KEYTRUDA is a prescription medicine used to treat a kind of bladder and urinary tract cancer called urothelial carcinoma. KEYTRUDA may be used with the medicine enfortumab vedotin in adults when your bladder or urinary tract cancer has spread or cannot be removed by surgery (advanced urothelial cancer), and you are not able to receive chemotherapy that contains the medicine cisplatin.

This use is approved based on how many patients responded to treatment and how long they responded. Studies are ongoing to provide additional information for clinical benefit.

INFORMATION FOR CAREGIVERS

Why support matters

For someone facing cancer, dealing with the physical and emotional effects can be incredibly difficult. As a caregiver, you realize that your help can make a difference for your loved one and you may want to do all you can. Keep in mind, caregivers go through everything their loved ones do—sometimes more. It’s important to also take care of your own physical and mental health. That’s why support matters, for both the person facing cancer and their caregivers.

The information on this page offers tips for how you can take care of your loved one, as well as ideas for making sure you take good care of yourself.

Supporting a loved one with cancer

Sometimes, your loved one may not know exactly what they need and might not feel like answering questions. It can be hard and frustrating, but there are ways to make these conversations a little less difficult and more effective.

Tips for the discussions:

  • Plan to have periodic check-ins with your loved one to see if anything has changed in terms of their feelings, goals for treatment, or your role as caregiver
  • Let them express their feelings and thoughts fully before you respond
  • Practice active listening by noticing body language, nodding, and asking follow-up questions to show that you’re engaged
  • Let them know you’re there for them
  • Do research to stay informed on your loved one’s cancer and treatment options

Making treatment decisions together with your loved ones and doctors

As a caregiver, you may be attending appointments with your loved one. During conversations with the care team, it’s important to speak up and ask questions. Asking questions can help you both understand any decisions that are made and learn what to expect during treatment. As a link between your loved one and their doctor, you can help guide conversations to get the information your loved one needs.

Tips for preparing for the conversation:

  • Get access to paperwork/approvals to have conversations on behalf of your loved one
  • Keep a copy of the advance health care directive and save a photo of it on your phone
  • Prepare questions for the care team to get clarification on treatment, side effects, and more

Taking care of yourself

From going to appointments, managing side effects, and prepping nutritious meals, to providing comfort, staying up to date on the latest research, handling paperwork, and more, caring for a loved one with cancer can be hard. Often, caregivers feel pressure to do it all themselves. The truth is the best way to take care of your loved one is to make sure you’re taking good care of yourself as well.

It’s not easy to manage a loved one’s care, but here are some ways to avoid burnout and stay motivated:

  • Stay connected to family and friends who can support you
  • Plan time to do something you love
  • Get out of the house every day, even for a short walk
  • Exercise
  • Have a creative outlet, such as painting or jewelry-making
  • Start a meditation practice
  • Keep a journal
  • Get short-term help for your loved one when you need a break

Financial help

Questions about insurance coverage or financial assistance? We can help.

To speak to a Merck Access Program representative:

FDA-Approved Indication

KEYTRUDA is a prescription medicine used to treat a kind of bladder and urinary tract cancer called urothelial carcinoma. KEYTRUDA may be used with the medicine enfortumab vedotin in adults when your bladder or urinary tract cancer has spread or cannot be removed by surgery (advanced urothelial cancer), and you are not able to receive chemotherapy that contains the medicine cisplatin.

This use is approved based on how many patients responded to treatment and how long they responded. Studies are ongoing to provide additional information for clinical benefit.

Important Safety Information

KEYTRUDA is a medicine that may treat certain cancers by working with your immune system. KEYTRUDA can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen any time during treatment or even after your treatment has ended.

Call or see your health care provider right away if you develop any signs or symptoms of the following problems or if they get worse. These are not all of the signs and symptoms of immune system problems that can happen with KEYTRUDA:

Lung problems: cough, shortness of breath, or chest pain.

Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; or severe stomach-area (abdomen) pain or tenderness.

Liver problems: yellowing of your skin or the whites of your eyes; severe nausea or vomiting; pain on the right side of your stomach area (abdomen); dark urine (tea colored); or bleeding or bruising more easily than normal.

Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heartbeat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual; urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness.

Kidney problems: decrease in the amount of your urine; blood in your urine; swelling of your ankles; loss of appetite.

Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in your mouth or in your nose, throat, or genital area; fever or flu-like symptoms; swollen lymph nodes.

Problems can also happen in other organs and tissues. Signs and symptoms of these problems may include: chest pain; irregular heartbeat; shortness of breath; swelling of ankles; confusion; sleepiness; memory problems; changes in mood or behavior; stiff neck; balance problems; tingling or numbness of the arms or legs; double vision; blurry vision; sensitivity to light; eye pain; changes in eyesight; persistent or severe muscle pain or weakness; muscle cramps; low red blood cells; bruising.

Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feeling like passing out, fever, and back pain.

Rejection of a transplanted organ. Your health care provider should tell you what signs and symptoms you should report and they will monitor you, depending on the type of organ transplant that you have had.

Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with KEYTRUDA. Your health care provider will monitor you for these complications.

Getting medical treatment right away may help keep these problems from becoming more serious. Your health care provider will check you for these problems during treatment with KEYTRUDA. They may treat you with corticosteroid or hormone replacement medicines. They may also need to delay or completely stop treatment with KEYTRUDA if you have severe side effects.

Before you receive KEYTRUDA, tell your health care provider if you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or have had or plan to have a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic); have had radiation treatment in your chest area; have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome.

If you are pregnant or plan to become pregnant, tell your health care provider. KEYTRUDA can harm your unborn baby. If you are able to become pregnant, you will be given a pregnancy test before you start treatment. Use effective birth control during treatment and for 4 months after your last dose of KEYTRUDA. Tell them right away if you think you may be pregnant or you become pregnant during treatment with KEYTRUDA.

Tell your health care provider if you are breastfeeding or plan to breastfeed. It is not known if KEYTRUDA passes into your breast milk. Do not breastfeed during treatment with KEYTRUDA and for 4 months after your last dose of KEYTRUDA.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Common side effects of KEYTRUDA when given with enfortumab vedotin include rash; tingling or numbness of the arms or legs; feeling tired; hair loss; weight loss; diarrhea; itching; decreased appetite; nausea; changes in sense of taste; urinary tract infections; constipation; swelling of your arms, hands, legs, and feet; dry eye; dizziness; joint aches; and dry skin.

These are not all the possible side effects of KEYTRUDA. Talk to your health care provider for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Medication Guide for KEYTRUDA and discuss it with your doctor. The physician Prescribing Information also is available.