Oncology nurses are intimately familiar with side effects related to chemotherapy. Advice for managing chemotherapy symptoms such as fatigue, diarrhea, dyspnea, skin toxicities, and increased risk of infection can be found in ONS’s Putting Evidence Into Practice (PEP) resources. However, immunotherapy treatments often offer similar side effects that are treated very differently from those associated with traditional treatments.

Immune-related adverse events (irAEs) can include diarrhea, fatigue, dyspnea, skin toxicities, and infection risk as well; however, these events are managed very differently from their chemotherapy counterparts. Some symptoms associated with immunotherapy treatments can lead to extreme consequences. The current ONS PEP standards deal mainly with interventions for symptoms associated only with chemotherapy and radiation therapy—not immunotherapy. 

Understanding the Difference When Treating Symptoms

PEP provides information about managing chemotherapy and radiation therapy side effects. Moreover, the following PEP symptom pages have incorporated information on potential irAEs and, if applicable, suggestions for managing those particular symptoms.

The mechanisms of irAEs are different from those of more traditional treatments, and consequences of irAEs can be much more extreme. Evidence regarding interventions for symptoms associated with immunotherapy is currently limited; however, the critical aspect for management is the immediate identification of the symptom and early intervention.

It’s important for oncology nurses to recognize that assessment, patient monitoring, and management of irAEs differs from common cancer treatments. ONS’s Immunotherapy in Cancer course offers dedicated resources and education about immunotherapy, irAEs, and more. Understanding these complexities will allow you to offer the best possible care for your patients undergoing immunotherapy treatments. 

Oncology nurses are on the frontline of symptom management for their patients. The way that side effects are monitored and treated related to chemotherapy and radiation therapy, as opposed to immunotherapy, can make a huge difference in the outcomes of your patients.