Nausea and vomiting are serious side effects of cancer therapy that can be very distressing. Nausea and vomiting affect most people who have chemotherapy. Radiation therapy to the brain, gastrointestinal tract, or liver also cause nausea and vomiting.
Nausea is an unpleasant wavelike feeling in the back of the throat or stomach that may lead to vomiting. Vomiting is throwing up the contents of the stomach through the mouth. Retching, also called dry heaves, is the movement of the stomach and esophagus without vomiting. Some people with cancer are bothered more by nausea than by vomiting.
Nausea and vomiting must be controlled so that you can continue treatment and have a better quality of life. Nausea and vomiting that are not controlled can cause
- Chemical changes in the body
- Mental changes
- Loss of appetite
- A torn esophagus
- Broken bones
- Reopening of surgical wounds
There are many types of nausea and vomiting that are caused by cancer therapy:
- Acute nausea and vomiting: Nausea and vomiting that happen within 24 hours after treatment starts.
- Delayed nausea and vomiting: Nausea and vomiting that happen more than 24 hours after chemotherapy; also called late nausea and vomiting.
- Anticipatory nausea and vomiting: Nausea and vomiting that happen before a chemotherapy treatment begins. If a person has had nausea and vomiting after an earlier chemotherapy treatment, they may have anticipatory nausea and vomiting before the next treatment. This usually begins after the third or fourth treatment. The smells, sights, and sounds of the treatment room may remind the person of earlier periods of nausea and vomiting and may, thus, trigger these side effects before chemotherapy has even begun.
- Breakthrough nausea and vomiting: Nausea and vomiting that happen within five days after getting anti-nausea treatment. Different drugs or doses are needed to prevent more nausea and vomiting.
- Refractory nausea and vomiting: Nausea and vomiting that do not respond to drugs taken to prevent it.
- Chronic nausea and vomiting: Nausea and vomiting that lasts for a period of time after treatment ends.
Practical Ways to Manage Cancer-Related Nausea and Vomiting
- Take an anti-nausea medicine. Talk with your doctor or nurse to learn when to take your medicine. Most people need to take an anti-nausea medicine even on days when they feel well. Tell your doctor or nurse if the medicine doesn’t help. There are different kinds of medicine, and one may work better than another for you.
- Drink plenty of water and fluids. Drinking will help to prevent dehydration, a serious problem that happens when your body loses too much fluid and you are not drinking enough. Try to sip on water, fruit juices, ginger ale, tea, or sports drinks throughout the day.
- Avoid certain foods. Don’t eat greasy, fried, sweet, or spicy foods if you feel sick after eating them. If the smell of food bothers you, ask others to make your food. Try eating cold foods that do not have strong smells, or let food cool down before you eat it.
- Try these tips on treatment days. Some people find that it helps to eat a small snack before treatment. Others avoid eating or drinking right before or after treatment because it makes them feel sick. After treatment, wait at least one hour before you eat or drink.
- Learn about complementary medicine practices that may help. Acupuncture relieves nausea and vomiting caused by chemotherapy in some people. Deep breathing, guided imagery, hypnosis, and other relaxation techniques (such as listening to music, reading a book, or meditating) also help some people.
Controlling nausea and vomiting will help you to feel better and prevent more serious problems, such as malnutrition and dehydration. Your doctor or nurse will determine what is causing your symptoms and recommend ways to prevent them.
Medicines called anti-nausea drugs or antiemetics are effective in preventing or reducing many types of nausea and vomiting. The medicine is taken at specific times to prevent or control symptoms of nausea and vomiting. Sometimes, several different medicines may need to be tried to find the one that works best. See sidebar (above) for practical steps you can take to feel better.
Source: National Cancer Institute, cancer.gov (December 2022)