How Is Chemotherapy-Induced Nausea and Vomiting Treated?

0

Along with hair loss, nausea and vomiting from chemotherapy are among patients’ greatest concerns during cancer treatment.

Fortunately, great strides have been made in the past decade or two, thanks to new generations of anti-nausea medications and better understanding of how to use them. Many patients won’t experience these distressing symptoms, or will have only mild discomfort.

But “despite these gains, there are still patients who break through our existing therapies,” says Bridget Fowler Scullion, PharmD, a pharmacist in Dana-Farber’s Adult Palliative Care Program. She is the primary author of Dana-Farber’s guidelines for treating chemotherapy-induced nausea and vomiting (CINV).

Certain chemotherapy compounds, including those containing platinum, are particularly likely to cause vomiting. The aim is to stop the problem before it begins, as part of the premedication regimen for chemotherapy. Patients receiving these agents typically are treated with a three-drug regimen, containing, for example, ondansetron (Zofran), dexamethasone (a steroid), and the drug aprepitant (Emend). Each works in a different way to target receptors in the brain that control nausea and vomiting.

Along with newer drugs, care teams have recently seen good results with an older drug, olanzapine, or Zyprexa, mainly used as an antipsychotic.

Even after they have received a chemotherapy infusion and returned home, patients may have delayed CINV for several days, so they are often prescribed doses of the medications to take during that period.

Not all patients will suffer nausea, depending on the type of chemotherapy and their own predispositions, Scullion notes. Being female and younger raises the risk, as does a history of nausea and vomiting during pregnancy or during previous chemotherapy treatment.

Some patients suffer from anticipatory nausea and vomiting that may be triggered, for example, merely by seeing one’s infusion nurse. This is improving as control of CINV overall improves, Scullion says. Such patients may also be prescribed a mild anti-anxiety drug like lorazepam to quell anticipatory queasiness.

Marinol, a semisynthetic form of THC, the active ingredient in marijuana, is prescribed for nausea and some patients say they benefit. Others try medical marijuana and report relief of nausea, Scullion says.

Most members of a patient’s care team are well acquainted with the problem of CINV and its treatment; Scullion says she and other pharmacists can also be consulted if patients have particular issues.

Learn more about chemotherapy and what to expect.

    Make An Appointment

    For adults: 877-960-1562

    Quick access: Appointments as soon as the next day for new adult patients

    For children: 888-733-4662

    All content in these blogs is provided by independent writers and does not represent the opinions or advice of Dana-Farber Cancer Institute or its partners.

    Latest Tweets

    Dana-Farber @danafarber
    People with certain chronic health conditions, including cancer, have a higher risk of becoming ill with the flu. A… https://t.co/tZYmreT9rp
    Dana-Farber @danafarber
    RT @TheJimmyFund: Help us spread kindness today. For every retweet, Cancer Fighters Club will give $10 – up to $4,000 – to support @DanaFar…
    Dana-Farber @danafarber
    A #bonemarrow biopsy can be used to diagnose #multiplemyeloma and a variety of other conditions. Learn more:… https://t.co/SJOlNO0V3d

    Republish our posts on your blog

    Interested in sharing one of our stories on your blog? Feel free to republish this content! We just ask that you credit Dana-Farber, link to the original article, and refrain from making edits that change the original context. Questions? Email the editors at insight_blog@dfci.harvard.edu.