1) The induction phase occurs principally in the lymphoid tissues. Antigen either finds it own way to lymphoid tissues (eg antigen in the circulation passing through the spleen) or it is transported to lymphoid tissues by migratory dendritic cells. The dendritic cells are an important part of the process of recognizing the abnormal cancer molecules and cells. Other cells involved in the process of recognition are certain B-cells and activated macrophages, which you can imagine as little "Pac-men" eating that which it identifies as abnormal and sending out information signals (cytokines) to rally other components of the immune system to join in the fight. Failure to recognize these abnormal molecules and cells is the first area of anergy that can be addressed through the therapeutic practices of onco-immunology.
2) Following activation of antigen-specific lymphocytes in the lymphoid tissues, these cells undergo a process of clonal expansion (they multiply to increase the number of troops) and differentiation. Some of these cells become activated effector lymphocytes, cells that do the work. They include the "brains" of the immune system, the helper T-cells the destroying angels of the immune system, the cytotoxic T cells, and antibody-secreting (plasma) B-cells. Some of these specialized cells remain in a semi-activated state and re-circulate through our body as memory cells. Memory cells have the job of remembering what the immune system did so that if those abnormal molecules or cells reappear they can quickly re-activate, sound the alarm and trigger a much faster and more effective immune response. Failure of clonal expansion and cell differentiation is the second area of anergy that can be identified and addressed through the therapeutic practices of onco-immunology, once recognized through specialized blood tests.
3) The final phase of activation of the immune response involves the activated effector cells themselves. The different effector cells, whose roles include the production of antibody by plasma cells, the generation of cytotoxic T lymphocytes and the induction of macrophage activation must work together to destroy the cancer cells. Failure of a co-ordinated immune response results in immune tolerance and the escape by cancer cells, freeing them to proliferate into tumors. Ultimately, it is left to the non-specific ("Pac-men") phagocytic cells to clean up the mess, and the macrophages and fibroblasts to repair damage and promote healing. Thus, in order to work effectively in response to cancer, the different components and cells of the immune system must act cooperatively to eliminate the threat. Sophisticated laboratory blood tests can identify areas of anergy that can be addressed through the therapeutic practices of onco-immunology. The speed with which immune damage can be repaired and the effector cells re-educated becomes the limiting factor. Other practices of onco-immunology include the use of special monoclonal antibodies to attack and target cancer cells, acting like a beacon for the rest of the immune system, upon which to focus their response.