Chemotherapy Induced Nausea and Vomiting
Nausea and vomiting are frequent side effects of chemotherapy and radiation therapy. These used to be among the most debilitating chemotherapy side effects, but the development of more effective antiemetic (antivomiting) drugs has provided relief. Now, due to these treatments, nausea and vomiting can be significantly reduced.
Nausea is feeling queasy or sick to your stomach, as though you're going to throw up. Vomiting is emptying your stomach by throwing up. Chemotherapy-induced nausea and vomiting can be acute (within the first 24 hours), delayed (vomiting that occurs after 24 hours), or anticipatory. Anticipatory vomiting is a conditioned response, which means it happens in response to a stimulus, chemotherapy. With this type of nausea and vomiting, the symptoms usually occur after initial exposure to chemotherapy drugs.
Why Cancer Patients Experience Chemotherapy Induced Nausea and Vomiting
A specific location in the brain controls emesis (vomiting): the "vomiting center." Emesis occurs when the vomiting center receives a signal from the brain, the gastrointestinal tract, or the inner ear.
Chemotherapy causes the release of a substance called serotonin (5-HT) and other chemicals in the small intestine, which signal the vomiting center in your brain to induce emesis.
Cancer Treatments Likely to Cause Nausea and Vomiting
Certain chemotherapy drugs are more likely to cause nausea and vomiting than others. Chemotherapy drugs are classified as mildly, moderately, or highly likely to cause nausea and vomiting. Certain types of chemotherapy are frequently associated with a high probability of nausea and vomiting, and doctors usually recommend appropriate antiemetics.
Many chemotherapy treatment plans use more than one drug. The amount of nausea and vomiting produced by combination chemotherapy treatment is typically greater than the nausea expected from any single drug.
Your doctor will determine the chemotherapy drug or drugs that are right for you. To understand more about the different ways chemotherapy is given, read about
how people receive chemotherapy.
Preventing Nausea and Vomiting
The best way to treat chemo induced nausea and vomiting is to prevent them from occurring in the first place. Medicines for controlling nausea and vomiting, called antiemetics, have been developed over the last several years. These drugs block the signal in the brain and gut that causes nausea and vomiting.
There are many different kinds of antiemetics; your doctor may have you try more than one before finding the prescription that works best for you.
Other Actions to Manage Nausea and Vomiting
There are several things you can do to help prevent nausea and vomiting.
First and foremost, make sure you receive and take your antiemetics as your doctor has ordered.
Let your health care professional know if your drugstore does not have them or if you are not sure how to take them. Also, call your doctor or nurse if you experience the following:
- You have vomiting and cannot take your medication.
- Your antiemetics help reduce your chemo induced nausea and vomiting, but may not completely eliminate your symptoms. The dose may have to be changed, or the doctor may change you to a different antiemetic.
In addition to taking your medication, the following general suggestions may help you prevent or control nausea and vomiting:
- Try eating foods and drinking beverages that have been easier for you to take or have made you feel better when you had the flu, morning sickness, or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, or flat soda, for example. Eat small, frequent meals (five or six), instead of three large meals each day.
- Do not eat fatty or fried foods, very spicy foods, or very sweet foods.
- If possible, have somebody else make the meals when you are nauseated.
- Do not eat your favorite foods when you are nauseated.
- If you have nausea and vomiting for only a few days after chemotherapy, cook and freeze several meals that you can reheat during times when you are nauseated.
- Eat foods that are at room temperature or cold. The smells from hot foods may make your nausea worse.
- Keep your mouth clean; brush at least twice a day.
- Consider shakes or liquid nutritional supplements to help maintain your nutrition.
- Control chemotherapy induced nausea with relaxation techniques.
- Ask your doctor or nurse if they can help you learn a relaxation exercise. This may make you feel less anxious and more in control, and may decrease your nausea.
Controlling Anticipatory Nausea and Vomiting
Anticipatory nausea and vomiting are poorly controlled with standard antiemetic treatment. In some clinical studies, drugs that treat anxiety (benzodiazepines) have provided some relief.
A number of nondrug approaches, also called cognitive and behavioral intervention, may help:
- Systematic desensitization
- Distraction from the negative experience with guided imagery or relaxation
- Manipulation of the setting and people associated with chemotherapy administration
- Biofeedback
- Blocking taste sensation with another strong taste (lemon, for example)
Antinauseants/Antiemetics
Help prevent nausea and vomiting:
Gastric Acid Inhibitors
Help control acid reflux, ulcers, and stomach pain:
Learn more about how you can best manage other types of chemotherapy side effects.
UNDERSTANDING CANCER
TREATING CANCER WITH CHEMOTHERAPY
CHEMOTHERAPY SIDE EFFECTS
TREATING CANCER IN OTHER WAYS
TRACKING YOUR TEST RESULTS
UNDERSTANDING INSURANCE AND TAX ISSUES: INSURANCE TIPS
WEB RESOURCES AND ORGANIZATIONS
TOOLS FOR ORGANIZING YOUR CANCER INFORMATION
FOR CAREGIVERS
GLOSSARY OF CANCER TERMS
REGISTER FOR PROGRAMS
FOR HEALTHCARE PROFESSIONALS
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