Anticipatory Nausea and Vomiting (Emesis)
Treatment of ANV
Antiemetic drugs do not seem to control ANV once it has developed; however, a variety of behavioral interventions have been investigated. These include progressive muscle relaxation with guided imagery, hypnosis, systematic desensitization, electromyography and thermal biofeedback, and distraction via the use of video games.[24,25] Progressive muscle relaxation with guided imagery, hypnosis, and systematic desensitization has been studied the most and is the recommended treatment. Referral to a psychologist or other mental health professional with specific training and experience in working with cancer patients is recommended when ANV is identified. The earlier ANV is identified, the more likely treatment will be effective; thus, early screening and referral are essential. In addition, physicians and nurses underestimate the incidence of chemotherapy-induced nausea and vomiting.[Level of evidence: II]
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