Nausea
Nausea is a sensation in the body experienced as the urge to vomit. More specifically, it is a subjective phenomenon of an unpleasant, wavelike sensation felt in the back of the throat and/or the upper middle region of the abdomen (epigastrium) that may or may not result in vomiting or retching (dry heaves). It can be induced through a variety of causes, including illness, drugs, pain, or inner ear
disease (1, 2). Nausea and vomiting can occur for a number of reasons related to
cancer and cancer
treatment, and controlling NV is an important aspect of treatment (2).
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There has been an attempt to categorize nausea and vomiting based on severity, frequency, and when in relation to treatment they occur. The most common types in
cancer patients are acute, delayed, or anticipatory nausea and vomiting that is
chemotherapy-induced. Also common is chronic nausea and vomiting in advanced cancer patients. (2).
Acute nausea and vomiting is that which occurs during the first 24-hour period after treatment (most often chemotherapy). Anticipatory nausea and vomiting is that which occurs just prior to the beginning of a new cycle of chemotherapy, in response to the smells, sights, and sounds of the treatment room. This is due to a conditioned response that typically occurs after three or four prior chemotherapy treatments, as the patient begins to associate these stimuli with the sensations of the treatment itself. Delayed (or late) nausea and vomiting occurs more than 24 hours after chemotherapy administration (2).
Chronic nausea and vomiting in advanced cancer patients may stem from a variety of factors. The reasons for nausea and vomiting in advanced cancer patients are not fully understood, but potential causes include side-effects of pain medication, the impact of the cancer treatment on the gastrointestinal system, or the cumulative toxic effects of chemotherapy and radiation treatment (2).
Not all cancer patients experience nausea and vomiting, and there are a variety of options to help the patient reduce the possibility of experiencing nausea. A doctor may issue an anti-nausea medication, especially before and after chemotherapy treatment. The patient can take certain other measures that may help, including eating small meals, drinking lots of fluids, getting fresh air, and utilizing relaxation techniques (3).