Improving Nausea Control during Chemo
I have been working in Oncology for thirty years. That means that I have witnessed many improvements in care, none more important than symptom control during chemotherapy. (Actually, that is not quite true. The most important improvement has been better treatments and more people living long and healthy lives.) The first few years at BIDMC (then Beth Israel Hospital), I remember that we gave people plastic emesis basins as they left the chemotherapy unit. We knew that they would begin vomiting before they got home. I heard many horror stories of people spending the night on the bathroom floor, barely able to move for several days.
Things are so much better! Those of us who have been treated in the era of zofran and Emend know that it is possible to live through chemo without ever throwing up. Many of us, including me, felt pretty rotten some of the time, but the nausea was definitely of the "I don't feel quite right" variety rather than the "I cannot leave the bathroom" type.
A new study in Lancet indicates that things are getting even better. Steven Grunberg, MD and his colleagues at the University of Vermont report that adding casopitant to the arsenal of anti-nausea medications helped all patients who were receiving very intense chemotherapy. Here is a quote:
-- Adding a single oral dose of the novel antinausea drug casopitant mesylate to a standard antiemetic regimen significantly reduced chemotherapy-induced nausea and vomiting for five days in a multinational study.
Compared to those receiving a placebo plus standard therapy (ondansetron (Zofran) and
dexamethasone), patients receiving casopitant mesylate had no retching, vomiting, or need for a rescue medication in the first 120 hours after highly emetogenic chemotherapy, according to Steven M. Grunberg, M.D., a hematologist at the University of Vermont in Burlington, and colleagues.
Moreover, the benefit was significant and durable for both a single oral dose and a three-day intravenous/oral combination.
I expect that this drug, like all the others, won't be a magic bullet. But, at the very least, it gives our doctors one more way to help us better tolerate chemotherapy.
If you are interested in reading more, click here.
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