It's common to feel sick to your stomach (nauseated) or to
vomit when you get chemotherapy. Nausea and vomiting are caused by cancer drugs
you may get during treatment. You may feel sick or vomit soon after your treatment session. But with some chemotherapy medicines, you may not get sick until days later. Some people have only nausea
or only vomiting. Others have both. Some people don't get sick at all from
There are many drugs that can prevent
nausea and vomiting. Preventing nausea and vomiting will help calm your stomach
so you can eat, stay strong, and give your body a chance to rest between cancer
Antinausea drugs work best if you start taking them
before you start chemotherapy.
What causes nausea and vomiting?
know exactly why cancer drugs cause nausea and vomiting. Some drugs affect the
parts of the nervous system that trigger nausea. Other drugs can irritate your
stomach lining and make you feel sick.
How big a dose you get can
also affect how you feel. A drug may be fine at a low dose. At a higher dose,
it may make you sick. But that higher dose may be what's needed to kill cancer
The way you receive a drug can also make a difference. A
drug that is given through your vein in an
IV may make you feel sick sooner than the same drug
given as a pill. That's because your body will absorb the IV drug faster.
What will increase your risk for nausea and vomiting?
There are more than 100 different drugs to treat
cancer. Some are much more likely to cause nausea and vomiting than others. You
and your doctor will decide which cancer drugs you will get based on the type
of cancer you have, where the cancer is in your body, and how serious the
cancer is (its
Other things besides cancer drugs can raise your risk for
nausea and vomiting. If you had chemotherapy before and it led to vomiting,
your brain will remember it. So just thinking about your cancer treatment can
make you feel sick. This is called anticipatory vomiting. But antinausea
medicine can help you control this feeling so that you can get through
How are nausea and vomiting treated?
The goal of treatment is to prevent nausea and
vomiting. Your doctor will look at which cancer drugs you are taking and your
history of getting sick. You will probably be given a medicine that works to
control nausea and vomiting in other people who are getting the same cancer
treatment. You may be given two or three medicines to take.
Antinausea medicines are usually taken as pills. But you might also get
them through an IV or as a patch that's taped to your skin. These medicines are
usually given before your first chemotherapy session. You will need to take
antinausea medicine as long as your cancer treatments last.
of the most common medicines used to control nausea and vomiting
Dronabinol and nabilone use an active ingredient from marijuana to treat nausea and vomiting in some people when other medicines don't work.
Medical marijuana is also legal in some areas.
The best way to prevent nausea and vomiting is to start
taking antinausea medicine well before you begin your cancer treatment. But
even if you have already started cancer treatment, it's not too late to try to
prevent nausea and vomiting. Talk with your doctor if chemotherapy is making
How do antinausea medicines work?
These medicines work in different ways. Some block a
chemical in the brain that controls vomiting. Other drugs reduce swelling in
the part of the brain that controls nausea. A few drugs slow down the
central nervous system. Some of these drugs work
alone. Others only work when you take them with other drugs.
antinausea medicines cause side effects. You may:
Not all antinausea medicines work the same for everyone. You
might have to try a few of these drugs, alone and together, to find what works
best for you. After you start to take antinausea medicines, tell your doctor
right away if you still feel sick.
What else can you do to manage nausea and vomiting?
In addition to
antinausea medicines, you can try some things at home to help yourself feel
better. If you're feeling sick, eat several small meals during the day instead
of a few large meals. Stay away from sweet, fried, or fatty foods. Suck on ice
cubes or mints. For more information, see:
CitationsNational Cancer Institute (2011). Nausea and Vomiting PDQ—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/supportivecare/nausea/HealthProfessional.Other Works ConsultedBlanchard EM, Hesketh PJ (2008). Nausea and
vomiting section of Management of adverse effects of treatment. In VT DeVita Jr
et al., eds., DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology, 8th ed., vol. 2, pp. 2639–2646.
Philadelphia: Lippincott Williams and Wilkins.Keeley PW (2009). Nausea and vomiting in people with cancer and other chronic diseases, search date April 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.National Comprehensive Cancer Network (2011). Antiemesis. NCCN Clinical Practice Guidelines in Oncology, version 3. Available online: http://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf.
October 31, 2011
E. Gregory Thompson, MD - Internal Medicine & Michael Seth Rabin, MD - Medical Oncology
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