Cancer: Controlling Nausea and Vomiting From Chemotherapy
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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.
Researchers do not know exactly why some chemotherapy drugs cause nausea and vomiting. They believe there are several ways that this can happen. Some drugs may affect the parts of your spinal cord or nervous system that trigger nausea and vomiting. Some drugs may cause nausea and vomiting by irritating the lining of your digestive system. Sometimes, if you had nausea when you had chemotherapy before, your brain remembers this and expects nausea when you have chemotherapy again.
Chemotherapy drugs are ranked according to how often they cause nausea and vomiting. Some cause very little of those side effects. Also, some people are more likely than others to get sick. Your doctor will consider many things about you, your treatment, and your cancer to decide if you are likely to feel sick.
Your risk of having nausea and vomiting
Whether you have nausea and vomiting may depend on:
You may feel sick shortly after your chemotherapy treatment begins. Or you may not feel sick until a day or two later. You may not feel sick at all. As soon as you start to feel sick, tell your doctor.
Many people start feeling sick before a treatment session even begins. This is called anticipatory nausea and vomiting. Any little thing—the smell of an alcohol swab, the sight of a nurse's uniform, the sounds of the treatment room—may trigger nausea. This usually doesn't happen until after the third or fourth treatment session. Learning how to control anticipatory nausea and vomiting is important, because it can make nausea and vomiting more severe when the chemotherapy actually starts.
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Nausea and vomiting are unavoidable side effects of cancer treatment.
People who feel good are better able to fight their cancer and have happier lives. Your body needs to be able to rest, to refuel, and to cope with the stresses of cancer and its treatment.
If untreated, nausea and vomiting can make you feel:
Controlling your nausea and vomiting can help you to:
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Controlling your nausea and vomiting is important because:
Having a good appetite and eating well will help you feel better.
Being relaxed and able to sleep will help your body fight the cancer.
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 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 ondansetron (Zofran) and lorazepam (Ativan).
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. Or your chemotherapy drug may need to be changed.
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.1
Although drugs are the main way to treat nausea and vomiting, there are other treatments that have been shown to work well.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:
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.
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:
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Taking control over nausea and vomiting starts by talking to your doctor about your symptoms.
You can afford to let the rules of good nutrition slide while you are being treated with chemotherapy.
It's important to tell your doctors or nurses when you feel any nausea. Sometimes people worry about bothering the doctor or nurse. Sometimes they think there is nothing that can be done, so it is not worth bringing up. Speak up about your fears and about any nausea you are feeling, no matter how slight. You may need a different medicine for nausea a few days after chemotherapy than the one you used right afterward.
To help you and your health care team deal with any nausea and vomiting, you may want to keep track of how you feel. You can use a symptoms diary to write down how you are feeling. Take your diary with you whenever you visit your doctor.
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