Actor Dipika Kakar’s Immunotherapy Side Effects Highlight Key Facts for Cancer Patients

Television actor Dipika Kakar recently spoke about experiencing side effects during immunotherapy, drawing attention to a cancer treatment that has evolved significantly over the past decade. Unlike chemotherapy, which directly attacks rapidly dividing cancer cells, immunotherapy works by empowering the body’s own immune system to identify and destroy tumours.

Immunotherapy has improved survival rates for many patients with cancers such as lung, kidney, melanoma, bladder, head and neck, and certain gastrointestinal cancers. However, because it stimulates the immune system, it can sometimes cause inflammation in healthy organs. While most side effects are mild and manageable, some can become serious if not detected early, making regular monitoring during treatment crucial.

“My immunotherapy procedure is going smoothly. The second cycle is done. This whole month has been crazy. After the first immunotherapy cycle, my body has been adjusting to the new chemotherapy cycles. There are side effects. After the first cycle, I got a viral fever, and I felt too low. After the second cycle, I am getting body rashes, and there is itching. I am getting used to this new normal,” said Kakar.

Dr Dipanjan Panda, Senior Consultant in Medical Oncology at Indraprastha Apollo Hospital, Delhi, explained how immunotherapy works. “Unlike chemotherapy, immunotherapy does not directly kill cancer cells. Instead, it empowers the patient’s own immune system to fight the cancer,” he said.

How does immunotherapy work?

Immunotherapy includes treatments that help the immune system recognise and attack cancer cells more effectively. The most common drugs today are immune checkpoint inhibitors, which act like molecular brakes on the immune system. Cancer cells often exploit these brakes to avoid being attacked. Checkpoint inhibitors release the brakes, allowing immune cells to target the cancer.

However, immunotherapy is not suitable for every patient or cancer type. Its effectiveness depends on factors such as cancer type and stage, tumour biology, biomarkers, overall health, and individual immune response.

Why are side effects different?

Because immunotherapy activates the immune system rather than directly destroying rapidly dividing cells, its side effects differ from those of chemotherapy. Instead of hair loss or severe blood count suppression, patients are more likely to experience immune-related adverse events, where the activated immune system mistakenly attacks normal tissues.

Common side effects include fatigue, skin rash or itching, fever, joint and muscle pain, nausea, diarrhoea, and reduced appetite. These are usually mild and respond well to supportive treatments.

Which organs can be affected?

In some patients, the immune system may attack healthy organs, causing inflammation in various parts of the body. The lungs may develop pneumonitis, leading to persistent cough and breathlessness. The liver may become inflamed, causing abnormal liver function tests or jaundice. The intestines may develop colitis with severe diarrhoea, while the thyroid, adrenal glands, and pancreas may be affected, leading to hormonal disturbances. Less commonly, the kidneys, heart, brain, or nerves can be involved.

Most patients tolerate immunotherapy well, and the majority of side effects are mild to moderate. Severe immune-related complications occur in only a small proportion of patients but require prompt recognition and treatment.

Why monitoring is crucial

Unlike chemotherapy, whose side effects often follow a predictable timeline, immune-related reactions can occur at any stage — within weeks of starting treatment, several months later, or even after immunotherapy has been completed. Regular monitoring allows doctors to detect and manage these side effects early, minimising their impact and ensuring the patient remains on the most effective treatment.

Dr Panda emphasised the importance of patient awareness: “Patients should report any new symptoms to their healthcare team without delay. Early intervention can prevent complications and improve outcomes.”

Kakar’s experience serves as a reminder that while immunotherapy offers hope, it also requires active participation from patients and close medical supervision. Her willingness to share her journey helps demystify a treatment that is changing the landscape of cancer care.