Nausea and Vomiting During Cancer Treatment
Today, we need to talk about a serious subject, but in some ways it was the favorite topic of discussion in most junior high cafeteria’s (at least when I was in junior high way back in the age). Anyway, nausea and vomiting.
It can be a serious issue with those undergoing cancer treatment, especially things like chemotherapy where a great deal of effort is used in trying to control the sense of nausea and therefore prevent vomiting.
Many antiemetics are used during this time to help prevent the nausea and the vomiting and go along with the treatment. We’re going to talk a little bit about that today.
When we think about nausea and vomiting in cancer treatment, we need to remember some of the causes that lead to nausea and vomiting as the patient is being treated. Obviously, chemotherapy, depending on what type of medication is being used, what type of chemicals are being used, can create either immediate nausea and vomiting or delayed nausea and vomiting, sometimes up to as long as 24 hours after the treatments been received.
Being aware of what type of medications and what type of chemo is being used, it will have either an immediate effect or a delayed effect. That’s important to know so that you can get the right antiemetics administered to help at least minimize if not prevent that.
Radiation treatment also has been known to cause nausea and vomiting in cancer patients who are receiving that treatment. Other things, though, to be aware of, not directly related to the cancer treatment itself that can cause nausea vomiting are such things as malignant tumors.
A malignant tumor that has been associated with the G.I. tract can cause nausea and vomiting. Also, electrolyte imbalances can cause nausea and vomiting. The discouraging thing there is if the electrolytes are out of balance and it leads to vomiting, then, because of all the loss of fluids, it actually exacerbates the situation and continues the electrolyte imbalance and worsens it.
Finally, certain kinds of infection can also lead to nausea and vomiting. Most of these things are associated with the G.I. tract. Now, we want to talk about different types of nausea and vomiting, not just things that are directly related to the medicine being administered, the type of treatment being administered, or some sort of problem with the person’s health.
We want to talk about, just briefly, anticipatory nausea and vomiting. This is more of at least starts in the mind it’s a psychological factor. If someone associates nausea and vomiting with a particular environment, particular set of practices, a particular smell, because of the fact they’ve associated that way in the past, they’re much more likely to do it again.
A cancer patient comes in for chemotherapy and they have known from their past treatments that the medicine makes them feel nauseous and they throw up. Just being in the same room being administered the same treatment can lead to anticipatory nausea and vomiting. This has made me sick in the past, I guess I’ll just get sick now.
Even before the chemicals are starting to flow. This is a serious issue that needs to be addressed, obviously, with talking to the patient and trying to help them deal with those anticipatory thoughts. Let’s not get the cart before the horse. If you’re going to be sick, let’s actually have a reason here.
Basically that’s an issue to be aware of, that certain smells, environments, and certainly things that the patient associates with nausea and vomiting can lead to that feeling and that activity without there even being a real physical cause. They’re anticipating it so much ahead of time because of their past experience.
Then, finally, refractory nausea and vomiting, here meaning uncontrolled. Basically, it’s gotten to the point where even antiemetics won’t help it. There are some chemotherapies that lead to that kind of vomiting. It’s really dangerous, because if there’s uncontrolled vomiting, it can lead to a serious amount of dehydration.
Being aware of the patient’s reaction to certain chemicals and getting from them how long have been vomiting. That sort of thing can help get on the right treatment to minimize this and to try to associate proper antiemetics so that the person is kept comfortable, not spending a great deal of time feeling nauseous or throwing up, and certainly not getting to this point where it’s uncontrollable and even antiemetics won’t help, so that the person gets utterly dehydrated has to be hospitalized.
Anyway, that’s a brief overview of nausea and vomiting as it relates to cancer treatment. We looked at traditional cancer treatments that lead to that. We talked about some things that are directly related to the cancer treatment that can also be causes of nausea and vomiting and we need to be able to rule those out in determining what is causing the patient to feel nauseous or to emit.
Is it just the treatment or could there be something else at play? Then, we talked about the importance of dealing with anticipatory and feelings of nausea and vomiting, and the dangers and trying to avoid the refractory form.