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Managing Nausea

Posted 12/5/2010

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In addition to hair loss, the most dreaded side effect of chemotherapy is nausea and possible vomiting. Although tremendous advances have been made in medications to prevent these feelings, there are still some women who experience distress. I remember years ago, when I first began to work in Oncology, we routinely gave people little plastic emesis basins as they left the treatment area. We knew they wouldn't get home, maybe wouldn't even reach their car, before the vomiting started. Those days are blessedly gone.

The quick summary here is that there are a lot of drugs that help a lot. When you first begin treatment, your doctor prescribes what is the most likely to be helpful, the combination that has been useful to the most patients. I tell everyone something like this: "With any luck, you won't feel badly. If you feel terrible and are having a lot of nausea and/or any vomiting, call. Don't just assume that this is the normal reaction to chemotherapy. It does not need to be." If you are unlucky this way, your doctor can make adjustments so things get better.

Here is a nice summary from MedScape about possible treatments. Per usual, I give you an excerpt and then a link:

Preventing and Managing Chemotherapy-Vomiting: The Physician's Perspective CME/CIEnduced Nausea and

Lee S. Schwartzberg, MD

Effective chemotherapy depends not only on the anticancer properties of the specific agents, but also on the ability of the therapy to be delivered on schedule and at full dose. Chemotherapy-induced nausea and vomiting (CINV) is one of

the most common and feared side effects of treatment.[1] The direct and indirect effects of CINV are substantial. Nausea and emesis can lead to reduction in effective drug delivery, potentially causing a substantial reduction in quality of life.

It is clear that preventing CINV should be the goal of clinicians because patients who experience CINV in one cycle of chemotherapy are more likely to encounter it at subsequent cycles. CINV is expensive, resulting in increased hospitalizations, increased use of resources both in the clinic and at home, and loss of productivity for both patients and caregivers.[2] As a result of advances in understanding the pathophysiology of CINV, effective treatments have been

developed to ameliorate this problem in the large majority of patients.

http://cme.medscape.com/viewarticle/729998

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