One of the most common side effects and issues after cancer diagnosis and treatment is nausea and vomiting. There are many reasons that can make a person nauseous in varying degrees of severity. Nausea is not solely linked to cancer, and cancer is not solely linked to nausea. Hyperemesis Gravidarum is a severe nausea and vomiting condition that occurs during pregnancy. Sometimes people who suffer from severe migraines are also very nauseous and vomitous when they are struggling with head pain. Whatever your reason for nausea, there are many different things you can try to treat and ease the symptoms.
Nausea is said to be an unpleasant feeling in the back of your throat and pit of your stomach that can lead to vomiting. Different people describe nausea in different ways. Some say things like, “sick to my stomach,” “queasy,” or describe it as an “upset stomach.” Nausea has other symptoms that often occur simultaneously with gut unease. Light-headedness, increased production of saliva, dizziness, trouble swallowing, skin temperature changes and a speeding heart are all very common.
There is little known about the exact cause of nausea, although many doctors believe that vomiting is controlled by a specific area in the brain responsible for making the decision to empty the stomach, or not. When someone is on chemotherapy, certain areas of the brain responsible for the control of the stomach are bothered, thusly creating nausea and vomiting to happen within the body.
Vomiting is described as “throwing up,” or emptying the contents of your stomach back out of your body through the mouth. When this process happens, your stomach muscles contract and squeeze all the contents out of your stomach. Retching happens when the stomach has emptied, but continues to squeeze and contract, forcing the body to gag repeatedly. Both nausea and vomiting can happen together, or separately.
What causes nausea with cancer?
There are many different things that can cause nausea and vomiting with a cancer patient. This could be anything from diagnosis, through surgery to remove the cancer, and treatment and recovery after. These are the most common triggers for nausea and vomiting for cancer patients.
-The cancer itself can affect the body, especially if it is in or affecting the brain.
-Bowel slowdown or blockage, otherwise known as an obstruction, can cause a backup within the gastrointestinal system which can lead to nausea.
-Inner ear problems like having trouble with equilibrium.
-Constipation can cause a backup and general unease in the abdomen and intestines.
-Chemotherapy’s main side effect are nausea and vomiting. This can often be combated with anti-nausea medications.
-An imbalance of minerals and salts in the blood can create a chaotic environment within the body and cause surges of sugars or hormones making one feel very nauseous.
-Radiation therapy can cause severe nausea and vomiting.
-Anxiety and the buildup of worry and nerves can cause vomiting.
-Certain other medications can cause nausea and vomiting, some as a side effect, others from the large dosages of such heavy medications.
-Infections, whether viral, bacterial, or parasitic, can cause stomach upset and discomfort and create intestinal distress. All these things can make a person feel nauseous or vomit.
-Other diseases, autoimmune illnesses, or life-long chronic illnesses can have stress related vomiting due to the illness, medication, or other life issues.
-Anticipatory vomiting happens when someone is so very used to vomiting and being sick in a certain setting, it happens regardless of any effort to not make it happen. For example, some people know that visiting the hospital makes them sick, so, every time they step foot in a hospital, they vomit.
What does nausea and vomiting do to the body?
Vomiting and nausea are two of the most common, most hated side effects of most all cancer treatments. These side effects rarely become deadly, although it can happen. These symptoms make it difficult for your body to get the nutrients it needs to function. When one is nauseous, they do not eat regularly and often skip and avoid meals. When one is continuously vomiting, the body is not holding any nutrition and not getting the calories and energy needed to thrive and heal.
When vomiting persists, dehydration first becomes an issue. With a lack of fluids and minerals in your body, your body will struggle more than it should and fight to get the minerals needed for your organ systems to function. Dehydration can make you insatiable for any sort of food or beverage, and if left untreated, can become a severe problem for any cancer patient.
You should let your cancer care team know immediately if any of these things happen:
-You cannot keep any fluids down at all.
-You cannot take any of your needed medications.
-You’ve been vomiting for twenty-four hours or longer.
Along with vomiting comes other issues like tiredness, exhaustion, trouble concentrating, weight loss and loss of appetite. If your vomiting is prolonged for long amounts of time, your body may be slow to heal and calm, which can interfere with your ability to take care of yourself. Vomiting is a very physically stressful event for your body every time it happens.
What types of medications are used to treat nausea and vomiting?
The medication you are prescribed for nausea and vomiting depends on the treatment you are receiving for your specific type of cancer. Some of the most common medications prescribed are:
-NK1 receptor antagonist drugs.Examples of medicines in this group include:
- Aprepitant (Emend)
- Fosaprepitant (Emend injection)
- Netupitant-palonosetron (Akynzeo)
- Rolapitant (Varubi).
-5-HT3 receptor antagonist drugs.This is another group of drugs used to prevent nausea and vomiting. Examples of medications in this group include:
- Granisetron (Kytril, Sancuso)
- Ondansetron (Zofran)
- Palonosetron (Aloxi)
- Dolasetron (Anzemet)
- Tropisetron (Navoban)
- Ramosetron (Nasea)
-Dopaminergic antagonist drugs. Examples of medicines in this group include:
- Metoclopramide (Reglan)
- Prochlorperazine (Compazine)
-Dexamethasone (multiple brand names)
-Olanzapine (Zyprexa)
There are certain types of cancers that require three or more types of antiemetic medications. If a cancer patient is at a high risk of vomiting and stomach discomfort, doctors will not wait to get them all four medications to ensure that they are get the nutrition that they need.
Are there any natural remedies to help ease nausea and vomiting?
Yes! There are natural remedies and some herbs that have been used for hundreds of years in certain cultures to treat nausea, vomiting and pain.
-Locally grown ginger eaten in small amounts or steeped into a tea can ease the symptoms of nausea.
-Lemon is an anti-nausea food that can be steeped into tea or made into lemon water to relieve symptoms.
-Chili peppers and those containing capsaicin have been proven to relieve gastrointestinal distress. Although this seems strange- putting a hot, spicy food into a sore belly, the results have proven that capsaicin acts as a nausea reliever.
-Peppermint and spearmint in many forms can relieve nausea and ease vomiting. Peppermint essential oil is now used for many things, including reliving nausea. By inhaling the vapors or mixing the oil with a carrier and applying to the skin, these oils are an easy way to help your body relax and avoid nausea. These mint herbs are also great in tea.
-Fresh air and plenty of fluids. Ease into the fluids as to not overwhelm your sensitive gut. Electrolytes are important, so consider keeping special drinks on hand for emergency hydration situations.
-Eat bland foods and bone broth. Keeping it simple and not forcing your stomach to work overtime will help ease the nausea and vomiting.
As with any natural medical measure, please discuss any new addition to your routine, herb or supplements with your doctor. This includes essential oils, as certain oils do cause some interesting reactions.
What questions should I ask my cancer care team about my nausea and vomiting?
-Can my nausea and vomiting be controlled by any medications?
-Is my cancer treatment responsible for this?
-What anti-nausea medications are available? Which should I use?
-Do these anti-nausea medications have side effects of their own?
-What happens if these medications do not control nausea or vomiting?
-How often am I allowed to take this medication?
-At what point do I call in if the treatment does not seem to be easing nausea or vomiting?
If you are experiencing nausea and vomiting during your cancer treatment, do not hesitate to contact them and discuss your options for palliative and extra assistance. While nausea and vomiting might not completely stop, there are numerous ways to ease the discomfort, pain, and ways to have a chance at a normal everyday life.
Citations:
National Institute of Health and Human Services
American Cancer Society
Cancer Society