Diarrhea- a possible side effect of Keytruda
Last updated: February 2023
As a Stage 4 bladder cancer patient (it had reached lymph nodes in the bladder area), I needed immunotherapy after the chemotherapy, then cystectomy with ileal conduit (determined by the pathology done on tissue removed during surgery that were still microscopic cancer cells present). I was begun on I.V. Keytruda, and got great CT scans for 14 months. Then the diarrhea began.
Is it IBS?
My oncologist always questioned me thoroughly concerning any other health issues I was having. Being elderly, and having so many elderly friends with IBS, I was thinking it was just that. But, the oncologist quickly sent me to a gastroenterologist at the cancer hospital, who ordered stool specimens and scheduled a colonoscopy, to get biopsies to determine the cause of the diarrhea.
Taking it to the G.I. specialist
The specimens and biopsies all confirmed that it was from the Keytruda, so I was begun on an infusion, given at different intervals. It controlled the diarrhea for 4 months, at which time it was no longer effective. The infusions and the immunotherapy were stopped, while we waited to see what would happen with oral meds it. For 4 months, nothing helped. I was Queen of the Restroom, 6-7 times daily. In late March, I was sent to another gastroenterologist who is doing research for the effectiveness of Fecal Transplants in patients who have received immunotherapy and gotten the side effect that I did.
Searching for answers
I was asked if I would like to participate in a study to verify whether Fecal t at would do the job. It will involve some extra stool collections and sigmoidoscopies, but I happily agreed to join the research program, as I want it to be approved by all insurance companies as a viable option for cancer patients (it has also been shown effective for C-Differential patients).
Healthy gut... healthy future...
Today, it has been 13 days since the implant (done at the same time as the colonoscopy), and it is helping. It is so freeing to be able to enjoy a normal day again! I am leaving on a trip today to visit extended family, and could not be happier. For any of you who may have this procedure recommended, it is totally painless (except for the colonoscopy prep, which is never fun). Healthy colon bacteria is obtained from a person with a healthy gut, tested as much as possible to make sure it doesn’t have any harmful virus or germs, and inserted into the cleaned-out colon, diluted in saline solution. The healthy bacteria attach to the inside of the intestine and begin to grow. The immunotherapy had wiped out the good bacteria in mine.
Hoping this explanation can allay the fears of anyone going through this. But, all hospitals are not doing this procedure yet.
This is my story.
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