New Ways to Beat Back Nausea
When it comes to chemotherapy, doctors have learned a great deal about how and why people feel nauseated—resulting in a vast improvement in medications that combat nausea and vomiting over the past several years. Patients often get meds right through their chemo IV or in effective antinausea pills. All of this makes nightmarish stories of chemo and radiation-induced illness much less common than they used to be.
That’s not to say the problem is solved. Some patients must try several different drug combinations before they get relief. “We know a lot more about the neural pathways (nerve cell connections) involved in nausea and vomiting,” explains Nancy Ledoyen, RN, operations manager for hematology/oncology at the Mayo Clinic in Scottsdale, AZ. “So there’s greater predictability. But, within that predictability, there’s still variability.”
Stop it before it starts
In every case, preventing nausea is the primary goal; in general, patients receive antinausea drugs before symptoms develop. “It’s helpful if you can block the nausea before the patient develops a problem,” says Julia A. Smith, MD, PhD, a clinical assistant professor of medicine at New York University. Once nausea develops, she warns, it’s harder to control.
Acute versus delayed nausea
If preventive measures fail and nausea does set in, it can be either acute (occurring within 24 hours of chemo or radiation) or delayed (occurring days later). Because of this, patients also often need antinausea drugs for several days after undergoing treatment, usually with at least two different meds.
Some patients have gotten relief from medical marijuana, which is now legal in 14 states. Physicians also have put marijuana’s active ingredient, tetrahydrocannabinol (THC), into prescription pill form.
There are also several nondrug methods that can help combat nausea. Not surprisingly, dietary choices are key. The best strategy involves eating small, frequent meals and sticking to relatively bland foods.
It’s also important to avoid dehydration, notes Gary E. Deng, MD, PhD, a physician with the integrative medicine service at Memorial Sloan-Kettering Cancer Center in New York City. Instead of drinking a lot of liquid at one time, he suggests sipping fluids throughout the day. Here are several other things that, with your doctor’s okay, you may want to try:
- Ginger capsules. Research studies have suggested that ginger capsules have antinausea effects, and Nancy says some of her patients have responded well to them.
- Antacids, gum and hard candy. Peppermints and lemon drops, especially, “can keep the gastrointestinal tract distracted,” says Nancy.
- Acupressure. Research at the University of Rochester Medical Center and elsewhere has found that acupressure wristbands can alleviate nausea in some patients. Acupuncture, which involves inserting needles into the body to relieve pain, may also help.
- Biofeedback, guided imagery, meditation and yoga. All of these strategies can relax and distract the mind, thereby easing discomfort.
None of these alternative approaches can replace prescribed medication. Treatment-related nausea and vomiting “is a true medical condition,” stresses Dr. Smith. But, with all the options now available, there’s no reason to suffer. “Asking for relief is not a reflection on a person’s emotional strength or moral character,” she emphasizes. “Patients should feel comfortable enough to call their doctors and say that they do not feel well.”