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From OncoLog, April 2012, Vol. 57, No. 4

Controlling Nausea and Vomiting from Chemotherapy
Several techniques can be used to prevent or reduce this side effect

Graphic: House Call Nausea and vomiting are side effects of some types of chemotherapy, but much can be done to prevent or decrease these reactions and make you more comfortable during cancer treatment.

Why nausea happens

Whether you experience these side effects depends on what type of chemotherapy you receive, since not all chemotherapy drugs cause nausea or vomiting. Other factors affecting nausea and vomiting are the dosage of the drugs, how and when they are given, whether you’ve experienced nausea or vomiting during previous chemotherapy, and other medical conditions not related t o the chemotherapy. Nausea is more common than vomiting.

Why does chemotherapy trigger these unpleasant side effects? Chemicals released during chemotherapy can stimulate an area of the brain called the chemoreceptor trigger zone, which recognizes the chemicals as toxins. Nausea and vomiting are the body’s reaction to these foreign substances.

Fighting nausea

Your physician can prescribe an antinausea (also called antiemetic) medication for preventing chemotherapy-related stomach upsets. Since acute nausea or vomiting is most likely to occur within 24 hours of receiving chemotherapy, the antinausea drugs usually are given 30–60 minutes before chemotherapy begins and may be continued at prescribed intervals for several hours or days after treatment (as delayed nausea can occur 2–5 days after treatment with certain types of chemotherapy). You may receive an additional medication if you develop nausea after your chemotherapy.

There are several other steps you can take to prevent or reduce chemotherapy-related nausea:

Eat small, frequent meals. Try to eat small meals six to eight times a day rather than having fewer, larger meals.

Avoid greasy or spicy foods or foods with strong smells. Cold and bland foods may be more appealing because they give off less bothersome odors.

Drink plenty of fluids. Aim to drink 8–10 cups of liquid per day, preferably between meals rather than with meals. Try cool beverages such as water, un-sweetened fruit juices, mint tea, or carbonated beverages. Since ginger often relieves nausea, try ginger tea or ginger ale. Clear soups, flavored gelatin, popsicles, and ice chips also are recommended. If smells trigger nausea, it might help to use a straw to drink from a cup with a lid.

Between meals, eat snacks that reduce nausea. These can include dry foods such as crackers, toast, dry cereals, or bread sticks. Sucking on lemon drops, mints, or ginger candy helps many people. Tart foods such as pickles or lemons are often effective for settling queasy stomachs.

Don’t eat your favorite foods when you feel nauseated. This will prevent you from later associating those foods with feeling sick to your stomach.

Cook and freeze meals before your treatment starts, or have someone else cook for you. This will prevent the cooking odors from making you feel sick. Eating in a well-ventilated area or outside also reduces food odors.

Don’t lie down right after you eat. If you want to rest within 30 minutes of eating, sit or recline with your head elevated.

Determine what works for you. When is the best time for you to eat and drink? Some people feel better when they eat a little just before their chemotherapy. Others feel better when they have nothing to eat or drink before treatment. Each time you start a new cycle of chemotherapy, be sure to tell your doctor or nurse what did or didn’t work the last time.

Get plenty of rest. Try to take a nap when you’re feeling nauseated.

Divert yourself. It can help to focus your attention on music, favorite crafts, crossword puzzles, television, reading, jigsaw puzzles, or letter writing.

Use relaxation techniques. Meditation and deep breathing can help control nausea. A number of other mind-body interventions also have proved effective for some patients. These include self-hypnosis, progressive muscle relaxation, biofeedback, guided imagery, systematic desensitization, and acupuncture or acupressure. A member of your health care team may be able to help you decide whether to try one or more of these techniques and refer you to a trained therapist.

Don’t give up. Sometimes it takes a few tries before you and your doctor find what works best for reducing your nausea. Tell your health care team if you’re experiencing nausea or vomiting so they can identify the medicine or combination of medicines that is most effective for you or suggest other techniques that can make you more comfortable. Always remember that it’s possible to feel better.

– K. Stuyck

For more information, talk to your physician, visit www.mdanderson.org, or call askMDAnderson at 877-632-6789.

Other articles in OncoLog, April 2012 issue:

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