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Control Chemotherapy Nausea & Vomiting

New drugs and alternative therapies can help reduce -- or eliminate -- chemotherapy side effects.
WebMD Feature

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 aggressive.

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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 it."

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 think about.

Chemotherapy can cause a number of types of nausea and vomiting.

  • Acute nausea and vomiting develops within a few hours of chemotherapy
  • Delayed nausea and vomiting can start more than 24 hours after treatment
  • 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 their treatment.

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.

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