02/07/2025
🤵♀️自2023年8月起，健保開始給付免疫治療合併抗血管新生標靶藥物（atezolizumab + bevacizumab ）於肝癌中晚期病人; 2025年2月1日 起，雙免疫藥物(Tremelimumab+Durvalumab) 也已納入台灣健保給付範圍，免疫治療逐漸成為中晚期肝癌病人的重要療法，不僅大大增加個案存活率也提升個案生活品質，現在我們來聊聊免疫治療副作用是什麼? 遇到了怎麼辦?
🤵♀️免疫療法的運作是通過「喚醒」身體的免疫系統來對抗癌症，但有時這個被激活的免疫系統也可能錯誤地攻擊健康細胞，導致我們所稱的免疫相關副作用。
⚠️這些常見副作用有：
• 皮膚：皮疹、搔癢、乾燥。
• 腸胃：腹瀉、胃痛、噁心。
• 精力 ：極度疲勞。
•腎臟：蛋白尿。
• 肝臟：感覺疲倦、尿液顏色變深、皮膚或眼睛變黃（黃疸）。
• 腺體（甲狀腺等）： 感覺過熱/過冷、體重變化、情緒變化。
• 肺部： 新出現的咳嗽或呼吸急促。
• 關節/肌肉： 酸痛、疼痛、僵硬。
‼️何時應聯絡醫療團隊或盡早回門(急)診：
• 發燒（體溫超過 38°C）
• 嚴重腹瀉（大量稀便，或帶有血絲/黏液）
• 新的或惡化的呼吸急促或咳嗽
• 嚴重胃痛
• 皮膚或眼睛變黃（黃疸）
• 嚴重頭痛或視力改變
• 嚴重皮疹、起水泡或皮膚脫皮
• 肌肉無力導致難以移動或行走
🔆我們如何處理副作用：
• 及早告知我們！ 您越早報告症狀，我們就越容易處理。
• 監測： 我們會定期檢查（驗血、身體檢查）以發現問題。
• 藥物： 醫師會評估時機，必要時使用類固醇來平息您的免疫系統。
• 暫停治療： 有時我們可能會暫時停止您的免疫治療，直到副作用好轉。這是正常情況，有助於確保您的安全。
• 轉診專科醫生： 對於嚴重的副作用，我們可能會將您轉診給該領域的專科醫生。
✅日常自我照護小撇步：
• 保持水分： 多喝水。
• 均衡飲食： 盡量均衡飲食。如果腸胃不適，請選擇清淡的食物。
• 休息與活動： 休息與輕度活動並行，以幫助緩解疲勞。
• 保護皮膚： 使用保濕霜和防曬乳（SPF 30+）。
• 記錄症狀： 寫下任何症狀、何時開始以及嚴重程度。這有助於我們了解情況。
💓免疫治療副作用不可怕，請隨時向我們提出任何問題。您的參與對您的安全和成功治療至關重要💗
🤵♀️ Since August 2023, National Health Insurance (NHI) has covered immunotherapy combined with anti-angiogenic targeted therapy (atezolizumab + bevacizumab) for patients with intermediate to advanced liver cancer. Starting February 1, 2025, dual immunotherapy (Tremelimumab + Durvalumab) has also been included in Taiwan's NHI coverage. Immunotherapy is gradually becoming an important treatment for patients with intermediate to advanced liver cancer, not only significantly increasing survival rates but also improving the quality of life for individuals. Now, let's discuss what immunotherapy side effects are and what to do if you experience them.
🤵♀️ Immunotherapy works by "waking up" the body's immune system to fight cancer. However, sometimes this activated immune system can mistakenly attack healthy cells, leading to what we call immune-related side effects.
⚠️ Common side effects include:
• Skin: Rash, itching, dryness.
• Gastrointestinal: Diarrhea, stomach pain, nausea.
• Energy: Extreme fatigue.
• Kidney: Proteinuria.
• Liver: Feeling tired, dark urine, yellowing of skin or eyes (jaundice).
• Glands (e.g., Thyroid): Feeling too hot/cold, weight changes, mood changes.
• Lungs: New or worsening cough or shortness of breath.
• Joints/Muscles: Aches, pain, stiffness.
‼️ When to contact your medical team or seek early (emergency) medical attention:
• Fever (body temperature over 38°C)
• Severe diarrhea (large amount of loose stools, or with blood/mucus)
• New or worsening shortness of breath or cough
• Severe stomach pain
• Yellowing of skin or eyes (jaundice)
• Severe headache or vision changes
• Severe rash, blistering, or peeling skin
• Muscle weakness leading to difficulty moving or walking
🔆 How we manage side effects:
• Tell us early! The sooner you report symptoms, the easier it is for us to manage them.
• Monitoring: We will conduct regular checks (blood tests, physical exams) to detect issues.
• Medication: Your doctor will assess the timing and, if necessary, use steroids to calm your immune system.
• Treatment Pause: Sometimes we may temporarily stop your immunotherapy until side effects improve. This is normal and helps ensure your safety.
• Referral to Specialists: For severe side effects, we may refer you to a specialist in that field.
✅ Daily Self-Care Tips:
• Stay Hydrated: Drink plenty of water.
• Balanced Diet: Try to eat a balanced diet. If you have stomach upset, choose bland foods.
• Rest and Activity: Balance rest with light activity to help alleviate fatigue.
• Protect Your Skin: Use moisturizer and sunscreen (SPF 30+).
• Record Symptoms: Write down any symptoms, when they started, and their severity. This helps us understand your condition.
💓 Immunotherapy side effects are not scary. Please feel free to ask us any questions at any time. Your participation is crucial for your safety and successful treatment. 💗
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