Immunotherapy side effects

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on April 1, 2022.

Immunotherapy has become one of the most common treatments for cancer and is designed to use the patient's own immune system to find and attack cancer cells.

Among the many different immunotherapy drugs, the three main types of treatments include:

Like any cancer treatment, immunotherapy has a potential risk of side effects. A key takeaway for any side effect of immunotherapy is to be aware of what to expect and have a management plan of action with the cancer care team.

How long will side effects from immunotherapy last?

Side effects of immunotherapy may occur at any point throughout treatment and be short- or long-term. It’s important to know the signs and have a management plan.

Severe side effects of immunotherapy

Patients should seek immediate attention if they’re experiencing the following severe side effects:

  • Colitis
  • Hepatitis
  • Kidney failure
  • Inflammation of the pancreas (pancreatitis)
  • Neuropathy
  • Inflammation of the heart (myocarditis)
  • Severe infections or skin reactions
  • Type 1 diabetes
  • Lung inflammation

What are the side effects of immunotherapy?

Immunotherapy uses drugs and substances to attack cancer and cancerous cells, or to slow its spread to other parts of the body, but it may also attack healthy cells, tissues or organs in the process.

The side effects depend on how healthy the patient was before treatment, the type of cancer and the length of treatment and dosage.

Knowing as much as possible about immunotherapy side effects and what to expect may help the patient feel more in control and at ease.

Common side effects of immunotherapy

A few main side effects of immunotherapy and how to manage them are listed below.

Fatigue: Immunotherapy can take a toll on the patient's body and be both physically and mentally exhausting. Cancer fatigue feels different from fatigue from the patient's usual day-to-day routine.

Some ways to manage fatigue include the following:

Balance rest and activity. Find a routine that allows for relaxation and also make time for a walk or partake in other outdoor activities.

Create a nutrition plan. Drink plenty of clear fluids and consume a balanced diet of protein, carbohydrates, fat, vitamins and minerals to keep energy levels up.

Connect with a mental health expert. Speaking with a counselor or psychologist may help the patient manage pain and cope with the stress and difficult thoughts often associated with cancer treatment.

Skin irritation: Immunotherapy often causes a series of skin reactions, including blistering, dryness and redness. In other cases, the skin may become sensitive to sunlight, and the patient's fingertips may crack.

Some ways to manage skin irritation are listed below:

Contact a dermatologist. The cancer care team may recommend speaking with a dermatologist to address more specialized treatments for managing skin problems.

Clean appropriately. Use warm water and unscented soap to rinse the skin, then pat it dry with a towel.

Moisturize often. Lather the irritated areas with a cream or a thicker lotion to help add moisture.

Ask about over-the-counter or other medicines. Cream or ointment for skin swelling or dryness may help relieve pain and itching and reduce any swelling or redness. In more severe cases, a doctor may prescribe an antihistamine or steroid.

Fever and chills: After immunotherapy, the patient's temperature may spike to help regulate his or her body’s processes.

Some ways to manage fever and chills include the following.

Cool down. Run cold water over a cloth and place it on the patient's forehead.

Avoid creating more heat. Don’t cover up with blankets, as this may increase body temperature.

Seek professional help if needed. If chills continue, speak with the care team. Medications may be prescribed to help.

Nausea and vomiting: During immunotherapy, the patient may feel queasy or lightheaded.

Some ways to manage nausea and vomiting are listed below.

Follow a simple diet. Try to stick to bland foods such as toast or crackers and clear liquids such as water. In some cases, ginger ale may also help.

Take a break. Relaxation techniques, hypnosis or acupuncture may help to ease symptoms.

Discuss medication options. If the problem persists, certain medicines may help control nausea and help the patient feel better.

Diarrhea: Immunotherapy may irritate the abdomen or areas around the patient's abdomen, which can lead to diarrhea or loose stools.

What follows are some ways to manage diarrhea.

Stay hydrated. Patients lose a lot of fluids with diarrhea, so it's important to drink plenty of water and electrolytes to replenish these levels and prevent dehydration. Potassium and sodium specifically are important to replenish, and the patient can get them from drinking sports drinks or broths. If diarrhea continues, the care team may prescribe medication.

Change the patient's meal structure. Aim for six to eight mini meals throughout the day instead of three larger ones. This may help so the patient's body isn’t working harder to digest larger meals. Try to include foods high in minerals such as potassium and sodium.

High blood pressure: Certain immunotherapy medications may cause high blood pressure.

Some ways to help manage high blood pressure naturally include:

  • Making exercise a part of the patient's regular routine
  • Following a balanced diet
  • Cutting back on sodium
  • Reducing and limiting alcohol and caffeine intake
  • Stopping smoking

If the patient is experiencing high blood pressure, speak with the care team to help find the most appropriate way to manage it. This may include taking medication. It may also help to have a blood pressure monitor at home so the patient can regularly check his or her levels.

Headaches: Immunotherapy treatment may cause flu-like symptoms, including headaches, which can feel like a throbbing in the head or behind the eyes.

Some ways to manage headaches are detailed below.

Try massage. Using fingers, gently massage the head, neck and around the eyes.

Seek cooling relief. Place a cool cloth on the patient's forehead or even take a cold shower.

Ask about medication. Ibuprofen, aspirin or acetaminophen may help relieve tension.

Are immunotherapy side effects worse than chemotherapy?

Because chemotherapy uses chemicals to destroy cancer cells and immunotherapy uses the patient’s own immune system, the side effects are different, and immunotherapy typically leads to lower toxicity than chemotherapy does. Both treatments may cause different side effects, so speak to the care team about any concerns regarding the potential side effects of these therapies.

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Show references
  • American Cancer Society. Immunotherapy.
  • National Cancer Institute (2021, September 23). Fatigue and Cancer Treatment
  • American Society of Clinical Oncology (2022, May). Side Effects of Immunotherapy.
  • Cancer Research Institute (2019, November). Immunotherapy Side Effects.
  • National Cancer Institute (2023, February 16). Immunotherapy Side Effects.
  • Centers for Disease Control and Prevention (2023, May 15). Side Effects of Cancer Treatment.
  • American Cancer Society. Tender Loving Care.
  • American Cancer Society (2020, February 1). Diarrhea.
  • American Society of Clinical Oncology (2021, September 1). Skin Reactions to Targeted Therapy and Immunotherapy.
  • Centers for Disease Control and Prevention (2023, August 29). Manage High Blood Pressure.
  • National Institutes of Health (2021, November 9). Managing tension headaches at home.