How do you decide whether or not to give immunotherapy in patients with a history of an isolated, severe autoimmune event?

This challenging but very relevant question brings up a very common general scenario that the patient/clinician team find themselves – between the rock and a hard place or as the Odyssean story of Scylla and Charybdis so colorfully illustrated with Scylla as a six-headed monster who lived on a rock on one side of a narrow strait while Charybdis was a deadly whirlpool on the other side. When ships passed close to Scylla's rock in order to avoid Charybdis, she would seize and devour their sailors. When facing two choices with potentially serious consequences- allowing cancer to progress by foregoing treatment or facing the risk of life-threatening side effects of the potentially effective therapy- how does one gauge appropriately to make the ...