Guest Author - Adelle Ottavini
At receiving the news that one has to start with some form of cancer therapy – you might think that nausea and vomiting will obviously enter the scenario. This is not always the case. Depending on the chemotherapy type you'll receive, the dosage thereof, frequency of treatments and even your personal history regarding ‘easy vomiting’ will determine these symptoms. Ask your oncologist what to expect, and also which anti-emetic (nausea) drugs he/she plans to prescribe to combat these feelings. Your overall wellness is very important to your caregiver – so you must reveal any-and-all feelings of discomfort.
It has been found that – except for chemo dosage-and-type, there are other factors that can influence CINV (chemotherapy induced nausea and vomiting). The percentage of patients being bothered by nausea are usually younger woman (under the age of 50), woman who experienced more acute morning-sickness during pregnancy, people who suffer from motion sickness, and people suffering from anxiety. Another (rather strange) discovery that has been made is that patients consuming alcohol suffers less from these symptoms. It is also to be noted that cancers of the brain and gastrointestinal cancers seem to cause nausea and vomiting in itself.
The main aim for patients-and caregivers is to prevent, rather than cure these feelings. That is why anti-emetic drugs should be taken before a chemotherapy session, and in the days thereafter. Never self-treat, even with herbs. Bear in mind that herbs are drugs, and should be discussed with your doctor. What worked for ‘someone who knows someone’ will almost certainly not work for you. For one, they most likely had a different type of cancer, received a different type of chemotherapy drug, and in different dosages! There are other, safer things you can do to help yourself.
ACUTE nausea and vomiting – within 24h of receiving therapy:
• Eat a small meal 2hours or more before therapy session.
• Do not take fluids with your meal/s.
• Wear comfortable, loose fitting clothes.
• Make sure to ‘distract’ yourself by reading, playing games, or watching a DVD.
• Try acupuncture therapy.
• Sip water or energy drinks (at room temperature) throughout the session!
• Suck on ice cubes or hard candy.
• Breathe evenly, in through your nose, and out through your mouth.
• Avoid caffeine and nicotine.
• Make sure you get ample fresh air.
• Do not exercise within 24h after therapy.
DELAYED nausea and vomiting – starts 24h to72h after receiving therapy:
• Eat a small meal 2hours or more before therapy session.
• Never take fluids with your meals.
• Take small meals, more often.
• Chew slowly.
• Do not lie flat after a meal.
• Distract yourself by reading, watching DVDs etc.
• Sip water and energy drinks constantly.
• Don’t eat if you don’t feel up to it – but keep on drinking!
• Contact your oncologist if your nausea keeps you from drinking.
• Try adding ginger to your diet.
• Bitter lemon-and grapefruit drinks seem to help.
• If you can, eat bland foods like soups, sandwiches and crackers.
• Do not exercise during this time.
• Avoid spices, fatty foods and sweets.
• Avoid favourite foods – to assure no anticipatory effects in future.
• Avoid caffeine and nicotine.
ANTICIPATORY nausea and vomiting – often starts before chemotherapy.
• This is the same type of nausea people experience when associating (e.g.) a type of drink to a horrible binge drinking experience as a student.
• This phenomenon is your body’s natural response to a stressful event.
• Distract and busy yourself.
• Meditate and visualise.
• Breathe evenly, in through your nose, and out through your mouth.
• Try hypnosis therapy.
• Anxiety drugs may help.
If you experience ‘break through’ nausea and vomiting, not necessarily related to chemotherapy or radiation therapy – discuss it with your caregiver. All of the ‘tips’ above will also help, but your doctor must be made aware of your discomfort. If ever you vomit 5 or more times a day – you should contact your doctor immediately. When experiencing intestinal pain with the nausea and/or vomiting – contact your doctor!! An anti-emetic drug might also wear off in efficiency. Your oncologist can adjust the dosage, or even change to another. Chronic nausea often occurs in patients with advanced cancer – this can be due to pain medication or even depression.
The most important keyword is HYDRATION. Never allow yourself to dehydrate, as there can be dire consequences. Did you know that ‘permanent’ dehydration can lead to: heartburn, migraines, wrinkles, arthritis, angina, asthma, high blood pressure, depression, chronic fatigue, brain damage and even death? Focus on getting in as much fluids as possible!!
