Cancer Care: Controlling Nausea and Vomiting

Nausea and vomiting are common side effects of cancer treatment. This includes chemotherapy, targeted therapy, and radiation therapy. When cancer treatment harms normal cells as well as cancer cells, it can cause side effects. In this case, treatment affects the cells lining your stomach. It also affects the part of your brain that controls vomiting.

Nausea is the feeling that you need to throw up. Vomiting is when you do throw up. It's when your body forces food that's in your stomach to come up and out through your mouth. Nausea and vomiting can and should be treated so you feel better.

Nausea and vomiting are common with cancer. They can be caused by many things other than cancer treatment. These include:

• Blockages in the digestive system
• Tumors in the digestive system, liver, or brain
• Constipation
• Infection
• Anxiety and stress
• Not enough water in your body (dehydration)
• Too much calcium in your blood
• Some pain medicines such as morphine
• Extra pressure in the fluid around your brain and the spinal cord

Sometimes belly pain and cramps happen along with nausea and vomiting. The symptoms can be mild and might go away on their own. Other times they can be severe. Your symptoms can be treated.

Nausea and vomiting can happen before, during, or after cancer treatments. Many medicines can be used to prevent and treat nausea and vomiting.

If not treated, vomiting can become serious. It can change the fluid and chemical balance in your body. It could even keep you from getting cancer treatment. Call your healthcare provider right away if you have any of these:

• Nausea or vomiting that lasts 24 hours or more
• Your vomit looks like blood or dark coffee grounds
• You can't take your anti-nausea medicines (antiemetic medicines)
• Your anti-nausea medicines are not working
• You have trouble keeping fluids down or haven't eaten for more than 2 days
• You become dizzy, lightheaded, or confused
• You have very dark urine or you stop urinating

Talk with your healthcare provider about how likely it is that your cancer treatments will cause nausea and vomiting. Ask about preventing these problems. Ask about the best way to manage them. Be sure you have the prescriptions filled. Know how and when to use your anti-nausea medicines. Also know when to call your healthcare provider.

Nausea or vomiting can almost always be treated with medicines called antiemetics.

You may take these medicines before or after treatment. You may have to try different kinds or combinations of antiemetics to feel better. But in most cases, nausea and vomiting can be controlled or even prevented.

• If you have medicines to control nausea, take them as directed. If you're told to take the medicine as needed, take it at the first hint of nausea. Don't wait until you start vomiting.
• Don't eat fatty or greasy foods.
• Eat small meals and snacks throughout the day. Nausea might be worse if your stomach is empty.
• Eat foods at room temperature or colder to limit strong smells.
• Eat dry foods such as toast, crackers, or pretzels. Also eat cool, light foods such as applesauce or sherbets. Bland foods such as oatmeal, mashed potatoes, baked potatoes, or skinned chicken are good, too.
• Try to keep taking in clear fluids in small sips. You can also have ice chips, gelatin, or ice pops.

• Get a little fresh air. Take a short walk.
• Talk to a friend, listen to music, or watch TV while you eat. This can help to keep you from thinking about nausea.
• Take a few deep, slow breaths while waiting for your nausea medicine to work.
• Eat by candlelight or in surroundings that you find relaxing.
• Use a method to help you relax, such as guided imagery. Imagine yourself in a beautiful, restful scene. Or daydream about the place you'd most like to be.