Chemotherapy and Nausea
Of the many side effects of chemo, most common is the nausea and vomiting that some patients experience. These are also the most dreaded side effects that patients worry about. While there have been some new medicines introduced that have cut down the nausea and vomiting patients experience, there are still people affected by it.
Irritation with Drugs
Chemotherapy drugs can irritate the lining of your stomach and the duodenum (the first section of the small intestine). This irritation stimulates nerves that activate the vomiting center (VC) and the chemoreceptor trigger zone (CTZ) in the brain which, in turn, causes the vomiting. Other side effects of chemo that cause nausea and vomiting are delayed gastric emptying, inflammation, or obstruction (intestinal blockage).
Effect of Nausea
Nausea itself is the uncomfortable, and sometimes painful, feeling of wavelike sensations in your stomach and the back of your throat. It is not unusual for a person to also feel symptoms like, weakness, light headedness, dizziness, and sweating. Nausea can lead to retching, vomiting or both.
Retching involves the recurring movement of the diaphragm and muscles in the stomach which are controlled by the VC.Vomiting is controlled by the VC and is the process of having the contents of your stomach forcefully removed through your mouth. It is also known as “throwing up”. Vomiting is a side effect of chemotherapy and might happen days after the treatment, or hours after it. If a person suffers from vomiting directly after their treatment, that is known as “Acute Vomiting”. “Delayed Vomiting” or “Delayed emesis” is when a person vomits 24 hours or later after their treatment. This side effect can last for several days.
Some people have had unpleasant experiences in the past with vomiting and nausea sometimes get “Anticipatory Vomiting”. This can occur if a person is confronted by the same odors, sounds, or sights that had caused them to get sick before. This is a factor in the treatment of cancer because some people will get “Anticipatory Vomiting” before they go to chemo because they got sick at their last round of chemo. This is common and there are treatments available to help stop it after it has started.
No one can know how bad or for how long a patient will have vomiting and nausea after their chemotherapy. Some people do not suffer from these side effects at all. But while we may not know what is going to happen, we know some of the chemotherapy drugs that are known to cause nausea and vomiting are: cisplatin, dacarbazine, mechlorethamine, melphalan, daunorubicin, cytarabine (high doses), streptozocin, carmustine, etoposide (high doses), cyclophosphamide, procarbazine, lomustine, and dactinomycin.
Other factors like fatigue, anxiety, or being a woman of menstrual age may also affect the degree and duration of vomiting and nausea.
In order to prevent vomiting and nausea, there are medicines that can be given to the patient before the chemo actually begins. No one can know how bad or for how long a patient will have vomiting and nausea after their chemotherapy. Some people do not suffer from these side effects at all. But while we may not know what is going to happen, we know some of the chemotherapy drugs that are known to cause nausea.