Managing nausea and vomiting caused by cancer treatment

Nausea and vomiting are the most common side effects of cancer treatment. Nausea and vomiting are often caused by the medicines used to treat cancer (chemotherapy) and can also occur when radiation therapy affects the digestive tract.

Some types of treatments are more likely to cause nausea and vomiting than others. Also, some people are more likely to get sick. Your doctor will consider several factors about you, your treatment, and your cancer to decide if you have a high risk of getting sick. Regardless of your risk, it is important to tell your doctor if you have problems with nausea or vomiting. There are many medicines that you can take, before you get chemotherapy, during your treatment, and for several days afterward that will help prevent or relieve nausea or vomiting. Good communication with your doctor may help you avoid problems with nausea or vomiting.

You may be more likely to have nausea or vomiting if you:1

  • Are female.
  • Are younger than 50.
  • Have a large tumor.
  • Have a history of motion sickness or vertigo.
  • Feel sick while you are having treatment.
  • Have had episodes of nausea or vomiting with previous cancer treatment.
  • Do not use alcohol.

Some types of treatments are more likely to cause nausea or vomiting than others. Your treatment is more likely to cause nausea or vomiting if:

  • You are taking chemotherapy medicines, such as cisplatin, cyclophosphamide, doxorubicin, or irinotecan.
  • You are taking combinations of chemotherapy medicines or taking high doses of medicines.
  • You are having radiation therapy to your digestive tract; especially your stomach or small intestine.

Most problems with nausea or vomiting occur on the day of your treatment. It is important to let your doctor know if you feel sick for a day or two after your treatment.

Your doctor will prescribe medicines to be taken with your treatments and when you get home to help relieve nausea. Let your doctor know if you continue to feel sick, despite these medicines. Because everyone's experience is different, you may have to try several types of antinausea medicines or use different doses to find the combination that works best for you.

Medicines to control and prevent nausea and vomiting may include:

  • Serotonin antagonists, such as ondansetron (Zofran), granisetron (Kytril), or dolasetron (Anzemet). These medicines work by blocking the effects of a chemical that controls vomiting (serotonin), which is produced in the brain and in the stomach. They are often more effective when they are combined with corticosteroids, such as dexamethasone (Hexadrol or Decadron), which reduce swelling in the part of the brain that controls nausea.
  • Phenothiazines, such as prochlorperazine (such as Compazine) and promethazine (such as Phenergan). These medicines stop nausea and vomiting by reducing the activity of the central nervous system.
  • Metoclopramide (such as Reglan), which increases the movements or contractions of the stomach and intestines. This decreases the amount of time it takes for the stomach contents to move through the digestive tract.
  • Dimenhydrinate (such as Dramamine), which is often used to treat motion sickness. It relieves nausea by blocking motion signals to the brain.

Citations

  1. Dow KH, Kalinowski BH (2004). Nursing care in patient management and quality of life. In JR Harris et al., eds., Diseases of the Breast, 3rd ed., pp. 1387–1404. Philadelphia: Lippincott Williams and Wilkins.

Last Updated: October 29, 2009

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