When stomach cancer has progressed and chemotherapy begins, people often say the scariest part isn't really the chemo itself but "not being able to eat." It's not unusual for the pain to be bad enough that someone ends up in the emergency room for painkillers even before the first round. And once the drugs actually start, a wave of chills can hit hard, leaving you shaking for a long stretch before finally finishing hours later and going home. The real trouble is what comes after. Your appetite disappears, anything with solid bits in it just won't go down, and when you're surviving on nutritional drinks and thin rice porridge, the weight drops alarmingly fast.
Hearing that someone who weighed 73 kilos fell to 56 in a couple of weeks is not rare. When you run that empty, you get admitted to a secondary or nearby general hospital for a few days of protein IV nutrition and vitamin injections, and you can visibly see a kilo or two come back and some energy return. But just when you start to feel a bit human again, that's when the talk of discharge begins. You go home, faithfully eat your 200 grams of porridge and your nutritional drinks, try to get in a short walk, and then a few days later you see the weight has slipped right back off. The discouragement of that is honestly hard to put into words.
During a stretch like this, whether your pain is well controlled matters more than you'd expect. With a narcotic pain patch on and the pain settled, your overall condition may not be bad at all, yet the weight can keep falling. The absence of pain doesn't mean you're eating well; it's simply that the amount you eat is so small. So rather than treating "pain management" and "nutrition management" as two separate things, it's more accurate to think of them as one bundle you have to handle together.
The thing people get most confused about is where to recover between chemo cycles. Big general hospitals usually keep admissions short. Once you've had a few days of IV nutrition and recovered to some degree, the bed needs to be freed up, so after about five or six days the discharge conversation often comes up. A long-term care hospital, on the other hand, has the advantage that you can stay longer and continue IV nutrition and pain management. That said, if chemo side effects suddenly worsen or an emergency arises, the place that can respond immediately is going to be the university or general hospital where the chemo is being done, so it's hard to say either one is simply the right answer.
In practice, a lot of people get their chemo at the big hospital they've been going to and fill in the recovery in between at a care hospital that handles nutrition and pain. When you're choosing a care hospital, check first whether they can give enough protein IV nutrition, whether prescribing and adjusting narcotic painkillers goes smoothly, and above all whether they communicate well with the chemo hospital you attend and share care information. If that piece doesn't line up, the back-and-forth only wears the patient down more.
One more thing worth adding: the steady weight loss isn't simply about "eating less." The disease itself eating away at the body plays a big part too. So don't blame yourself too much, and one option is to ask your medical team to connect you with a nutrition support team (nutrition counseling). What's written here is just a summary of the experiences of people walking a similar road, so please make the actual decisions about admission and care in consultation with your attending physician.