What to Expect: Subcutaneous Immunotherapy for Cancer
Health ConditionsCancerCancer Treatment

What to Expect When Starting Subcutaneous Immunotherapy for Cancer

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Published on April 1, 2026
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Y our oncologist may prescribe immunotherapy at various points in the cancer treatment journey. Immunotherapy is known to be especially effective in treating late-stage cancer that hasn’t responded to other therapies, but it’s also becoming a more common first-line treatment for certain cancers. It’s sometimes even used to prevent cancer from returning after surgery. While most immunotherapies are given via an IV infusion, some can be given as a subcutaneous (under the skin) injection.

“A huge advantage of subcutaneous injection immunotherapy is that we don’t need to deliver the medication intravenously, so it makes the administration of these drugs a lot easier,” says Lawrence Fong, MD, scientific director of the Fred Hutch Cancer Center Immunotherapy Integrated Research Center in Seattle.

That said, even though it’s quicker to receive an injection than an infusion, you may still spend a few hours getting the treatment. “It’s not a quick, in-and-out visit like a flu vaccine,” says Justine Cohen, DO, a skin cancer oncologist at Dana-Farber Cancer Institute in Boston.

Like other cancer drugs, subcutaneous immunotherapy is a complex medication that needs to be administered by a healthcare professional, and your doctor will need to monitor your health to make sure you’re well enough to keep getting it. The upside to all this monitoring, though, is that any disease progression — or improvement — will be under close scrutiny by your care team, and they can respond accordingly. Here’s what to expect from the treatment.

How to Prep for Subcutaneous Immunotherapy

Subcutaneous immunotherapy is administered at a cancer center. You might also get blood work or receive other treatments, such as chemotherapy, on the same day as the immunotherapy appointment. Here are a few things you can do before the first injection to make sure you’re as comfortable and prepared as possible:

Treatment Steps

Even though it may take less than 15 minutes to administer the subcutaneous immunotherapy, you’ll still need to take the time to meet with your doctor and undergo other tests or treatments they prescribe, Dr. Cohen explains.

Here’s what you can usually expect from the process, start to finish.

Subcutaneous Immunotherapy Process

  1. When you arrive at the cancer center, you’ll check in and fill out any necessary paperwork.
  2. Next, you’ll be called into an exam room and have your blood drawn to check blood cells, kidney and liver function, and thyroid levels. (Immunotherapy can cause inflammation in the organs, so if the blood work comes back abnormal, you may have to reschedule the injection.) You’ll also undergo a physical exam to get your vitals.
  3. Depending on which immunotherapy drug you’ve been prescribed, you may receive an antihistamine or other medications to prevent an allergic reaction during treatment.
  4. If you’re also having chemotherapy or another infusion treatment, you’ll have an IV placed in your arm, unless you already have a port. Note that any infusion treatments will be before or after the injection, not at the same time.
  5. Then, you may be sent back to the waiting room while the injection is prepared.
  6. Once the medication is ready and the blood work comes back (usually within 30 minutes), you’ll talk to your doctor about the results. If the results are normal, you’ll be ready for treatment.
  7. Next, you’ll be escorted to a chair, where a healthcare provider will clean the injection site (either the abdomen or thigh). Let them know if one area is tender, so they can use another. They’ll then insert the needle into the skin. 
  8. The healthcare provider will slowly press down on the plunger to administer the medication via a syringe or a winged or butterfly needle connected to a syringe. The injection will take up to 15 minutes to administer, depending on the type of drug and dose. (The needle is about the size of a needle used for a flu shot.) Take slow, deep breaths to stay relaxed during the process.
  9. When the injection is finished, you may be asked to stay awhile, so your care team can monitor you for side effects and adverse reactions.

Treatment Timeline

Some subcutaneous immunotherapies are given every two or three weeks, while others are given every six weeks. So the treatment course will look a little different, depending on which drug you’ve been prescribed. Generally speaking, you can expect the schedule to look like this:

Side Effects of Subcutaneous Injection Immunotherapy

The side effects of subcutaneous injection therapy are similar to those of infusion therapy, says Dr. Fong. If you’re also receiving another treatment, such as chemotherapy or radiation, you may have additional side effects from the injection.

Although rare, there’s also a chance of more serious side effects from subcutaneous immunotherapy, usually as a result of increased inflammation in the body. These can include:

  • Autoimmune reactions, including joint pain and swelling (arthritis)
  • Heart issues, including an irregular heartbeat (arrhythmia) or inflammation in the heart (myocarditis or pericarditis)
  • Liver issues, including hepatitis, which can result in jaundice, stomach pain on the right side, and vomiting, among other issues. Your doctor will monitor liver enzymes with regular blood work.
  • Lung problems, including pneumonitis, which may result in chest pain, coughing, and shortness of breath
  • Neurological complications, including neuropathy and a brain condition called encephalitis. Encephalitis can cause fever, seizures, and a stiff neck, while neuropathy can cause numbness or tingling in the hands and feet.

If you experience any of these symptoms, call your doctor right away.

Real-Life Tips for Subcutaneous Injection Therapy

If you have a fear of needles, you can ask that everything be set up and ready to go before you come into the room, to minimize anticipation as the nurse prepares the medication.

— Stephanie Williams, diagnosed with non-small cell lung cancer in 2021

— Stephanie Williams, diagnosed with non-small cell lung cancer in 2021
Report any unusual feelings early, especially the first few times you get the injection, such as itch, cough, chills, or shortness of breath.

— Grace Allison, an oncology certified nurse and senior patient navigator at the Multiple Myeloma Research Foundation

— Grace Allison, an oncology certified nurse and senior patient navigator at the Multiple Myeloma Research Foundation
I would tend to hold my breath [during the injection], so I asked a nurse to help me breathe and distract me.

— Cyndi Johnson, diagnosed with metastatic breast cancer in 2018 and a Susan G. Komen advocate

— Cyndi Johnson, diagnosed with metastatic breast cancer in 2018 and a Susan G. Komen advocate
Some people prefer the nurse to count down or count to three [before starting the injection].

— Williams

— Williams
Ask for ways that you can practice infection prevention — and [stave off] any other side effects you experience, such as fatigue.

— Allison

— Allison

Know What’s Next on Subcutaneous Injection Therapy

The goal of immunotherapy can vary from person to person, depending on the type and stage of cancer. But often, this treatment can result in long-lasting benefits, including controlling or curing the disease. Work with your care team to develop treatment goals and change them as needed. And speak up if you’re experiencing side effects.
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Tawee Tanvetyanon, MD, MPH

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Tawee Tanvetyanon, MD, MPH, is a professor of oncologic sciences and senior member at H. Lee Moffitt Cancer Center and Morsani College of Medicine at the University of South Florid...

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Maria Masters

Maria Masters

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Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and she has held positions at Men's Health and Family Circle. Her work has appeared in Hea...

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