Introduction

Of all the side effects of
chemotherapy, nausea and vomiting are two of the most distressing. But in many cases, nausea and vomiting can be controlled and even prevented.

  • Nausea and vomiting can be controlled and even
    prevented. The best treatment plan is one set up by you and your health care
    team, based on your particular needs and feelings. You are the authority on how
    well you feel and how much nausea you have.
  • Today’s antinausea
    drugs are very good at preventing and controlling nausea and vomiting. Your
    doctor should be able to find one that works for you.
  • Prevent
    nausea. When you or your doctor foresee that a treatment will make you very
    sick, it’s best that you take
    antinausea medicine beforehand.
  • There are several other ways to get relief and make yourself feel
    better before and after your chemotherapy treatments.

How can I control nausea and vomiting?

The best way
to control nausea and vomiting is to begin treatment for it before you start
chemotherapy. Talk to your doctor about your treatment plan. Find out
if the cancer drug you’ll receive is likely to make you sick. Ask your
doctor what medicines are available to prevent nausea and vomiting. Talk about
your concerns, no matter how small. The more you know about your treatment, the
more you will feel in control and the easier it will be to talk about it with
your doctors and nurses.

Antinausea drugs

Antinausea drugs are usually taken on a
regular daily schedule for as long as chemotherapy lasts. Sometimes you may be
asked to take the antinausea drug “only as needed.” You may be given more than
one kind of antinausea drug. Drugs to relieve your nausea include aprepitant (Emend) and ondansetron (Zofran) .

Antinausea drugs can be given as pills you swallow, through your vein (IV), or as shots. Some drugs are available as
suppositories, as capsules that melt in your mouth, or as a patch that is taped
to your skin.

Be sure to follow your doctor’s instructions for taking your antinausea medicines and to report back about how well they are
working.

If you have nausea and vomiting after chemotherapy in
spite of taking antinausea drugs, tell your doctor immediately. A different
antinausea drug may be the answer.

Medical marijuana

Marijuana, either in its natural form or as a
synthetic drug, has been shown to ease the nausea and vomiting caused by
chemotherapy. Although it worked better than many of the antinausea
drugs available in the past, it doesn’t seem to work as well as other
medicines available today. And marijuana can cause
unpleasant side effects including dry mouth, low blood pressure, and dizziness,
especially in older people or people who haven’t used it before. Also,
the legality of marijuana for medical use is still a question in many
countries.

Some doctors still use the synthetic form of marijuana
to treat nausea and vomiting. These drugs have not been shown to work as well
as other drugs now available, but they may be helpful for certain
people.footnote 1

Complementary therapy

Although drugs are the main way to treat nausea and
vomiting, there are other treatments that have been shown to work well.footnote 1 They involve the help of a
qualified therapist who can teach you to use your mind and body to control
nausea and vomiting. These techniques help stop anticipatory nausea and
vomiting. They work by relaxing you, distracting your attention, helping you
feel in control, and making you feel less helpless. These treatments
include:

  • Biofeedback. Biofeedback uses
    the mind to control a body function that the body normally regulates on its
    own, such as skin temperature, muscle tension, or heart rate.
  • Guided imagery. This is a series of thoughts and
    suggestions that direct your imagination toward a relaxed, focused state. This
    technique can help you mentally block the nausea and
    vomiting.
  • Distraction. For example, kids
    getting chemotherapy may use a video game to help keep their mind off what is
    happening. This may also help mentally block the nausea and vomiting.
  • Progressive muscle relaxation. This is a technique in which you learn to relax by
    tensing and then releasing different groups of muscles, one at a
    time.
  • Self-hypnosis. A
    therapist can teach you to hypnotize yourself. Some people are able to learn
    from books.

Acupuncture

Some studies
have shown that
acupuncture is an effective treatment for nausea and
vomiting caused by chemotherapy.footnote 2 Your doctor may refer you to a qualified
acupuncturist.

You can also try
acupressure. Constant pressure on the P6 point is used
to prevent or reduce nausea. The P6 point is on the
inner side of your arm, in line with your middle finger. It is close to your
wrist, one-sixth of the distance between your wrist and elbow. You can press on
your arm with a thumb or finger or try wearing wristbands (such as Sea-Bands)
that press a plastic disc on the P6 point on each arm.

Nutrition

Eating well may seem to be an odd way to treat nausea and vomiting, but
it’s very important. As a cancer patient, you need nutritious foods to help you
feel better, keep up your strength and energy, keep up your weight, and keep up
your ability to fight infection and recover as quickly as possible.

Here are some tips for eating well during chemotherapy:

  • Eat small, frequent meals or snacks. Treat
    yourself by choosing the foods you like best.
  • Make the most of the
    days when your appetite is good.
  • Ask friends and family for help
    with shopping and preparing meals. Consider having meals delivered to your home
    or have lunch at a community or senior center.
  • Nutritional
    supplements are convenient and can help you get the extra calories and protein
    you need. Try a variety to find out which ones work best. Your doctor, nurse,
    or dietitian can help and may have samples for you to try.
  • Is there
    a time of day when you are able to eat more? Many people find that breakfast
    time is best. Try eating more during that time of day when you
    can.
  • Don’t force yourself to eat when you are
    nauseated.
  • Eat food cold or at room temperature.
  • Keep
    your mouth clean, and brush your teeth after vomiting.
  • Have fresh
    air with a fan or an open window.
  • Limit sounds, sights, and smells
    that make you feel sick.
  • When you don’t feel like eating your
    normal foods, try apple or grape juice, weak teas, clear broths, dry toast,
    cooked cereal, and gelatin desserts. Avoid citrus juices and
    lemonade.
  • Try ginger, such as candied ginger or ginger tea. Real ginger-not ginger flavoring-helps to reduce nausea.
  • Eat a light meal or snack before your chemotherapy appointment so
    that you have something in your stomach.
  • If your chemotherapy is
    the kind that takes several hours rather than a few minutes, bring a light meal
    or snacks with you. Your treatment center should have a refrigerator and
    microwave available for your use.

References

Citations

  1. National Cancer Institute (2011). Nausea and Vomiting PDQ-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/supportivecare/nausea/HealthProfessional.
  2. National Cancer Institute (2013). Acupuncture PDQ – Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/healthprofessional.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Jimmy Ruiz, MD – Hematology, Oncology

Current as ofMay 3, 2017