Nausea and Vomiting from Cancer

Symptom and Description

Nausea (feeling queasy or sick to your stomach) and/or vomiting (throwing up) may happen from many causes with cancer, and may be worse if you are getting chemotherapy and radiation therapy. Nausea and vomiting may come on slowly or very quickly with cancer-related problems. Your doctor will treat the problem causing the nausea and vomiting, and treat the nausea and vomiting, too.

Learning Needs

Nausea and vomiting are very unpleasant. Either or both may be barely noticeable or may be severe and cause you to be unable to do things that are important to you. In addition, if you vomit a lot you can get dehydrated and have other problems from losing body salts.

You should call your doctor or nurse if:

• You have nausea that lasts for more than a few days, or if nausea keeps you from doing things that are important to you.

• You vomit more than once or twice a day for 2 days.

• You cannot keep any liquids (such as water, juices, soda) or food down.

• You are vomiting and you lose more than 2 pounds in a day (this is from losing water). You will usually feel thirsty and your mouth will seem dry when you are losing a lot of water.

• You are vomiting many times and your urine is dark yellow and you are not going to the bathroom as often as you normally do.

• You are vomiting and feel lightheaded or dizzy, or confused (mixed up).

• The stuff you throw up looks like coffee grounds (this could be blood).

Prevention

We have many medicines to control nausea and vomiting (antiemetics). Your doctor will prescribe one or more of them for you.

• Make sure you get your antiemetics. Let your doctor or nurse know if your drug store does not have them or if you cannot afford to pay for them.

• If you are not sure how to take your antiemetics, call your doctor or nurse.

• Take the antiemetic(s) as your doctor has ordered. If you have vomiting and cannot take them, call your doctor or nurse.

• If your antiemetics help lessen your nausea and vomiting but not as much as you would like, call your doctor or nurse. The dose of the antiemetic may have to be changed, or the doctor may change you to a different antiemetic.

Management

When nausea and vomiting are very bad, you may need to come to the office for antiemetics, and possibly for fluids, through a vein (an IV). Sometimes your doctor will also order blood tests and x-ray films to find out why you are vomiting. Most of the time, your doctor and nurse will be able to get your vomiting under control so that you can take pills to control it. In a very small number of people this is not possible. Then you may need to take antiemetics into your rectum by suppository or through your vein.

Self-Management

In addition to taking your antiemetics, you can try one or more things that other people have found helpful:

• Try eating foods and drinking beverages that were easy for you to take or have made you feel better when you had the flu, had morning sickness, or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.

• Do not eat your favorite foods when you are nauseated.

• Do not eat fatty or fried foods, very spicy foods, or very sweet foods when you are nauseated.

• If possible, have somebody else make the meals when you are nauseated.

• If you have nausea and vomiting only for a few days after chemotherapy, cook and freeze several meals that you can reheat during times you are nauseated.

• Eat foods that are at room temperature or cold. The smells from hot foods may make your nausea worse.

• Keep your mouth clean; brush at least twice a day.

• Ask your doctor or nurse if they can help you learn a relaxation exercise. This might make you feel less anxious and more in control, and decrease your nausea.

• Ask your doctor or nurse about using acupressure bands on your wrists, which may help to decrease your nausea.

Follow-up

Call your nurse and/or doctor if any of the following happen:

• You have nausea and vomiting that are not controlled with the antiemetics ordered.

• You have side effects that you do not like from your antiemetics.

• You start to have a lot of nausea and vomiting and cannot keep liquids down and are losing weight.

• You are dizzy and/or confused.