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
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.)