Nausea and vomiting are among the most debilitating side effects of cancer treatment. But no one should suffer needlessly. In many cases, these side effects can be managed with anti-nausea medication and behavioral treatment.
Seventy percent to 80 percent of people treated for cancer have bouts of nausea, and most cancer patients who have chemotherapy experience nausea and vomiting. These side effects also can be caused by:
- Radiation therapy, especially to the gastrointestinal tract, liver or brain
- The cancer itself, usually if it has spread to the brain
- Other medications
- Bowel obstruction or constipation
- An imbalance of electrolytes, which is the loss of minerals and salts in the blood
Do all cancer patients vomit?
Some cancer patients vomit in expectation of treatment, especially if they have vomited previously. This is known as anticipatory vomiting. Other patients vomit within 24 hours after treatment, or two or more days later. In general, nausea and vomiting are most common in cancer patients who:
- Have vomited previously after treatment
- Have a history of motion sickness
- Are anxious before cancer treatment
- Are younger than 50, especially in the case of women
- Had morning sickness during pregnancy
Managing nausea and preventing vomiting
It’s best to get in front of nausea and vomiting, because they are easier to prevent than to stop once they occur. Drugs known as anti-emetics can keep these side effects at bay for many patients on chemo or receiving radiation therapy. This is especially true if the side effects occur a short time after treatment or several days later.
For patients who vomit in anticipation of treatment, anti-nausea drugs do not seem to provide much relief. Anticipatory vomiting usually occurs in patients who have had several courses of treatment and are highly sensitive to associated smells, sounds and sights. Behavioral treatment can help these patients, and those taking anti-nausea medicines. Some common behavioral treatments:
- Muscle relaxation: Patients methodically tense and release various muscle groups as a way to relax, relieve stress and ease nervousness.
- Guided imagery: This technique helps people imagine they are in a relaxing, safe place. By imagining what they feel, hear and see there, some patients can block nausea and vomiting.
- Self-hypnosis: Patients learn to divert their attention to an idea through focused attention and concentration.
- Biofeedback: Patients learn to control their body’s physical responses. This often is used in combination with muscle relaxation.
- Acupuncture: Needles are used to prick the skin to ease physical, mental and emotional conditions.
- Distraction: Patients try to divert their attention from treatment by an activity such as playing video games or listening to music.
When vomiting becomes a problem
Vomiting can lead to dehydration, which in turn can hurt your appetite and desire to drink liquids.
If you do have trouble with vomiting, your doctor may ask you to weigh yourself daily to spot any weight loss caused by dehydration.
Nausea and vomiting also can cause fatigue and depression, and make it hard to concentrate. Be sure they don’t interfere with your ability to take care of yourself. Let your cancer treatment team know right away if you:
- Can’t keep fluids down
- Can’t take the medicines you need
- Vomit repeatedly over a period of 24 hours or longer
What you should know
If you are preparing for cancer treatment, here are some questions to ask your doctor:
- Can nausea and vomiting be prevented or controlled in my case?
- Which anti-nausea and vomiting treatments are right for me?
- Do these treatments have side effects?
- What happens if the treatment doesn’t control my nausea and vomiting?
Chances are, you already have a cancer care team if you are undergoing treatment. If you may be facing cancer treatment and haven’t decided on a care team, find a cancer center in your area.