Mastering Chemotherapy-Induced Nausea and Vomiting: Essential Insights for Patients

Chemotherapy, a cornerstone in cancer treatment, often brings with it the challenging side effects of nausea and vomiting. Fortunately, modern medications and prevention techniques can significantly ease these symptoms.

Used to eradicate cancer cells, shrink tumors before surgery or radiation, and eliminate remaining cancer cells post-treatment, chemotherapy is a potent intervention. However, alongside fatigue, nausea and vomiting are among the most frequent and impactful side effects, affecting up to 80% of patients and considerably diminishing quality of life.

If you're about to begin chemotherapy, understanding these side effects and how to manage them can empower you throughout your treatment journey.

Discover more about chemotherapy below.

What Is Chemotherapy-Induced Nausea and Vomiting?

Chemotherapy-induced nausea and vomiting (CINV) refers to the nausea and vomiting directly caused by chemotherapy. Some patients experience nausea more frequently than vomiting, often with nausea preceding vomiting episodes.

According to the National Cancer Institute, CINV can occur before, during, or after treatment and is categorized into several types:

• Acute: Occurs within 24 hours of treatment initiation.
• Delayed: Manifests after the first 24 hours.
• Anticipatory: Triggered before treatment by sensory cues like sights and smells.
• Breakthrough: Happens within five days despite anti-nausea medication.
• Refractory: Resistant to anti-nausea treatments.
• Chronic: Persists beyond the chemotherapy period.

How Is Chemotherapy-Induced Nausea and Vomiting Treated?

Treatment typically combines prescription medications with supportive home care strategies.

Medications

Doctors may prescribe several drug types to combat CINV, including:

• Serotonin (5-HT3) antagonists: ondansetron, granisetron, dolasetron, palonosetron
• NK-1 receptor antagonists: aprepitant, rolapitant, fosaprepitant
• Steroids: dexamethasone
• Dopamine antagonists: prochlorperazine, metoclopramide
• Benzodiazepines: lorazepam, alprazolam
• Cannabinoids: dronabinol, nabilone
• Olanzapine
• Combination therapies of anti-nausea drugs

Your healthcare provider will tailor the medication schedule for optimal effectiveness.

Home Remedies

Simple practices like staying well-hydrated can prevent constipation, which may worsen nausea. Some patients find relief with tart foods such as lemons and pickles, or natural remedies like ginger and peppermint.

Potential Complications of Chemotherapy-Induced Nausea and Vomiting

CINV can significantly affect both physical and emotional well-being, leading to complications such as:

• Dehydration
• Malnutrition
• Electrolyte imbalances
• Gastrointestinal trauma
• Depression

Research indicates that severe CINV may cause some patients to hesitate or discontinue cancer treatment.

Who Is at Higher Risk for CINV?

While CINV can affect anyone undergoing chemotherapy, it is more common among females and individuals under 50 years old. Factors increasing risk include:

• History of motion sickness
• History of morning sickness
• Poor response to previous chemotherapy
• Radiation therapy
• Malnutrition
• Dehydration
• First chemotherapy cycle

Certain chemotherapy drugs are also more likely to induce nausea and vomiting; discussing your treatment plan with your doctor will help set expectations.

Can Chemotherapy-Induced Nausea and Vomiting Be Prevented?

Not everyone experiences CINV, but it remains prevalent. Alongside prescribed antiemetics, lifestyle adjustments can help reduce symptoms. These include eating smaller, appealing meals, avoiding spicy or greasy foods, choosing cold foods, and steering clear of triggering smells.

Dietary counseling has shown benefits, especially for breast cancer patients. Additionally, a 2020 Annals of Oncology study found that oral cannabis extracts significantly improved CINV symptoms.

Outlook for Managing Chemotherapy-Induced Nausea and Vomiting

A comprehensive management approach tailored to individual risk factors can minimize complications and enhance quality of life during chemotherapy.

Frequently Asked Questions

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Which Chemotherapy Drugs Are Most Likely to Cause Nausea and Vomiting?

According to the American Society of Clinical Oncology (ASCO), high-risk intravenous chemotherapy drugs include:

• Anthracycline/cyclophosphamide combination
• Carmustine
• Cisplatin
• Cyclophosphamide
• Dacarbazine
• Dactinomycin
• Mechlorethamine
• Streptozotocin

Oral medications such as altretamine and procarbazine are also considered high risk.

Can Other Chemotherapy Medications Cause Nausea and Vomiting?

Yes, moderate-risk chemotherapy agents cause these side effects in 30-90% of patients, and even low-risk drugs can occasionally lead to nausea and vomiting.

Is Trying Complementary Therapies Beneficial?

Complementary therapies including aromatherapy, acupuncture, and relaxation techniques may offer relief for some patients experiencing CINV.

Summary

Chemotherapy-induced nausea and vomiting are common but manageable side effects. Engaging with your healthcare team about preventive strategies and treatment options can significantly improve your comfort and treatment adherence.

Consult your doctor before starting chemotherapy to discuss potential side effects and effective prevention methods.

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