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108,109 These findings provide a prime collateral lethality therapeutic strategy for the treatment of a substantial fraction of GC or PDAC patients
Nothing complicated
Serious Warning Signs Severe abdominal pain: Especially if sudden onset, radiating to back, or with vomiting (possible pancreatitis, occurred in 0.3% of patients) Severe vomiting: If unable to keep any fluids down for 24 hours (dehydration risk) Signs of dehydration: Dark urine, dizziness on standing, confusion, decreased urination (acute kidney injury risk) Vision changes: Blurred vision, eye pain (rare but requires evaluation) Rapid heart rate: Persistent heart rate over 100 at rest (some increase normal, average 2-4 bpm, but sustained tachycardia needs evaluation) Suicidal thoughts: Any thoughts of self-harm (under 1% occurrence but requires immediate support) Severe allergic reaction: Difficulty breathing, throat swelling, severe rash (anaphylaxis requires emergency care) Lump in neck: Especially with difficulty swallowing (thyroid concern, rare but part of class warning) Trust your instincts
Intramuscular B12 injections bypass the digestive tract entirely, ensuring full bioavailability where oral supplementation may be insufficient or ineffective
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