Dear @doshi

I admire the way you're looking out for your wife. She needs you now more than ever.

Below is my response to your questions bared typing my personal experience and research:
For HRD-negative endometrial cancer, maintenance treatment may not be necessary unless recommended by the oncologist. Immunotherapy options are available, particularly for those with mismatch repair deficiency (dMMR) or microsatellite instability (MSI-H). Keytruda aka Pembrolizumab has shown promising results, with a 52-57% objective response rate in clinical trials for these folks.

If considering Keytruda, discuss cost concerns with the oncologist or healthcare provider. They may offer guidance on managing expenses or exploring alternative options.

To support your wife's recovery, consider:
- Cutting out sugar and focusing on colorful, nutrient-rich foods
- Pressed green juices or smoothies and Mediterranean-style salads with mixed vegetables
- Eating something like her favorite breakfast before each round of chemo, and soup, salad, or a tuna sandwich on pita afterward is helpful because she might not feel like eating much for the next 5 days or so after each round of chemo
- Drinking water every hour during waking hours to flush out toxins

Don't forget to:
- Prioritize healthy meals, such as those including yogurt topped with chai seeds, flax seeds, and women's myKind vitamins
- Pay close attention to blood work before each treatment to ensure organs, white and red blood cells, and thyroid are okay enough for treatment and to determine if you wife's diet needs to be adjusted (folace, magnesium, potassium, vitamin B12, vitamin D are important)
Take care of yourself during this challenging time
- Pray for a healthy outcome and stay positive. Your wife's body will be going through lots of changes, so please encourage her with soft affection and kindness. Go to every infusion appointment with her. Let her interact with the doctor on her own (list/discuss symtoms) and only advocate if she forgets to mention something or needs you to affirm something.

My personal Experience:
I was diagnosed with stage IVB, Grade 2 endometrial cancer and underwent six rounds of chemo with Keytruda aka Pembrolizumab and seven rounds of Keytruda alone for maintenance because I was dMMR. Your wife is pMMR, but there might be other viable options for maintenance, but you'll have to consult with your oncologist and you may be getting ahead a little.

Due to toxicity, high blood pressure, and glucose levels, I stopped Keytruda after seven out of the 14 rounds prescribed. I added airborne to my water 10 days out of every month to keep my immunity due to dying cells. It's been four months since my last maintenance treatment, and I'm awaiting the results of my CT scan this week.
My CA 125 marker is within normal range since round three of chemo.

Here are ways to support cell performance or regeneration during chemo:

Nutrition;
1. Eat foods rich in antioxidants: berries, leafy greens, and other fruits and vegetables.
2. Include healthy fats: avocado, nuts, olive oil.
3. Consume omega-3 fatty acids: salmon, walnuts.
4. Eat foods high in CoQ10: organ meats, fatty fish.

Lifestyle;
1. exercise: walking
2. Manage stress: meditation, yoga.
3. Get enough sleep (7-9 hours).
4. Limit exposure to toxins.

Foods to Avoid:
1. Processed meats
2. Refined sugars
3. Fried foods
4. Foods high in saturated fats

Additional Tips;
1. Stay hydrated.
2. Limit alcohol consumption.
3. Quit smoking.
4. Consult a healthcare professional.

Remember, consult a healthcare professional before adding supplements or making significant changes.

References:
*** Mayo Clinic - Mitochondrial function

Love (for ourselves and others) suffers long and is kind. 😇

Warm regards!