Yes. There are several different types of nausea associated with chemotherapy treatment. One of the most important things you can do is to learn the symptoms of each type of nausea, so you will be better equipped to manage nausea. The National Comprehensive Cancer Network (http://www.nccn.org/patients/patient_gls/_english/_nausea_and_vomiting/index.htm) publishes patient guidelines that detail 5 different classes of nausea and vomiting:
Acute onset nausea, which usually starts a few minutes to several hours after the chemotherapy is given and ends about 24 hours after treatment. For many patients, the worst episodes of acute onset nausea occur more than 5 or 6 hours after the treatment.
Delayed vomiting, which usually occurs more than 24 hours after chemotherapy is given. Delayed vomiting might occur with the following chemo drugs: cisplatin, carboplatin, cyclophosphamide, and doxorubicin. The timing and duration of delayed vomiting will depend on the particular drug. For example, cisplatin-related vomiting will usually be at its worst from 48 to 72 hours following chemotherapy and can last 6 to 7 days.
Anticipatory nausea/vomiting, which are learned from previous experiences with vomiting. The anticipatory nausea and vomiting results from an unpleasant experience with chemotherapy. Anticipatory nausea/vomiting occurs as the person is preparing for her next dose of chemotherapy. The patient anticipates that nausea/vomiting will occur as it did before. Fortunately, anticipatory nausea/vomiting is not very common.
Breakthrough vomiting, which occurs despite the use of treatment to prevent nausea and vomiting. Breakthrough vomiting requires more anti-nausea/anti-vomiting treatment.
Refractory vomiting, which occurs after one or several chemotherapy treatments, even though the person also is being treated to prevent or control nausea and vomiting. The nausea and vomiting treatment is no longer effective. The patient has become “refractory” (is no longer responding) to treatment to prevent nausea and vomiting.
Depending on the type of nausea/vomiting, your doctor may prescribe an anti-emetic, an anti-nausea medication. Anti-emetics belong to a class of drugs called serotonin antagonists that act on the parts of the brain that trigger feeling of nausea.
In addition to medications, there are several other things you can do to help avoid nausea, including modifying your eating and drinking habits:
Try to keep yourself well hydrated. It is more important to drink plenty of liquid, than it is to eat three meals a day. Sip cool water or ginger ale through a straw throughout the day. You also may find that sucking on ice chips helps keep you refreshed.
Cold foods or foods served at room temperature are less likely to upset your stomach.
Avoid sweets and fatty, fried foods.
Eat dry foods like toast, crackers or dry cereal.
Avoid heavy meals before therapy. Do not eat for 1 or 2 hours before or after your treatments.
Avoid strong odors that might trigger feelings of nausea.
Avoid coffee and other caffeinated products that might dehydrate you. Alcohol also should be avoided, as it can dehydrate you.
Try sipping ginger or peppermint teas, both of which help with nausea and will help you feel refreshed.
If you are feeling sick, many patients find that taking a short walk before a meal can help.
You may find that the best time to try to eat is after you have vomited. Sucking on an antacid tablet may prevent the acidic burning sensation that follows vomiting.
Rest after eating.
Breathe through your mouth if you are nauseated.
(Adapted from the Royal Marsden Hospital, Patient Information, Coping with Nausea and Vomiting (2001). [www.royalmarsden.com])
Several alternative medicine techniques, most notably acupuncture, also have proven very effective in helping many cancer patients curtail nausea.
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