How to manage back pain from Keytruda infusion

Hello @shanm. My brother took keytruda and sadly fatigue is part of the chemo deal. He felt the fatigue less after a couple of treatments. He dealt with the back pain by using lidocaine patches.
We found that the cost was considerably less and the pain relief was considerably more with the prescription ones. The over the counter patches did not help much but the Rx ones did, without added pain medications.
My brother had lung cancer. May I ask what kind of cancer your husband has?

He has prostate that started in 2023. He did chemo. Then in 2025 He had to have 20 radiation treatments for a tumor in the prostate. Now they are trying to figure out if the spread is small cell prostate only or possibly also colorectal cancer.

@shanm can you get an appointment with palliative care team to implement better pain management protocols? My husband takes HYDROmorphone 2 mg as needed every 4 hours plus a Butrans 10 mcg/hr pain patch of transdermal buprenorphine. For some reason oncologist usually defers to palliative care to manage pain - I think with opioids. The radiation pain and fatigue will slowly improve. Keytruda fatigue waxes & wanes. Hopefully your husband has some good days soon!

@fightingbluehen69 some docs prescribe lowest dose of oxycodone combined with Tylenol…some even add Claritin for pain control…..effective but not great for the long term.

@nycmusic yes! We use the Claritin daily right after the neulasta onpro device & Udenyca nobody - both devices to retrieve white blood cells from bone marrow resulting in long bone pain (femur in leg, humerus in arm) and for histamine-driven inflammation in bone, it was found that for that specific bone pain, Claritin helps!! And yes, Tylenol does too, especially the 8 hour or extra strength.
We also switched from getting infusion of Zometa every 6 months while on Keytruda, to now monthly injections of Xgeva, due to some lytic rather than sclerotic bone lesions.
Targeted radiation for the bones takes a while to see relief, but it does work!!
Here’s a photo of the Neulasta device, applied by oncology nurse at chemo infusion, and it goes off & automatically injects 27 hours after chemo infusion.
Boosts immunity by making new white blood cells, specifically the infection fighters, the important neutrophils. If neutrophils are zero you definitely get one!!

Sorry typo Udenyca *onbody (not nobody lol)

@fightingbluehen69 thanks, useful for my friend enduring rough chemo…

Docetaxel? Or ‘taxel’? Ask for magic mouthwash & if tongue starts hurting get the medication for thrush. Protein drinks- Fairlife chocolate taste pretty good. Your friend is brave and lucky to have your care.