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B12 may be injected into a muscle or beneath the skin at 100 mcg every day or alternate days for 7 days, and then every 3 or 4 days for a month

If gastrointestinal symptoms become severe or persistent, dose reduction or temporary treatment interruption may be necessary, and patients should consult their healthcare provider

It is a simple, physician-supervised process focused on safety and comfort

These cases underscore the need for more predictive preclinical models, improved safety evaluation, and strategies to overcome tumor heterogeneity

Patients should not attempt to "wait out" severe abdominal pain or assume it represents a normal medication side effect