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Cancer and Vomiting

Chemotherapy treatment is notorious for its side effects. One of the most severe is vomiting.  Radiation therapy can also cause vomiting, although it is less common than with chemotherapy treatment.

 

Knowledge is Power

Luckily, current oncology standards of practice have made vomiting less common, thanks to the effective and proactive use of preventative anti-nausea medications during treatment.

Nausea and vomiting after chemotherapy usually resolves within 1 to 2 days; however, it is possible to have symptoms up to 4 days after chemotherapy. This is dependent on the type of chemotherapy drugs used, their dosage, and frequency of treatment.

It is critical to seek immediate medical attention if nausea or vomiting is severe enough that one cannot keep any food down. It can quickly result in dehydration and depletion of electrolytes.

Dehydration, if not treated in a timely manner, can lead to serious complications.  Intravenous fluid replacement may be required to restore adequate hydration.

 

When vomiting, it is important to remember:

  • Lie on your side (so as to not inhale the vomit) if you feel like you are going to vomit and are unable to get up.
  • Replace necessary fluids if you are vomiting frequently – note that requirements may be well above the standard 64 oz per day required in most individuals in order to replace fluids that were lost.
  • Include additional sources of fluids such as clear liquid beverages such as broth, juice, decaffeinated tea, gelatin, fruit ices, ice chips and ice pops.
  • Replete electrolytes by consuming foods that contain potassium and sodium.  Potassium can be found in foods such as fruit juices and nectars, bananas, and potatoes. Sodium can be found in foods such as pretzels, bouillon or broth.
  • Suck on hard candy with pleasant taste and smells.

 

In addition, these preventative strategies can help:

  • Eat small frequent meals (5 to 6 meals) during the day instead of 3 larger meals.
  • Avoid spicy, greasy, or dense foods. Instead, choose bland, light foods.
  • Use plastic silverware; metal may leave a bitter taste.
  • Take your time when eating and drinking and sip and eat slowly.
  • Be aware of certain smells that bother you and avoid these foods.
  • Consume ginger ale or other ginger products may help to settle your stomach.
  • Distract yourself with pleasant things.
  • Create a schedule where anti-nausea medications are taken within half an hour to an hour before mealtime.
  • Ask your doctor about possible adjustment in your medications or alternative treatments that may help and for additional guidance.

 

References
[i] Martin, Kathryn, et al. “Nausea and Vomiting.” UpToDate Inc. Wolters Kluwer Health, June 2012. Web. <http://www.uptodate.com/contents/nausea-and-vomiting-with-cancer-treatment-the-basics>
[ii] “Caring for the Patient With Cancer at Home: A Guide for Patients and Families.” American Cancer Society. American Cancer Society, 11 Aug. 2011. Web. <http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/DealingwithSymptomsatHome/caring-for-the-patient-with-cancer-at-home-nausea-and-vomiting>
Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

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