late | During treatment or after stopping | Checkpoint inhibitor toxicity can appear weeks to months later, so patients should carry treatment information. | Guide sourcesClinical context |
| Not all tumours respond | Cancer- and biomarker-dependent | PD-L1, MSI/MMR, tumour type and prior treatments may influence suitability and response. | Guide sourcesClinical context |
| Steroids or treatment interruption needed | Toxicity-dependent | Moderate to severe immune toxicity may require steroids, specialist input or stopping immunotherapy. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Immunotherapy is given over months, so 'afterwards' means living alongside treatment, watching for side effects and having scans to see if it is working. There is no single recovery period.
- Tiredness that can build up over a course of treatment.
- Mild skin changes, itching or a rash.
- Occasional looser stools or mild tummy upset.
- Aching joints or muscles.
- Needing regular blood tests to monitor organs and hormone levels.
Aftercare
- Report new or worsening symptoms promptly — do not wait to see if they settle.
- Attend all monitoring blood tests, which check your liver, kidneys, thyroid and other glands.
- Carry an alert card or note saying you are having immunotherapy, and show it to any healthcare professional.
- Do not start steroids, other immune-affecting medicines or new supplements without telling your team.
- Keep your 24-hour cancer team or acute oncology number to hand.
- Tell your team before any vaccinations, dental work or other treatments.
- Use sun protection if your skin is more sensitive.
- Written list of side effects to report and how urgently
- 24-hour acute oncology / cancer team contact number saved
- Immunotherapy alert card or note to carry
- Up-to-date list of medicines, supplements and allergies
- Blood-test and scan appointments booked
- Someone aware of your treatment in case you become unwell
- Thermometer at home to check for fever
⚠ Get urgent help if…
- Diarrhoea that is frequent, severe, contains blood, or wakes you at night.
- New or worsening cough, breathlessness or chest pain.
- Yellowing of the skin or eyes, dark urine, or pain in the upper-right tummy (liver inflammation).
- A high temperature or signs of infection.
- Severe tiredness, dizziness, confusion, severe headache, or feeling very unwell (possible hormone or brain effects).
- Severe skin rash, blistering or peeling.
- New muscle weakness, double vision, or difficulty swallowing or breathing — seek emergency help.
- Palpitations, fainting or chest tightness — seek emergency help.
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good response means scans show the cancer shrinking or staying stable, and for some people this lasts a long time. Immunotherapy can sometimes take a while to show its effect.
However, it does not work for everyone, and it is not a guaranteed cure. Whether the aim is to try to cure the cancer or to control it depends on your diagnosis. Your oncologist should be honest about what is realistic for you and will base decisions on how the cancer responds and how you tolerate treatment.
For some people, the benefit of immunotherapy continues even after treatment stops, which is one of its distinctive features. For others, the cancer may progress and the plan is changed. Because side effects can appear or persist after treatment ends, follow-up and monitoring continue for a time.
Related tests, treatments or support
Immunotherapy may be given on its own, in combination with another immunotherapy drug, or alongside chemotherapy, targeted therapy, radiotherapy or surgery, depending on the cancer. Combining drugs can improve results but often increases the risk and severity of side effects.
Follow-up & long-term care
You are reviewed regularly during treatment, with blood tests before cycles and scans to check response. After treatment, follow-up continues to watch for late side effects and to monitor the cancer. Your team should give you clear instructions on when and how to report problems urgently.
- Ongoing blood tests to monitor liver, kidney and hormone function, sometimes for months.
- Lifelong hormone replacement (for example thyroid medicine) if a gland has been permanently affected.
- Continued awareness of late side effects after treatment finishes.
- Keeping an alert card and informing all healthcare professionals you are or were on immunotherapy.
Repeat, follow-on and what comes next
- Treatment is continued, paused, switched or stopped depending on response and side effects.
- Immunotherapy may be paused while a side effect is treated, then sometimes restarted.
- If the cancer progresses, the oncologist may change to a different treatment.
- Some glands damaged by immunotherapy may need lifelong hormone replacement.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Written guidance on immune-related side effects and exactly when to seek urgent help.
- A 24-hour acute oncology contact route and an alert card to carry.
- Regular blood-test monitoring of organs and hormones, with clear follow-up.
- Prompt access to treatment (often steroids) if a serious side effect develops, and good coordination with the NHS.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The specific immunotherapy drug or combination used.
- How many cycles of treatment are given and over what period.
- Day-unit and nursing time for each infusion.
- Blood tests and scans needed to monitor safety and response.
- Management of side effects, including any hospital stays.
- Specialist oncology consultations and follow-up.
- Whether the treatment is approved on the NHS or only available privately or in a trial.
- The cost per cycle and the expected number of cycles.
- The oncology consultation, day-unit and nursing fees.
- Monitoring blood tests and scans, and who reports them.
- What happens, and what it costs, if you need treatment for side effects or a hospital admission.
- The drug name and whether it is NICE-approved for your cancer.
- How private treatment is coordinated with NHS care, including emergencies.
On the NHS? Many immunotherapy treatments are funded by the NHS for specific cancers where NICE has approved them; other uses may be private or only available within clinical trials, and paying privately does not guarantee a better outcome.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being led to believe immunotherapy is a guaranteed cure.
- Not being warned that side effects can be serious and can appear after treatment ends.
- Not receiving clear, written instructions on which symptoms need urgent contact.
- No clear plan for who to call out of hours, or how private and NHS emergency care fit together.
Marketing red flags
- Claims that immunotherapy cures cancer or works for everyone.
- Overseas or private clinics offering unproven 'immune-boosting' cancer cures for large fees.
- Downplaying serious immune-related side effects or the need for monitoring.
- Offering immunotherapy for cancers or situations where it is not evidence-based.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Is immunotherapy likely to help my cancer, and is the aim to try to cure it or to control it?
- Which immune-related side effects should I watch for, and which need urgent contact?
- How will you monitor my organs and hormones during treatment?
- What should I do, and who should I call, if I feel unwell at night or at the weekend?
- What happens if it does not work or causes serious side effects?
- Is this treatment approved for my cancer on the NHS, or is it private or part of a trial?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is immunotherapy a cure for cancer?
How is it different from chemotherapy?
Why is reporting side effects so important?
Can side effects happen after treatment finishes?
Is it available on the NHS?
Can I have vaccinations during immunotherapy?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cancer Research UK — Immunotherapy Cancer Research UK — Checkpoint inhibitors Macmillan — Immunotherapy NICE — Cancer immunotherapy guidance Immune-related adverse events review — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Seeing a medical oncologist · Targeted (biological) cancer therapy · Cancer treatment tablets (oral anticancer therapy) · Hormone therapy for cancer · Intravenous infusion treatment (a drip into a vein)