Patients often ask if there’s a way to know whether they will experience nausea and vomiting associated with chemo. Although no one knows for sure until nausea and vomiting occur, certain risk factors might predispose patients to experiencing these side effects.
One of these risk factors involves the type of chemotherapy patients receive. Some chemotherapies are more likely to cause nausea and vomiting. So knowing the type of chemotherapy you are going to receive is an important step in understanding if you need preventive medicines for nausea and vomiting.
When choosing preventive medicines for nausea and vomiting, I like to use this rule of thumb—the strength of the preventive medicines should match the intensity of the chemotherapy. In other words, if the chemotherapy I prescribe is more likely to cause nausea and vomiting, then that patient will receive the strongest combination of preventive medicines for nausea and vomiting.
Another set of risk factors for nausea and vomiting depends upon the patient. Research has shown that the following types of people are more likely to experience nausea and vomiting after chemo:
- People under age 50
- Women
- People who do not often drink alcoholic beverages (less than 1.5 oz of alcohol per day)
- People who have experienced motion sickness, morning sickness, and/or those who have already experienced nausea and vomiting after chemo
- People with cancer of the brain, liver, or stomach
- People taking some pain medications
- People who are very anxious or nervous Read more about this.
Can anxiety or nervousness make you sick? Anxiety is a normal response to having cancer, and it is also a risk factor for nausea and vomiting. In fact, some people become so worried about their chemo that they develop what is called anticipatory nausea and vomiting. This means you may experience nausea or vomiting by just thinking about your chemo.
This can happen because you have already experienced nausea and vomiting associated with chemo, so your body has learned to expect these effects. You may also be feeling a lot of emotional stress before chemo that can cause nausea and vomiting.
However, do not let anyone tell you it’s all in your head. Anticipatory nausea and vomiting is as real as any other side effect, and it deserves treatment.
Before you start chemotherapy, talk with your doctor about your risk of nausea and vomiting. Find out which chemotherapies you will receive and if they are likely to cause these side effects. You can also work together to determine if you have personal risk factors for nausea and vomiting. Get more info on risk factors.
Whether you have just 1 or several risk factors for nausea and vomiting, talk with your doctor about setting up a plan for preventive medicines. Not only is this plan important to preventing nausea and vomiting, it’s an important step in preparing your overall treatment plan.
And as you go through chemo, keep the lines of communication open. Make sure that you communicate any side effects you may experience to your oncology care team. If they know what you’re going through, they might be able to make adjustments to your treatment plan to make your experience more comfortable. Communication is key!
Take care and good luck,
Dr Schwartzberg
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