Symptom Specific Services

Nausea and Vomiting
• Will I experience nausea and vomiting during cancer treatment?
• Chemotherapy and nausea and vomiting
• Radiation oncology and nausea and vomiting
• Can nausea and vomiting due to cancer treatment be controlled?
• Relieving nausea

Will I experience nausea and vomiting during cancer treatment?
Most people believe nausea and vomiting are unavoidable side effects of cancer treatment although, in fact, not all cancer patients experience nausea or vomiting during treatment.

You may experience nausea and vomiting, especially if you are undergoing treatment with certain chemotherapy drugs or radiation oncology to the gastrointestinal (GI) tract, liver or brain. You may also experience a feeling of fullness, a change in the way food tastes, very strong heartburn, or fatigue.

Nausea and vomiting can occur before, during, or after chemotherapy or radiation oncology. Delayed nausea and vomiting can cause serious problems such as dehydration, which may lead to hospitalization.

Vomiting can occur before treatment as a response to other triggers in the environment, such as certain objects, odors or tastes. Smells are more likely to trigger nausea, while thoughts of treatment can trigger vomiting.

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Chemotherapy and nausea and vomiting
Chemotherapy is the most common treatment-related cause of nausea and vomiting. However, not all patients receiving chemotherapy experience nausea or vomiting before or during chemotherapy.

Usually, the pattern of nausea and vomiting is not set forth until the fourth or fifth course of treatment. Nausea or vomiting may occur prior to the beginning of a new cycle of chemotherapy, in response to a particular smell or the sight and sounds of the treatment room. This is called anticipatory nausea and vomiting and is treated differently.

The drug, dose, schedule of administration, route, and factors that are unique to you all determine how often nausea occurs and how severe it will be. Usually, these symptoms can be prevented or controlled.

You may be more prone to nausea and vomiting depending on a number of factors, such as:

• Type of chemotherapy (some are more likely to cause nausea and vomiting)

• If you were sweating after the last chemotherapy

• If you felt warm or hot after the last chemotherapy

• If you felt dizzy or lightheaded after chemotherapy

• The severity of nausea and vomiting after your last chemotherapy

• Number of chemotherapy courses you received

• Length of treatment infusions

• Your gender (women are more likely to experience nausea or vomiting than men)

• If you experienced a strange taste during chemotherapy

• If you are younger than 50 years old

• If you get motion sickness

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Radiation oncology and nausea and vomiting
Nausea and vomiting caused by radiation oncology may be acute and temporary, which means that it usually occurs 30 minutes to several hours after treatment. Symptoms often improve on days when no treatment is given.

Radiation oncology to other parts of the body also can cause nausea and vomiting. Patients receiving radiation to the GI tract or brain are more likely to experience nausea and vomiting than those receiving radiation oncology for cancer in other sites. In general, the higher the daily dose of radiation and the greater the amount of tissue that is exposed, the more likely nausea and vomiting are to occur. For example, total body irradiation before bone marrow transplantation frequently causes nausea and vomiting.

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Can nausea and vomiting due to cancer treatment be controlled?
Anti-nausea drugs are the most common treatment for nausea and vomiting caused by cancer therapy. These drugs may be used alone or in combination with other medications. Some drugs last only a short time in the body and need to be given more often, while others last a long time and do not need to be taken as often. The level of these drugs in the blood must be kept constant in order for nausea and vomiting to be controlled effectively.

Nausea and vomiting can sometimes be controlled without using drugs. Some methods that help control or eliminate nausea and vomiting are:

• Changing your diet

• Changing your view of chemotherapy

• Relaxation exercises

• Muscle relaxation

• Deep breathing

• Guided imagery

• Hypnosis

Continuum Cancer Centers of New York have an orientation program to educate patients about chemotherapy procedures and medical surroundings. This program can lessen the stress related to chemotherapy, and it may help you cope better.

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Relieving Nausea
To help relieve nausea and vomiting associated with chemotherapy:

• Some anti-nausea drugs are designed to make you sleepy, so you can rest more easily.

• Relax and try to distract yourself with television, radio or other activities you enjoy. Bring a tape player or radio with headphones you use during your treatments. In the infusion area, we have DVD players and movies on disc. You may bring your own disc as well.

• Wear loose-fitting clothing that doesn't bind or add stress to your body.

• Rinse your mouth often to eliminate any bad taste. Avoid strong foods or odors, which could bring on nausea.

• Take small sips of fluids or suck on ice chips an hour or so after feeling sick. This helps settle your stomach.

• Eat a cracker or toast. These foods can help put something back into your stomach, usually without causing upset.

• Have someone stay with you to provide gentle encouragement to help you to relax.

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