Nausea

What is it?

Nausea is a general feeling of being unwell and a desire to vomit.  It is probably one of the most commonly feared and misunderstood side effects of chemotherapy treatment.  Major pharmaceutical advancements have been made in this area however, rendering nausea one of the most controllable and avoidable side effects today.  Furthermore, it is interesting to note that there are many chemo drugs for which no anti-emetics are prescribed because they simply do not cause nausea.

Nausea can become a complex issue however, when more than chemo drugs are involved.  Disease encroachment in the alimentary tract, stomach bypasses – mechanical obstructions, bowel complications and psychological issues can all play a role.   Pain, smell, stress and noise can be factors.

In preventing chemo-related nausea, the day before your treatment is as important as chemo day itself.  Adequate hydration - at least 6-8 cups of liquid the afternoon/evening before - and diet play an extremely important role in how your drugs will be accepted by you.  As an aside, in cases where a patient does not have a port installed, a well-hydrated vein accepts an IV much better.  Some patients prefer to take liquids only on chemo morning to avoid the possibility of stomach upset.

Be aware that you may be able to taste certain chemo drugs as well as the saline which is frequently run prior to and often alongside the drugs.  For most patients, there is nothing odd-tasting or off-putting about these solutions.

The chemo suite (room) is typically very chilly – it’s an anti-nausea trick - so dress warmly, bring a blanket, booties and maybe a warm hat. Bring small snacks and drinks, music - a funny DVD - a favorite stuffed toy - anything of a positive nature.  Wear comfortable, loose-fitting clothes and be prepared for numerous trips to the ladies room.

Once back home, take the medications as and when prescribed even if you do not feel nauseous.  Keeping ahead of a possible onset is the ounce of prevention. 

Conventional Wisdom:

Certain chemo drug infusion protocols require that you take anti-nausea medications at regular intervals before your treatment. It is crucial to your comfort and well being to follow these instructions. It is also important that your chemo staff knows beforehand if you have forgotten to take these medications or not taken them at the recommended time intervals.

The key thing to remember is to not let nausea get ahead of you. Should this occur and you not be able to swallow a pill, there are injectibles and suppository forms of anti-nausea drugs. It is important to replace the liquids lost through vomiting and to maintain adequate nutrition by having lighter meals, many snacks and/or liquid whole-meal replacements.

Finally, anti-nausea drugs can cause constipation - which can cause nausea. So, in order to avoid this "chicken and egg" occurrence, it is important to be aware of the side effects caused by your medications and what to do about them. See Constipation.

Self Help:

Nausea is best treated by being avoided! To a certain extent, it can be psychological. Remember that chemotherapy is your life-line. Embrace your treatment with a positive attitude, including meditation and relaxation techniques. Even a simple thing like bringing your favorite scent on a tissue to the treatment can cause very positive associations instead of fear. Reading during your infusion is often difficult as certain of the anti-nausea drugs can cause extreme drowsiness - so snooze (if not provided, bring a neck pillow) - take advantage of the down-time.

Forget about your favorite foods during treatment. Some, but not all chemo drugs can cause taste, smell and opinion differences which are very difficult to dispel afterwards. Line up a variety of high-protein, low fat foods including things that you wouldn't normally buy so that when you really don't know what you feel you can eat, you have a choice. See the Nutrition - Anti-nausea section for ideas. If you can, put small servings in the freezer during your "good days". Soups are always welcome as are stews and casseroles. Avoid strong smelling, strong tasting and very spicy food. An everyday habit such as a cup of coffee may become the enemy during your chemo treatments so be aware of what can possibly trigger nausea and simply avoid it.

P.S. I just learned of a nifty trick which apparently works when all else fails – peel an orange, tangerine or lemon and breathe in the scent from the peel.  It is said to dispel nausea in an instant!

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