Stomach Pain and Folfox/Keytruda?
My husband has 2 more Folfox/ Keytruda treatments to go. His most recent CT scan on Sept. 12, showed no growth, no decrease in the tumor. No mets. He is stage 3, HER2 +. Not a surgery candidate, and 65 years old. He was diagnosed in Dec. 2022 as stage 4, and had chemo and radiation Feb. 2023, which shrunk the tumor. He went from not being able to eat because of pain and obstruction, to mostly being able eat if he takes Ativan and Zolfran right before eating. He also takes Prilosec. He has Oxycodone 5 mg for pain, which hasn't been helping the last few days.
Has anyone had stomach pain as a side effect from Keytruda? If his tumor hasn't grown, why would he have an increase in stomach pain after this round of Folfox? He's felt good until this last infusion. He was supposed to get fluids before treatment, but they forgot. The side effects were amplified this time. Could his stomach pain be caused from not getting the fluids before treatment?
The Oncologist said he is pleased with the results, so I'm hanging on to that, but I'm not even sure what to ask the Oncologist. Does he need stronger pain killers?
Interested in more discussions like this? Go to the Esophageal Cancer Support Group.
Connect

He had no good days after this last chemo/ immuno treatment, not even the nice two or three days he usually has from the steroids. It's been two weeks.
To make a long story short, his symptoms- severe stomach pain that doubles him over, nausea, sometimes vomiting, headache, diarrhea- all within a few minutes of swallowing a bite of food (and water this last treatment), seem to indicate a Gastritis type of issue. The symptoms are all there every time and last from a couple of minutes to 20 minutes. He's so thin, he can't afford to lose any more weight! We looked into the diet modifications for Gastritis and have been following them for the last two days. The two things that have made the biggest difference for him are eliminating caffeine and while continuing the twice daily Prilosec, also using Tums before eating and after eating. And using Tums during the day when his stomach hurts for any reason. The Prilosec helps heal the stomach lining, helping to reduce acid production, and the Tums help dilute the stomach acid that's already there, or that gets dumped during eating. Bland , low acid food has really helped, although we tried that before without the Tums, and without the caffeine elimination and it didn't help at all.
Last night, day 2, he stayed up late, just eating and eating. Pain free. He is eating better than he has in a couple of months. We have cancelled his Monday treatment and will be consulting with the oncologist. We've been trying to get to the bottom of this pain for months. From what I've read, there isn't really a treatment, other than strict diet and the acid reducers, and time. I guess that's why the doctor never offered anything to treat it with. The Oxycodone he has did not even touch this pain.
Hopefully this can help someone experiencing the same symptoms.
-
Like -
Helpful -
Hug
1 ReactionIdk. - Pain from the J-tube (when he had one) suggests to me that there may have been a problem with the J-tube insertion. I know such things happen because exactly that happened to my wife. She had her J-tube removed months ago (never having used it successfully). Sometimes, she thinks she may have residual pain/discomfort from that faulty procedure.
She's on Folfox and Keytruda now and experiences stomach pain, cramping, nausea, and dumping from time to time.
-
Like -
Helpful -
Hug
1 ReactionThank you for responding.
He had a J tube, but it caused him so much pain! That pain was different from what he has now. When we found he wasn't a surgery candidate, we had it removed and he felt so much better. I see where some people tolerate it well, but he is so much better without it.
What he does, is take Ativan and Zolfran, then he can eat - the pain is when the food gets to his stomach, and for some reason, this combination together seems to help. Most of the time. Since the tumor hasn't changed, no mets, I can only figure the chemo or immuno therapy is causing the stomach pains. Maybe inflammation?
@nuggetofmine, I'm tagging @davidwrenn @rk6344 @esop @socalkelly who have had Folfox and Keytruda for stage 4 esophageal cancer. I'm hoping they can offer helpful suggestions.
Clearly you are concerned about his pain as well as his not being to eat. I would definitely consult with your oncologist or symptom management nurse. He may require different pain management options. Has a feeding tube been discussed?
-
Like -
Helpful -
Hug
1 Reaction