Nausea and Vomiting

Side effects of cancer treatments often include nausea and vomiting. There are many reasons for this:

• Cancer treatments themselves
• Some pain medications
• Liver damage
• Severe constipation or bowel blockage
• Anxiety

Adverse effects of nausea and vomiting

Nausea and vomiting do more than add emotional distress to an already stressful situation. Vomiting also can cause physical problems, such as dehydration, weight loss, and electrolyte imbalances. In rare cases, vomiting can cause esophageal tears and the risk of aspirating food into the lungs.

Nausea and vomiting: a complex process

Nausea and vomiting are caused by a complex interaction of nerve impulses between the brain and stomach. This information comes from three areas of your body:

• The gastrointestinal (GI) tract
• The central nervous system
• A "vomiting center," located at the base of your brain

This "vomiting center" sorts through all the input from the rest of these places and decides whether to produce a nausea or vomiting response. Many different drugs can break this cycle at different stages of communicating with the brain or gut.

Risk factors for nausea and vomiting:

Some people are more likely to experience nausea and vomiting with cancer treatments than other people. Statistically, you are more likely to experience nausea or vomiting with cancer treatments if you

• Are a woman.
• Are younger than age 50.
• Have a history of motion sickness or nausea during pregnancy.
• Have had nausea or vomiting with previous cancer treatments.
• Have a large tumor.
• Are getting high doses of chemotherapy (especially platinum-based treatments).
• Have little time between treatment cycles.

You may have these risk factors and still not experience nausea or vomiting-it varies with each person.

Good communication is key

Despite your healthcare providers' knowledge, YOU are the authority on how you feel. Be sure to explain fully if you are nauseated (and to what extent) and what your needs are. Your input is critical in minimizing or eliminating nausea and vomiting.

Nausea and vomiting can happen before, during, or after a cancer treatment, especially with certain kinds of chemotherapy. Some people experience nausea or vomiting in anticipation (before) receiving chemotherapy. Others get sick to their stomachs during and immediately after treatment. Sometimes nausea and vomiting happen several days afterwards. Occasionally, nausea and vomiting continue despite medications that normally are effective. In that case, "rescue" drugs can stop persistent symptoms.

Your oncologist should assess how well your antiemetic regimen is working at the end of each treatment cycle. If he or she doesn't bring it up, make sure you discuss it. Take all your prescribed antiemetics during your entire period of expected nausea and vomiting (for example, the day of a treatment, plus three days afterwards).

If your antiemetics don't take care of the problem, tell your oncologist right away. You may simply need a different antiemetic. In some cases, your chemotherapy may need to be changed.