Not so long ago, crippling nausea and vomiting were routine for people
undergoing chemotherapy. But thanks to new drugs and other treatments, that
isn't the case anymore.
"We've made great progress," says Karen Syrjala, PhD, director of
biobehavioral sciences at the Fred Hutchinson Cancer Research Center in
Seattle. "We have much less nausea and vomiting now -- even though we're
using much higher doses of chemotherapy than we did before." Because we can
control the side effects, Syrjala says cancer treatment itself is much more
Recurrent disease indicates failure of prior chemotherapy unless initial therapy was surgery alone. One study found recurrence of disease in 2.5% of patients with nonmetastatic disease, 3.7% of patients with good-prognosis metastatic disease, and 13% of patients with poor-prognosis metastatic disease. Nearly all recurrences occur within 3 years of remission (85% before 18 months). A patient whose disease progresses after primary surgical therapy is generally treated with single-agent chemotherapy...
Antinausea medications -- or antiemetics -- are so effective, that experts
have shifted their focus from treating nausea to its aggressive prevention.
"My standard goal is to stop nausea before it happens," says Christy
Russell, MD, chair of the American Cancer Society Breast Cancer Advisory
Committee, "rather than waiting for it to start and then treating
Of course, not all cases of nausea and vomiting can be prevented -- 70-80%
of people on chemotherapy still face some risk. But thanks to better treatment,
most people in chemotherapy are able to go about their normal lives, working
and caring for their families.
"You may not feel great all the time," says Carmen Escalante, MD,
chair of the department of general internal medicine at the University of Texas
M. D. Anderson Cancer Center. "But you can keep going. And that's a big
improvement on what chemotherapy used to be like."
Chemotherapy Side Effects: How Serious Are They?
For people who have faced it, chemotherapy-induced nausea and vomiting feel
like a lot more than side effects. They can be overwhelming, becoming all you
Chemotherapy can cause a number of types of nausea and vomiting.
Acute nausea and vomiting develops within a few hours of
Delayed nausea and vomiting can start more than 24 hours
Breakthrough vomiting occurs when you vomit despite being
on an antinausea drug
Anticipatory vomiting happens before treatment, and is a
learned response to previous treatments
Untreated nausea and vomiting can have serious effects. Nausea can leave you
exhausted, anxious, and undernourished.
"It's important to control nausea," says Russell, who is also
associate professor of medicine at the University of Southern California School
of Medicine in Los Angeles. "If you don't, you might have to lower the
doses of the chemotherapy drugs. That's something you want to avoid if at all
possible." She says that uncontrolled nausea also makes people give up on
Chronic vomiting can also have direct and serious consequences.
"Vomiting can throw off your balance of electrolytes," Syrjala tells
WebMD. "Losing fluids can increase the toxicity of the chemotherapy. It can
prevent you from going on with your treatment."
Chemotherapy Side Effects: Who's at Risk?
Who's at risk for chemotherapy side effects can depend on what drugs they
take -- some are much more likely to cause symptoms than others.