How to Manage Immunotherapy Side Effects for Head and Neck Cancer

Tips to Manage Infusion Reactions at Home

Alter recommends keeping the following tips in mind.

• Watch for delayed symptoms like rash, itching, fever, or dizziness.
• Call your cancer care team or their 24-hour hotline right away if you notice anything unusual, even if it seems mild.
• Call 911 for trouble breathing or swelling of the face or throat.

Tips to Manage Mouth and Throat Pain

Alter suggests these steps to help keep your mouth and throat as comfortable as possible.

• Regularly rinse your mouth with a solution of ¼ teaspoon of baking soda and ⅛ teaspoon of salt mixed in 1 cup of warm water. Swish and spit, but don’t swallow the solution.
• Brush with a soft toothbrush after meals and at bedtime.
• Eat soft, moist foods and avoid anything spicy, acidic, or rough in texture.
• Drink plenty of fluids throughout the day. A straw can help bypass sore spots.
• Ask your care team about medicated mouthwashes, pain-relieving lozenges, and sprays.
• Use lip balm to prevent dryness.

Tips to Manage Skin Reactions

Alter recommends the following tips for managing skin reactions.

• Use gentle, fragrance-free soaps and moisturizers.
• Shower with lukewarm water, instead of hot, and pat your skin dry after.
• Apply a thick, unscented cream or lotion often, especially after showering.
• Avoid direct sunlight, wear protective clothing, and use a broad-spectrum sunscreen with an SPF of 30 or higher daily.
• Apply cool, moist compresses to itchy areas for relief.
• Talk to your care team about topical steroid creams or oral medications for more stubborn or severe reactions.

Tips to Manage Digestive Issues

Alter recommends the following tips for managing digestive symptoms at home.

• Don’t take over-the-counter antidiarrheal medication without checking with your care team first, as it may not be appropriate depending on the cause.
• Drink 8 to 10 glasses of clear fluids daily, such as water, broth, or electrolyte beverages, to stay hydrated.
• Stick to bland, low-fiber foods and avoid anything spicy, greasy, or high in fat.
• Keep track of your bowel movements, including how often and what they look like, and report any blood or mucus to your care team right away.

Tips to Manage Fatigue

Fatigue can linger long after treatment ends, sometimes for several months to a year, says Alter. Here’s what he recommends to help cope with it.

• Discuss symptoms of fatigue with your care team, and ask about blood tests to check for other causes, such as anemia or thyroid problems.
• Balance short periods of rest with light activity like walking.
• Drink plenty of non-caffeinated fluids and be sure you’re getting enough nutrients.
• Try relaxation techniques like deep breathing or meditation to help manage stress.

These cognitive challenges may improve within a few months after completing treatment, though they can also linger for months or years, Alter says.

Tips to Manage Brain Fog

• Use planners, calendars, or phone reminders to stay organized.
• Focus on one thing at a time and tackle demanding tasks when you feel most alert.
• Keep your mind engaged with puzzles, reading, or learning something new.
• Prioritize sleep, as poor rest tends to make cognitive symptoms worse.
• Ask your care team about cognitive rehabilitation or whether any current medications you’re taking may be contributing to fatigue.

Immunotherapy can affect almost any organ system, sometimes months after treatment begins and after it ends, Alter says.

• Shortness of breath, a new dry cough, or chest pain, which could mean lung inflammation
• Severe or persistent diarrhea, or blood in your stool
• Yellowing of the skin or eyes, which can indicate liver issues
• Significant joint swelling or muscle weakness
• Any symptom that feels sudden, severe, or concerning

• Immunotherapy side effects like infusion reactions and digestive issues can range from mild to serious. Watch for symptoms like trouble breathing, ongoing diarrhea, or dizziness, and contact your care team right away.
• Mouth and throat pain and skin reactions can occur but are often manageable with daily care, like oral hygiene, soft foods, moisturizing regularly, and protecting your skin from irritation and sun exposure.
• To manage fatigue and brain fog, alternate rest with light activity like walking, keep a consistent sleep schedule, and use calendar reminders to stay organized.
• Many immunotherapy side effects can be treated effectively when caught early. Keep your care team informed of any new or changing symptoms so they can help you stay on course with treatment and prevent complications.