At some point in your life, you have most likely experienced nausea and vomiting. Maybe they came together, or maybe you experience both in a myriad of ways, but these common issues are linked to many-an illness. Cancer and cancer treatments like chemotherapy and many of the pill-form treatment medications all lead to very high levels of nausea and vomiting.
Chemotherapy has been being used to treat cancer since the 1950s. The advantage that chemotherapy provides to the body is that it kills the cancer cells. The downfalls of chemotherapy are that healthy cells can also be damaged, muscles weakened, nausea, vomiting, and a list of other things. In the past, cancer patients had no real choice and had to simply deal with nausea and vomiting. Thankfully, that is no longer the case. There are many medications, therapies and holistic, natural approaches to easing these symptoms.
Why does chemo have such a sickening effect on the body?
Chemotherapy is a medication that is taken during cancer treatment and care, along with many other illnesses that utilize the power behind this pill. Because this medication is foreign to your body, it sets off “warning signals” for your brain and digestive system, which flips the switch in the brain’s vomiting center, releasing chemicals which make you queasy, nauseous, and sick. Chemo can also interfere with the function of your digestive system, which also makes you sick. This medication can cause three types of nausea and vomiting:
- Delayed: This means the nausea and vomiting will not begin until roughly twenty-four hours after your treatment and can last for days.
- Acute: This type starts within a few hours of your treatment.
- Anticipatory: This version begins before you get your chemo, because you have mentally told yourself you will be getting sick.
When vomiting is constant, it can harm the body mentally, physically and emotionally. It leaves the body feeling weak, dehydrated, and nutrient depleted. Your electrolytes will become unbalanced, which means you lack sodium and potassium, two very important aspects to proper body function. If you become too ill for too long, you may need to speak with your doctor about adjusting your chemo dosage and frequency.
Certain kinds of chemotherapy are much more likely to make you ill than others. Sickness happens most often with the drugs cisplatin and doxorubicin. Although, other problems with treatment can arise that will cause nausea and vomiting. They are:
- If you are getting more than one type of chemotherapy treatment together, or too close together.
- If you are on a high dose of medication.
- If you take chemo through your vein, rather than by mouth.
- If you are a woman.
- If you are younger than fifty years old.
- If you get motion sickness regularly.
Are there any medications that can help to ease the symptoms?
Yes! There are certain medications that can help to relieve, or at least ease, your symptoms. You may take one or a combination of some of these medications:
- Aprepitant (Cinvanti, Emend)
- Dolasetron (Anzemet)
- Fosnetupitant/palonosetron (Akynzeo)
- Granisetron (Kytril, Sustol, Sancuso)
- Ondansetron (Zofran, Zuplenz)
- Palonosetron (Aloxi)
- Rolapitant (Varubi)
Along with those medications, there are also medications created for other issues that have proven to be of use for cancer patients as well. They are:
- Anti-anxiety drugs like alprazolam (Niravam, Xanax), diazepam (Valium), and lorazepam (Ativan)
- Cannabinoids like
- abilone (Cesamet)
- dronabinol (Marinol, Syndros)
- Corticosteroids like
- dexamethasone (Decadron, Hexadrol)
- methylprednisolone (Medrol)
- Dopamine antagonists like
- metoclopramide (Reglan)
- prochlorperazine
- Motion sickness medicines like the scopolamine patch
I don’t like to take extra medications. Are there any natural or holistic approaches to controlling or easing my nausea and vomiting?
You should consider trying a complimentary therapy treatment. These are “outside” of scope of “traditional” medicine and can be used alongside any other treatment you are undergoing. Here are some of those therapies:
- Acupuncture is a form of Chinese traditional medicine that uses fine needles to stimulate various pressure points around your body. The idea is to restore your natural energy flow. The practitioner may even add an electric current to boost the effect. The point that is often used to treat nausea is called P6. It is located on the underside of the wrist, a couple of inches below your hand. Side effects are usually mild, including pain and minor bleeding where the needles go in.
- Acupressure is similar acupuncture but uses firm pressure instead of needles.
- Biofeedback teaches you how to control body functions that usually happen automatically. You can learn how to slow your heart rate or breathing to calm you down.
- Hypnosis gets you into a state where you’re focused and open to suggestion. You can go to a hypnotist or use self-hypnosis to bring about changes in behavior.
I am having trouble relaxing. Are there any special techniques to try?
Getting your mind off your treatment can be very challenging, but very beneficial when you do. Try some of these techniques to help calm yourself and ease your mind whenever you need.
- Progressive muscle relaxation. Start at your feet. Tense and then relax each muscle group in your body. By the time you reach your head, you should feel much calmer.
- Guided imagery. Use your imagination to picture yourself in a calming scene — like a tranquil village by a lake. Imagine your stress drifting away from you like a boat sailing off on the current.
- Distraction. Listen to music, read a book, or watch a funny movie to take your mind off the treatment ahead.
Do you have any tips for self-care when it comes to nausea and vomiting?
There are some changes you could make in your daily life that may help to alleviate the symptoms you are dealing with. Here are some of those tips:
- Avoid any foods that make you feel sick. Common culprits include fatty, fried, and strong-smelling foods.
- Eat several small meals throughout the day instead of three big meals. Have a snack before your chemotherapy treatment.
- Do not cook when you do not feel well. The smell of warming food can make nausea worse.
- Eat cold food if the smell of hot food bothers you.
- Drink extra water and other fluids so you do not get dehydrated.
- Eat candied ginger or drink flat ginger ale or gin.
- Suck on peppermint candies.
How can I help guard myself against nausea and vomiting?
Ask questions. There are many ways that you can act in your own life to find personal solutions and stable ground for your nausea and vomiting. Check out these points, questions and topics for discussion with your doctor, or to consider in your own life.
- Ask your health care professional to explain to you the chemotherapy drug you will be taking, and the likely side effects of the drug.
- Find out if the chemotherapy drugs are likely to cause nausea and vomiting.
- If so find out when that is likely to occur and how long, it typically lasts. For example, will it start during chemotherapy or not until several hours later? Will it last for more than one day?
- Ask what your doctor will be prescribing to prevent and control nausea and vomiting. Learn how, when, and how often to take these medications.
Fluids:
- Drink fluids throughout the day like water and juices. Many persons on chemotherapy need to drink at least two quarts of fluids per day. Ask your doctor or nurse if this applies to you. Also, if you are vomiting it is important to replace the fluids lost to avoid getting dehydrated.
- Avoid drinking liquids at meals.
Eating hints:
- Eat small amounts of food throughout the day.
- Eat before you get too hungry.
- Eat dry foods such as dry cereal, toast, or crackers without liquids especially first thing in the morning.
- Avoid heavy, high fat and greasy meals right before chemotherapy.
- Do not eat your favorite foods during this time. They will no longer be favorite foods if you begin to associate them with nausea and vomiting episodes.
Surroundings:
- Avoid strong odors.
- Don’t lay flat for at least two hours after eating. Rest by sitting up or reclining with your head elevated.
- Fresh air and loose clothing may be helpful after eating.
- Exercising after eating may slow down digestion and increase discomfort.
Distraction:
- Relax and try to keep your mind off the chemotherapy. Bring soothing music, relaxation tapes, or CD’s, with you to chemo. Perhaps you would like to bring a funny movie to watch during chemotherapy and/or a friend or family member to keep you company.
Other ways to minimize chemotherapy nausea:
- If you are vomiting, stop eating. Once you stop vomiting, start back on food slowly. Start with small amounts of clear liquids, such as broth, juice soda, sports drinks, or water. Then, advance to light, mild foods like Jello, bananas, rice, or toast. Soon, you will be back to solid foods.
- Avoid caffeine and smoking.
- Suck on hard candy, popsicles, or ice during chemotherapy.
- Take the medications for nausea and vomiting as prescribed by your doctor. If you are running low, ask for a refill.
- Notify your nurse or doctor if you feel nauseated during chemotherapy.
If your nausea and vomiting seem relentless and never ending, consult your doctor. Nausea and vomiting can also be caused by medical conditions unrelated to chemotherapy. Therefore, it is important to call your doctor if any of the following occurs:
- You continue to suffer from chemotherapy-based nausea and vomiting despite taking your anti-nausea medications.
- Nausea that interferes with your ability to eat.
- Vomiting four to five times in a 24-hour period.
- Feel bloated.
- Have pain or a swollen stomach before nausea and vomiting occurs.
- If you are bothered by side effects from the anti-nausea medications.
- Are having weight loss at an alarming rate.
We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained on this website is meant to be helpful and educational but is not a substitute for medical advice. If you have specific medication questions, contact your doctor or pharmacist.
Citations:
ChemoCare.com
National Institute of Health and Human Services
American Cancer Society