The first step to preventing nausea, says Redwing Keyssar, palliative care program coordinator for Seniors-at-Home, a program of Jewish Family and Children's Services in the San Francisco Bay Area, is to take the threat of nausea seriously. If the doctor says that a chemotherapy drug is likely to cause nausea, listen to the warning and take preventive steps.
It's common for patients to wait until they feel really nauseated before starting to treat it, says Keyssar, but that approach often backfires. "Once the place in the brain that controls vomiting is activated, it's hard to stop," she says.
If the person you're caring for isn't keen on taking medication for symptoms that haven't appeared yet, explain -- or better yet, have his doctor explain -- that nausea is one of the reasons some patients don't want to continue cancer treatment, so doctors make it a priority to try to control nausea before it starts.
Certain chemotherapy drugs are more likely to cause nausea and vomiting than others. These include:
- Carboplatin
- Carmustine (BiCNU)
- Cisplatin (Platinol)
- Cyclophosphamide (Cytoxan)
- Dacarbazine (DTIC-Dome)
- Mechlorethamine (Mustargen)
- Streptozocin (Zanosar)
If the chemotherapy regimen includes one of these drugs, he's likely to suffer from nausea and vomiting after treatment. Many other chemotherapy drugs also cause nausea when given at high doses, so find out what drug he's taking and whether the dosage is high or low, so you can anticipate whether he's likely to experience nausea.
Most people undergoing chemotherapy are prescribed drugs to prevent nausea and vomiting. Known as antiemetics, these drugs work by regulating the chemicals in the brain that control nausea. Some are given orally and some intravenously, and they're used alone or in combination.
Usually, the doctor will begin treatment with antiemetics before chemotherapy begins, and the treatment will continue for several hours or days after each dose of chemo. It's important to take a proactive approach with antiemetics because once nausea and vomiting begin, they're much more difficult to control.
Commonly used antiemetics include:
- Ondansetron (Zofran)
- Dolasetron (Anzemet)
- Granisetron (Kytril)
- Aprepitant (Emend 09)
- Palonosetron (Aloxi)
- Dexamethasone (Decadron)
- Methylprednisolone
- Dronabinol (Marinol)
- Prochlorperazine
- Metoclopramide (Reglan)
- Lorazepam (Ativan)
Anxiety can also play a key role in triggering nausea, Keyssar says. Experts don't know why, but people with high levels of anxiety tend to experience more nausea. And, ironically, if someone is worried about feeling nauseated, the worry itself can make nausea more likely. To prevent this from happening, ask the doctor about medication to treat anxiety, Keyssar says.
Another way to prevent nausea from hitting as severely after chemo: Eat a light meal a couple of hours before each treatment.
costipation. i will make sure ..... i try not to get constipation. if i have to take laxativies if necessary. t y
Dear anon, my dad had horrible nausea during his cancer treatment as well. What worked well for us when he was really having difficulty was smoothies; we'd make them super nutritious with protein powder, yogurt, etc and eventually when we were trying to help him keep weight on we'd use ice cream too. Good luck, I'll be thinking about you!
p.s. my dad is also went through cancer treatments (prior to the vertigo) and was only able to eat crackers and boost during that time.
Still looking for things my dad can eat... He has been suffering from BPPV (vertigo) for almost 6 weeks and has been so nauseaus he hadn't been able to keep much food down. After 10 days in the hospital and IV's, we finally brought him home. The ONLY thing he has been able to eat is oatmeal - we have been fortifying it with quinoa and hemp seeds and organic maple syrup. Maybe more nutritious than crackers. I will try the distraction techniques as well. Thanks!
Dear Destanme, thanks for your information, I do agree that Chinese medicine can be enormously helpful to people going through chemo. When my father was being treated with chemo and radiation for esophageal cancer, we used Chinese medicine, and it did strengthen his digestive system, improve his appetite, and help him tolerate the harsh treatments.
Hugs Destanme
I treat patients who are under going Chemo treatments with Chinese Medicine. Emotions often cause upset stomach as often seen in children who vomit when emotionally upset or people who eat (or don't eat) when stressed out. In Chinese Medicine this is known as Liver invading Spleen/Stomach. By calming the emotions you can calm the stomach. Another reason for nausea is that the patient is intentionally being poisoned to kill off cancer. The body naturally wants to expel these toxins; vomiting is a way in which the body can void itself of toxins (food poisoning, etc). We know that they cannot vomit away the chemo but the body is trying what it knows. Before chemo begins you can strengthen the digestive system so that it is less easily offended. After chemo you can assist the body in voiding the toxins, which are no longer needed therapeutically. I highly recommend combined Chinese Medical treatments WITH chemotherapy to offset side effects and allow patients to continue their treatments.
It helped me identify triggers that I didn't recognize that have been affecting me.
thanks very much very helpful for my sister in law with cancer of the bowel. You answered some great questions so far a great site for me to copy for my sister inlaw with no computer at age 64 Ron
Great articles for chemo. and stomah pain
My mother has stage 3 breast cancer and she has gone through chemo and radiation and I have to say, she did not once have any nausea. I can't, right this minute, say what treatment was used, but thank goodness she did not experience that! The appetite was not real good, but no matter what she ate she kept it down. Her oncologist, Dr. Soniwalla, was a God send and he told us the breakthroughs made it possible to have the chemo and not the nausea and he was right.
Really helped me understand what my father could be going through.