Let's Talk About Nausea and Vomiting from Cancer Treatment

Important Information: Please Read Before Proceeding

Your Doctor’s Advice is Final: Always follow the advice of your treating doctor and healthcare team. Their medical guidance is based on your specific health condition and should be considered final.

For Informational Purposes Only: This content is written by a practicing oncologist to help you understand your health. However, it is for general information only and is not a substitute for a direct consultation with your own qualified doctor.

Empowering Patients: Our goal is to empower you with knowledge so you can ask better questions and have more informed discussions with your healthcare team about your treatment options.

Do Not Self-Medicate: Never use the information on this website to make decisions about your treatment or to self-medicate. This can be very dangerous.

Regarding Translations: Articles translated into languages other than English are done using automated artificial intelligence (AI). These translations may have errors or inaccuracies. Please consult the original English article for the most accurate information or clarify these with your treating team.

Starting the Conversation: Understanding Sickness During Cancer Therapy

Facing cancer treatment can bring up many questions and concerns, and one of the most common worries is about feeling sick because of the disease and more so because of the treatment. Nausea and vomiting are side effects that many people associate with chemotherapy, and it’s natural to feel anxious about them. Fear of these side effects results in many people not taking treatment.

There is a good news! Today, these side effects can be very well controlled or even prevented for most patients because the development of new drugs. We want to provide clear, supportive information for patients and caregivers in India to help you understand what might happen, how you can manage it, and when to talk to your medical team. You are not alone in this. You may want to read this in a language other than English or you may want to show it to a person who is not conversant with English. Technology has come to rescue. You can choose the language you are comfortable with of the languages that appear on the top right corner.

What Exactly Are Nausea and Vomiting from Treatment?

This is a side effect caused by cancer treatments like chemotherapy, and sometimes targeted therapy or radiotherapy. Doctors often call it Chemotherapy-Induced Nausea and Vomiting (CINV).

Nausea is that unpleasant, queasy feeling in your stomach that makes you feel like you are about to vomit.
Vomiting (also called emesis) is the physical act of your stomach emptying its contents through your mouth.

It’s helpful to know that this can happen at different times:

Acute Nausea: This can happen within the first 24 hours after a treatment session.
Delayed Nausea: This may start more than 24 hours after treatment and can last for a few days.
Anticipatory Nausea: This is a learned response where your mind starts to connect the hospital environment, the thought of having chemotherapy with feeling sick. High levels of anxiety can play a large role here.

Why Does Treatment Cause Sickness?

Understanding why this happens can make it feel less mysterious. There are two main reasons:

Effect on the Brain: Chemotherapy drugs travel through your bloodstream. When they reach a part of your brain called the “vomiting centre,” they can trigger signals that make you feel sick.
Effect on the Digestive System: Treatment can irritate the lining of your stomach and intestines. These irritated cells release chemicals that also send a “feel sick” signal to your brain.

A key thing to remember is that not all chemotherapy drugs are the same. Doctors know which drugs or combinations of drugs have a high risk of causing sickness and which have a very low risk. They will create a prevention plan for you based on your specific treatment.

What are the Common Signs and Symptoms?

The signs are usually straightforward, but how you feel can be very personal. You might experience:

A constant feeling of wanting to be sick.
More saliva in your mouth than usual.
Feeling weak, lightheaded, or dizzy.
Not feeling hungry or wanting to eat.
Retching (gagging without bringing anything up).
The physical act of vomiting.

If these symptoms are not managed, they can lead to other issues like dehydration, poor nutrition, and extreme tiredness (fatigue), so it’s important to address them. Also, if CINV in a cycle increases the risk of anticipatory nausea and vomiting.

How Can We Manage This Together?

Managing nausea and vomiting is a team effort between you, your caregivers, and your medical team. Your doctor will prescribe anti-sickness medicines (antiemetics), and following their advice is the most important step.

A. Your Treatment is Unique – Let’s Talk to Your Doctor

Ask About Your Specific Plan: Have a conversation with your doctor about the potential for nausea with your particular chemotherapy. Knowing what to expect allows you both to create the best prevention plan.
Avoid Comparing Your Journey: Please try not to rely on stories from other patients. Their chemotherapy drugs, doses, and personal sensitivity could be completely different from yours. Your journey is your own, and your team is focused on you.
The Power of Your Mindset: While the cause is physical, your state of mind matters. High anxiety can make nausea feel worse. Trusting in your medical team and their plan can help you feel more in control and less anxious.

B. Following the Medicine Plan Correctly:

Your medical team has a standard plan to prevent sickness.

Understanding the Plan: On the day of your chemotherapy, you will receive strong anti-sickness medicines through your drip or as tablets before the treatment even starts. This is to prevent immediate nausea. You will also be given tablets to take at home for a few days after treatment. This is crucial for preventing delayed nausea.
Follow Your Home Schedule Strictly: It is much easier to prevent nausea than to stop it. Please take your at-home medicine exactly on schedule, even if you feel perfectly fine.
Your Feedback is Powerful: If you still feel sick despite the medicines, you must tell your doctor. This is not a failure; it is important information. Your doctor can use your feedback to adjust the plan for your next treatment cycle, perhaps with different or stronger medicines, so you have a better experience.

C. Food and Drink Strategies:

Eat Small, Frequent Meals: Instead of three large meals, try 5 or 6 small snacks. An empty stomach can make nausea feel worse.
Choose “Comfort” Foods: Think about bland, easy-to-digest foods like plain rice, toast, crackers, chicken soup, or curd (dahi).
Avoid Trigger Foods: Foods that are very oily, spicy, sweet, or have strong smells can be triggers. It’s okay to avoid them for a while.
Try Cool Foods: Hot foods have stronger smells. Cool or room-temperature foods are often easier to tolerate.
Stay Hydrated: This is very important. Sip small amounts of clear fluids like water, coconut water, or clear soups throughout the day.
Sit Up After Eating: Rest and relax, but try not to lie down flat for at least an hour after a meal.

D. Other Comfort Measures:

Fresh Air: Sometimes, a little fresh air can make a big difference.
Avoid Strong Smells: Stay away from cooking smells, strong perfumes, and smoke if they bother you.
Wear Loose Clothing: Comfort is key. Avoid anything tight around your stomach.
Relaxation and Mindfulness: Studies show that calming your mind can help. Try simple deep breathing, gentle yoga, or listening to soothing music. These practices can reduce anxiety and help you feel more in control.
Suck on Hard Sweets: Some people find that sucking on mints, ginger sweets, or ice chips can help settle their stomach.

When Should You Call Your Doctor Immediately?

It’s always better to be safe and check with your team. Please contact your hospital or doctor right away if:

You are unable to keep any food or liquids down for more than 24 hours.
You vomit three to five times or more within a 24-hour period.
Your anti-sickness medicine doesn’t seem to be helping.
You feel very weak, dizzy, or confused (these are signs of dehydration).
You are not passing much urine, or your urine is very dark.
You vomit blood, or your vomit looks like coffee grounds.

Your medical team is your partner. They can give you stronger medicines or fluids through a drip to help you feel better. Never hesitate to call them. Your well-being is their top priority.