Cancer Therapy: Managing Side Effects - Nausea and Vomiting (The James)

Cancer Therapy: Managing Side Effects - Nausea and Vomiting (The James)

 

Nausea is an uncomfortable sick feeling in your stomach, like you may vomit (or throw up). Nausea and/or vomiting can be side effects of cancer treatment.

 

Why do people with cancer have nausea and vomiting?

Nausea and/or vomiting can be caused by any of the following:

  • Some chemotherapy drugs
  • Some biotherapy drugs
  • Radiation therapy to the chest, stomach, head, neck, throat or back
  • Pain
  • Anxiety
  • Constipation
  • Location of your cancer
  • Certain medicines (such as opioid pain medicine)
  • Anesthesia
  • Abnormal levels of electrolytes (minerals) in your blood
  • High blood sugar levels
  • Other diseases and illnesses
  • Infections

 

Why does nausea and vomiting happen?

Chemotherapy or biotherapy can irritate your stomach or trigger the vomiting center in your brain. Nausea and vomiting may happen a few hours after treatment or can be delayed to a few days after treatment.

Not all chemotherapy and biotherapy drugs cause nausea and vomiting. How often the nausea and/or vomiting happens and how long it may last depends on the type of drug, the dose you take and how the drug is given (for example by IV or by mouth).

 

What are the ways to help reduce nausea and vomiting?

  • Anti-Nausea Medicines
    •  Anti-nausea medicines are used to help prevent and control nausea and vomiting.
    • Take this medicine as ordered by your doctor. You may need to take anti-nausea medicine on a regular basis before and after your treatment. You may also need to take anti-nausea medicine on an as needed basis to help with any nausea or vomiting.
    • If pills do not stay down, most anti-nausea medicines can be given in another way, such as injections, suppositories, or under the tongue.
    • If your anti-nausea medicine does not seem to be working, tell your doctor, nurse or pharmacist. There are other anti-nausea medicines that may be able to help.
    • If anti-nausea medicine makes you weak, dizzy, or sleepy, ask someone to stay with you and help you.
    • Some medicines that help lower stomach acid may help with nausea. Tell your doctor, nurse or pharmacist if you are having bad heartburn or acid reflux that is causing nausea.
  • Eating Hints
    • You may need to limit what you eat on the day you get treatment. Talk to your dietitian or other member of your health care team if you have questions about eating right before or after your treatment.
    • Eat small amounts of food throughout the day. Eat slowly and give yourself plenty of time to eat.
    • Keeping a small amount of food in your stomach may help control feelings of nausea.
    • Limit drinking fluids with meals.
    • Try to eat bland foods, such as dry toast, saltine crackers, dry popcorn, boiled/baked potatoes, white rice, or bananas.
    • Try to eat foods that are easy to digest such as cereal, white bread, crackers, sherbet, fruit, or plain vegetables.
    • Try to eat foods cold or at room temperature. Do not allow refrigerated foods to sit at room temperature more than 30 minutes before you eat them.
    • Drink plenty of fluids between meals. Try water, weak tea, ginger tea, clear soups, or diluted sports drinks.
    • Ginger, lemon and salty foods or drinks may help with nausea. Try lemon or ginger candies or small amounts of salty foods before meals.
      • Caution: Ginger tea may not be used with some health conditions. Ask your doctor or nurse.
    •  Try eating cool foods such as Jell-O, frozen fruit bars, ice chips, or popsicles. Try ice cubes made from a favorite non-alcoholic beverage, 7UP™, ginger ale, or cola.
    •  Avoid spicy “hot” foods, such as chili, hot peppers or barbecue sauces.
    •  Sometimes fatty, fried or greasy foods such as french fries, cheeses, butter, oil, cream, margarine, or red meats can be hard on an upset stomach.  Avoid them if they bother you.  
    • If foods with strong odors bother you, go into another room when these foods are cooking. You may also try eating cold foods since they usually do not have a strong odor.
    •  It may be helpful not to eat your favorite foods when you have nausea. That way you will not connect these foods with nausea and vomiting.
    • If you do not have a sore mouth or throat, try tart or sour foods such as citrus juice, cranberry juice, pickles, or relish.
    •  It may be helpful to ask caregivers to cook foods for you so you will not have to smell the cooking odors.
  • Other Ways to Help
    • Rest before and after meals. Do not lie down flat right after eating. Sit up or recline with your head up.
    • Slow, deep breathing through your mouth or swallowing will sometimes help the feeling of nausea to pass.
    •  Avoid unpleasant sights, sounds and smells that might trigger nausea.
    • Do mouth care after every meal and before meals if you have a bad taste in your mouth.
    • A bad taste in your mouth may be taken away by rinsing your mouth removing and cleaning dentures, brushing your teeth, or sucking on hard candy such as peppermint or lemon drops.
    • Open a window or step outside to get fresh air.
    • Do not do exercises or make quick movements that may change your sense of balance.
    • Distract yourself by doing calm activities such as reading, listening to music, playing games, watching TV, or working on a hobby.
    • Learn how to do relaxation and guided imagery techniques.
    • Try to rest or take a nap when you have nausea.
    • Even if you cannot eat foods, try to drink at least 8 to 10 large glasses of non-caffeinated fluids a day to avoid dehydration.
    • Talk to your doctor about taking vitamins and nutritional supplements.
    • Constipation may cause or add to your nausea. Talk to your doctor about what you can take or do to help with constipation.
    • Take medicines to keep pain under control.
    • For comfort, try a cool cloth on your forehead or on the back of your neck.
    • Sit up or turn on your side when vomiting to prevent vomit from going down into your lungs.

 

When should I call my doctor?

Call your doctor right away if you have any of the following symptoms:

  • Unable to drink and keep fluids down
  • Abdominal pain
  • Blood in your vomit
  • Vomit that looks like coffee grounds
  • Dizziness, especially when you stand up
  • A decrease in how often you urinate
  • Dark colored urine
  • Loss of more than 5 pounds in a week or 10 pounds in a month.
Call your doctor right away if you are unable to drink or keep fluids down or if you vomit more than 1 or 2 times in a 24 hour period.

 

Where can I get more information and resources?

  • Cancer Therapy: Managing Side Effects - Mouth Sores
  • Eating Hints - a book from the National Cancer Institute. You can download a copy from this link.
  • Fight Cancer-Related Fatigue with Good Nutrition
  • Using Exercise to Fight Cancer-Related Fatigue
  • Cancer Survivorship
  • Cancer Internet Resources
  • Cancer Patient Education Resources at The James
  • JamesCare for Life Programs - JamesCare for Life offers a wide range of programs to support patients, families and caregivers during and after cancer.
For more information we encourage you to visit our video library at http://cancer.osu.edu/patientedvideos.

 

 

© February 3, 2023. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.