Coping With Nausea

What is nausea and vomiting?

Nausea is an uneasy feeling in your stomach or the back of the throat that feels like the urge to vomit and it may come and go in waves. You may feel it without vomiting. Vomiting is the forceful discharge of stomach contents through the mouth. You may also hear the term “retching" or “dry heaving.” This is the experience of vomit-like feelings, but without any substance or actual vomiting.

Symptoms of nausea and vomiting can be mild or severe. Mild cases are challenging and uncomfortable but usually are not harmful to your health. More severe cases of vomiting can cause other health problems, like dehydration, weight loss, and fatigue.

What causes nausea and vomiting?

Some, not all, cancer treatments can cause nausea and vomiting, and some people are more likely to experience nausea and vomiting than others.

The causes of nausea and vomiting can include:

• Chemotherapy
  • Certain chemotherapy drug or a higher dosage of chemotherapy can make it worse
• Radiation therapy
  • Radiation treatment to large areas of the body like the gastrointestinal (GI) tract, liver, or brain or a higher dosage is also more likely to cause these symptoms
• Other medications used in cancer treatment
  • Other methods used to treat cancer like targeted therapy and immunotherapy can cause nausea or vomiting
  • Medications prescribed to help with cancer treatment side effects, like pain medications, can cause stomach problems
• Certain cancers
  • Specific types of cancers are more likely to cause nausea and vomiting, including brain tumors, liver tumors, and GI tumors

How can I manage the nausea or vomiting?

Always talk to your healthcare team if you are experiencing nausea or vomiting. Ask them about each medicine prescribed for you and whether it has a risk of causing stomach upset. These problems can affect your daily life, mental health, physical health, and even delay treatment due to complications. You can also ask if you might be at a higher risk for experiencing symptoms of nausea and vomiting. Lastly, make sure to keep them updated on how you are feeling or what side effects you are experiencing, so that they can prescribe medicine to help relieve your symptoms. It may take a few tries to find the medicines that work best for you.

Here are some things you can try out to help with nausea and vomiting:

• Eat the foods you like or what sounds good to you at this time. What you like to eat may change, so you may need to try alternative foods
• Do not skip meals or snacks, try to always have some type of food in your stomach. Eat frequently throughout the day with snacks like smoothies, trail mix, and fruit
• Eat a small meal or snack before your treatment
• Sip liquids slowly throughout the day with a focus on clear liquids like ginger ale, apple juice, broth, and tea
• Try popsicles or gelatin, especially if you have mouth sores. You can also try hard candy with pleasant smells to help get rid of bad tastes
• If you are having difficulty eating, try bland foods like dry toast and crackers
• Eat food cold or at room temperature to decrease its smell and taste
• Avoid fatty, fried, spicy, or very sweet foods
• Eat small amounts of high-calorie foods that are easy to consume, like pudding, ice cream, sherbets, yogurt, and milkshakes, a few times a day
• Use butter, oils, syrups, sauces, and milk in foods to raise calories
• Avoid low-fat foods unless fats upset your stomach or cause other problems
• Tart or sour foods may be easier to keep down (unless you have mouth sores)

What are some non-medical options to cope with nausea?

• Rest quietly while sitting upright for at least an hour after each meal
• Distract yourself with soft music, a favorite TV program, or spending time with your loved ones
• Relax and take slow, deep breaths as the nausea comes on, to stay calm
• Use guided imagery to imagine you are in a place that’s relaxing for you like a vacation spot, a room at home, or some other safe or pleasant place to mentally block the nausea and vomiting
• Try acupuncture, a traditional Chinese technique in which very thin needles are put into the skin, to help alleviate the nausea. There are a number of different acupuncture techniques, including some that use pressure rather than needles (acupressure)
• Specially trained health professionals use music to help promote healing. There’s some evidence that, when used with standard treatment, music therapy may help to reduce nausea and vomiting

What can my caregivers do to help?

• Try to avoid strong food odors, use kitchen vent fans to reduce smells, cover or remove foods with strong or unpleasant smells
• Use plastic forks and spoons rather than metal ones, which may cause a bitter taste
• Encourage your loved one to sip on clear liquids slowly throughout the day to avoid dehydration and constipation

Coping with nausea and vomiting can be difficult and it is understandable if you are worried or upset. Get the rest you need, ask for help, and continue to talk to your healthcare team so they can help you feel better.