Next to alopecia, anticipation of nausea and vomiting is one of the biggest anxiety factors for cancer patients. And in fact– Anticipatory Nausea and Vomiting (ANV) is a phenomenon that reportedly occurs in 32% of all cancer patients. Nausea and vomiting related to chemotherapy is classified as acute: occurring within 24 hours of treatment, or delayed: occurring after 24 hours
Per the National Cancer Institute, the potential for nausea and vomiting increase if the patient:
- Experienced severe episodes of nausea and vomiting after past chemotherapy sessions.
- Is female.
- Is younger than 50 years.
- Has a fluid and/or electrolyte imbalance
- Has a tumor in the GI tract, liver, or brain
- Has constipation.
- Is receiving certain drugs.
- Has an infection, including sepsis.
- Has kidney disease.
- Experiences anxiety.
In reality while chemotherapy drugs are grouped according to their potential to cause nausea and vomiting, it is your body’s unique response and the dosage of chemo you receive, along with how it is prescribed that will determine the occurrence and severity of nausea and vomiting. Radiation of the gastrointestinal area and brain creates a high potential for nausea and vomiting.
Chemotherapeutic drugs are classified by their potential for inducing nausea and vomiting, mild, moderate and severe. Typically combination therapy causes more nausea and vomiting. Some of the chemo drugs which cause severe nausea and vomiting include cisplatin, high dose cytarabine, dacarbazine, streptozocin, mechlorethamine.
Cancer Net provides a comprehensive table of intravenous chemo drugs and their potential for n/v.
It is widely acknowledged that prevention is the best treatment for nausea and vomiting.
Chemocare.com lists the following prescription medications which are utilized to prevent and combat n/v:
- aprepitant (Emend®)
- dolasetron (Anzemet®)
- granisetron (Kytril®)
- ondansetron (Zofran®)
- palonosetron (Aloxi®)
- proclorperazine (Compazine®)
- promethazine (Anergan®),(Phenergan®)
- lorazepam (Ativan®)
- metoclopramide (Reglan®)
- dexamethasone (Decadron®)
- famotidine (Pepcid®)
- ranitidine (Zantac®)
Marinol is both an antiemetic and an appetite stimulator and is approved by the FDA for patients who do not respond to traditional therapy. It is derived from the marijuana plant.
Alternative and Complementary Therapy:
- Distraction (television, video games, conversation)
- Guided Imagery
Self Help For Nausea and Vomiting:
- Avoid fatty, greasy, high carbohydrate food which take longer to digest
- Dry foods such as crackers, toast, or dry cereal can prepare you for more complex meals
- Avoid milk based products until the n/v subsides, instead ingesting clear liquids
- Clear soda such as ginger ale or lemon-lime may settle your stomach but drink them FLAT
- Try sipping sports beverages high in electrolytes
- Suck on small amounts of ice chips
- Cold cloths to the back of your neck can ease your nausea and vomiting centers
- Sip beverages slowly
Above all, contact your health care provider if your nausea and vomiting is severe or contains blood.