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Nausea and vomiting are the most dreaded side effects of chemotherapy, according to Reference 1. This fits what I've always thought. I still have etched into my brain something I heard from a cancer survivor decades ago: “You get used to throwing up every morning.” I've always thought I would rather see Dr. Kevorkian. But it doesn't have to be this way, with current treatments for nausea.
Today there are many drugs available to prevent nausea, and there are many options for chemotherapy. Some chemotherapy drugs have little if any effect on the digestive system. Others affect some patients, but not everyone. Your doctor should be able to explain how much nausea your chemotherapy program is likely to produce.
Anti-nausea medications include the following classes of drugs:
1. Steroids, such as decadron and hexadrol. Side effects include water retention, restlessness, confusion, insomnia, and euphoria.
2. Prochlorperazine. This is a widely used anti-nausea medication. Side effects include drowsiness, low blood pressure, and restlessness.
3. Benzodiazepines, such as Ativan and Valium. These are also used as tranquilizers or anti-anxiety medications. Side effects include sedation and forgetfulness.
4. Antihistamines, such as Benadryl. These are widely used for motion sickness, and the main side effect is drowsiness.
5. Other drugs, including Marinol (derived from marijuana), and antacids such as Pepsid, Prilosec, Tagamet, and Zantac.
Alternative remedies for nausea are also available:
1. Ginger and Chinese herbal medicine can be helpful for some. Licensed acupuncturists can recommend Chinese herbs. Tell your oncologist what your preferences are, and let him/her know about herbal products you're taking.
2. Dietary changes: eat small amounts of food more frequently. Stick with bland foods such as mashed potatoes, cottage cheese, toast, crackers, and sherbet. Try eating mostly cold or room temperature foods.
3. Stay away from the kitchen and the aromas of food.
4. Drink lots of fluids, such as tea, juices, soup, soda, watermelon, lemonade, and broth. Popsicles work well for some.
5. Get plenty of fresh air and mild physical activity.
Different patients have different sensitivities to nausea. Be sure to let your doctor know how you feel about the trade-offs between nausea and medication side effects.
References:
Judith McKay, RN, OCN, and Tamera Schacher, RN, OCN, MSN, “The Chemotherapy Survival Guide: Everything You Need to Know to Get Through Treatment”, third edition, New Harbinger Publications, Inc, 2009.
White B, “Ginger: an overview”, Am Fam Phys 2007 Jul 1; 75(11): 1689-91.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.
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