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Control Chemotherapy Nausea & Vomiting

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

Chemotherapy Side Effects: Who's at Risk? continued...

For instance, without preventative treatment, chemotherapy drugs like Adriamycin (doxorubicin) and Platinol (cisplatin) have a greater than 90% chance of causing nausea and vomiting. But drugs like methotrexate or Navelbine (vinorelbine) pose less than a 10% risk.

While the type of medicine is the biggest factor, other things affect your chances of getting sick. Some risk factors are:

  • Getting high doses of chemotherapy drugs
  • Getting certain chemotherapy drugs intravenously instead of by mouth, since it will be absorbed more quickly
  • Getting frequent treatments -- the less time you have to recover between treatments, the greater your risk of nausea
  • Being a woman
  • Being younger than 50
  • Having a history of motion sickness
  • Being prone to vomiting when sick
  • Not drinking alcohol

Talk to your doctor if you think you might be at higher risk of side effects. He or she might want you to start taking antinausea medicines before beginning chemotherapy.

Anticipatory Nausea -- Expecting to Get Sick

After starting treatment, about one out of three people in chemotherapy develop anticipatory, or conditioned, nausea. You may find that anything which reminds you of getting chemotherapy -- the smell of the doctor's office, the freeway exit that takes you to your clinic -- triggers queasiness. About one out of ten develop anticipatory vomiting.

"People are sometimes embarrassed of this," says Syrjala. "They think it's a sign of weakness to get sick before you actually get treatment." But that's not the case.

Syrjala says this is simply the body's natural response to anything that makes it sick. It happens for the same reason you might still have a strong aversion to a food that gave you food poisoning -- even if it happened decades ago. "Your body is just trying to protect you," she says.

While this connection can be broken after it's already been established, Syrjala says the best strategy is to prevent it. She recommends people at high risk of developing nausea take antinausea medicines before they start treatment. Changes in your behavior can help as well.

"One of the best things you can do is distract yourself," says Syrjala. For example, before and during chemotherapy, concentrate on something besides your treatment. An intense conversation, video games, or books-on-tape are all ways to do this.

New Antinausea Drugs

Chemotherapy drugs cause nausea in different ways. Some stimulate the nausea centers in the brain, says Russell, while others may stimulate parts of the esophagus, stomach, or intestines. Most antinausea drugs block the chemical stimulation of the nausea receptors.

Experts say that a treatment breakthrough came in the early 1990s, with the introduction of 5HT3 antagonists. "Those drugs were a huge step forward," says Russell. They include Anzemet (dolasetron), Kytril (granisetron), and Zofran (ondansetron.)

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