Managing Side Effects - Nausea and Vomiting - Patient Education ...
Managing Side Effects - Nausea and Vomiting - Patient Education ... Managing Side Effects - Nausea and Vomiting - Patient Education ...
Cancer Therapy: Managing Side Effects - Nausea and Vomiting Nausea is a sick, uncomfortable feeling in your stomach that often comes before you vomit, or “throw up.” Nausea and vomiting are possible side effects of the medicines used for cancer treatments. This can be chemotherapy and/or biotherapy. Chemotherapy and biotherapy drugs can irritate your stomach or stimulate the vomiting center in your brain. The severity of stomach upset and how long it lasts depend on the drug and the dose you take. Not all chemotherapy and biotherapy drugs cause nausea and vomiting. Radiation therapy also may cause nausea and vomiting. This is more likely to happen when you are receiving radiation to your chest, stomach or back. Radiation treatment to other parts of your body should not cause nausea and vomiting. Nausea and vomiting from these treatments are usually temporary. Call your doctor right away any time you are too nauseated to drink fluids or any time you have more than one or two episodes of vomiting in a 24-hour period. Other causes of nausea and vomiting may include: your disease, infection, constipation, high blood sugar levels, low sodium (salt) levels, high calcium levels, and various medicines. © Copyright 2009 - November 16, 2010. James Cancer Hospital & Solove Research Institute, The Ohio State University Medical Center - Upon request all patient education handouts are available in other formats for people with special hearing, vision and language needs, call (614) 293-3191. Learn more about your health care. More on next page
- Page 2 and 3: Page 2 Ways to Reduce Nausea and Vo
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Cancer Therapy: <strong>Managing</strong> <strong>Side</strong><br />
<strong>Effects</strong> - <strong>Nausea</strong> <strong>and</strong> <strong>Vomiting</strong><br />
<strong>Nausea</strong> is a sick, uncomfortable feeling in your stomach that often<br />
comes before you vomit, or “throw up.” <strong>Nausea</strong> <strong>and</strong> vomiting are<br />
possible side effects of the medicines used for cancer treatments. This<br />
can be chemotherapy <strong>and</strong>/or biotherapy. Chemotherapy <strong>and</strong> biotherapy<br />
drugs can irritate your stomach or stimulate the vomiting center in your<br />
brain. The severity of stomach upset <strong>and</strong> how long it lasts depend on<br />
the drug <strong>and</strong> the dose you take. Not all chemotherapy <strong>and</strong> biotherapy<br />
drugs cause nausea <strong>and</strong> vomiting.<br />
Radiation therapy also may cause nausea <strong>and</strong> vomiting. This is more<br />
likely to happen when you are receiving radiation to your chest,<br />
stomach or back. Radiation treatment to other parts of your body<br />
should not cause nausea <strong>and</strong> vomiting.<br />
<strong>Nausea</strong> <strong>and</strong> vomiting from these treatments are usually temporary.<br />
Call your doctor right away any time you are too nauseated to<br />
drink fluids or any time you have more than one or two episodes<br />
of vomiting in a 24-hour period.<br />
Other causes of nausea <strong>and</strong> vomiting may include: your disease,<br />
infection, constipation, high blood sugar levels, low sodium (salt)<br />
levels, high calcium levels, <strong>and</strong> various medicines.<br />
© Copyright 2009 - November 16, 2010. James Cancer Hospital &<br />
Solove Research Institute, The Ohio State University Medical Center<br />
- Upon request all patient education h<strong>and</strong>outs are available in other<br />
formats for people with special hearing, vision <strong>and</strong> language needs,<br />
call (614) 293-3191.<br />
Learn more about your health care.<br />
More on next page
Page 2<br />
Ways to Reduce <strong>Nausea</strong> <strong>and</strong> <strong>Vomiting</strong><br />
Foods <strong>and</strong> liquids<br />
• You may need to limit what you eat on the day you get<br />
chemotherapy, biotherapy, or radiation therapy, or any time your<br />
stomach is upset. Talk to you nurse if you have questions about<br />
eating immediately before or after your treatment.<br />
• Eat small amounts often during the day, instead of three large<br />
meals. Eat slowly, in a pleasant place. Give yourself plenty of time<br />
to eat. Eat whenever your feel like eating.<br />
• Do not drink liquids with meals. Wait 30 to 60 minutes after<br />
eating. Clear cool liquids are often tolerated well, especially fluids<br />
like Gatorade TM , <strong>and</strong> Exceed TM . Try weak tea, ginger tea, clear<br />
soups, gelatin, or popsicles. Try ice cubes made from a favorite<br />
non-alcoholic beverage, 7-UP TM , ginger ale, or cola.<br />
Caution: Ginger tea may not be used with some health<br />
conditions. Ask your doctor or nurse.<br />
• Eat bl<strong>and</strong> dry foods, such as unbuttered toast with jelly, saltine<br />
crackers, dry popcorn, or boiled/baked potatoes.<br />
• Foods that digest easily include: skim milk, cereal, sherbet, fruit,<br />
<strong>and</strong> plain vegetables.<br />
• Eat foods that are cool or at room temperature. Do not allow<br />
refrigerated foods to sit at room temperature more than 30 minutes<br />
before you eat them.<br />
• Avoid spicy “hot” foods, such as chili, hot peppers or barbecue<br />
sauces. Do not eat fatty, fried or greasy foods such as French fries,<br />
cheeses, butter, oil, cream, margarine, or red meats. Many patients<br />
do not like foods that are sweet.<br />
• If foods with strong odors bother you, go into another room while<br />
these foods are cooking.<br />
• Avoid your favorite foods during times of severe stomach upset.<br />
That way you will not connect them in your mind with nausea <strong>and</strong><br />
vomiting.<br />
• Sucking on hard c<strong>and</strong>y such as lemon drops may relieve a metallic<br />
taste in your mouth. Use plastic utensils whenever possible. If you
Page 3<br />
do not have a sore mouth or throat, try citrus juice. Pickles, relish<br />
or cranberry juice may also be helpful.<br />
• Family members should not coax, bribe or threaten you about food.<br />
They can help best by cooking the foods for you so you will not<br />
have to smell the cooking odors.<br />
Anti-emetic Medicine (anti = against, emetic = vomiting)<br />
• Take anti-emetic medicine as it is ordered, about one half hour<br />
before eating. Take the medicine a day before treatment or for<br />
several hours before treatment, even if you feel fine. You may<br />
need to continue it regularly for a few days after treatment.<br />
• If pills do not stay down, most anti-emetic medicines can be given<br />
in another form, such as injections, suppositories, or under the<br />
tongue.<br />
• If your anti-emetic medicine does not seem to be working, tell your<br />
doctor or nurse. There are many anti-emetic medicines <strong>and</strong>/or other<br />
drugs that may work better.<br />
• Antacids such as Maalox TM or Mylanta TM may help mild nausea or<br />
heartburn.<br />
• If you are weak, dizzy, or sleepy from the anti-emetic medicine,<br />
ask someone to stay with you <strong>and</strong> help you.<br />
Other Ways to Help<br />
• Rest before <strong>and</strong> after meals, but do not lie down for 2 hours after<br />
eating. Sit in a comfortable chair with your feet up.<br />
• Slow, deep breathing through your mouth or swallowing will<br />
sometimes help the feeling of nausea to pass.<br />
• Avoid unpleasant sights, sounds <strong>and</strong> smells that might trigger<br />
nausea.<br />
• Do mouth care after every meal <strong>and</strong> before meals if you have a bad<br />
taste in your mouth.
Page 4<br />
• A bad taste in your mouth may be taken away by rinsing your<br />
mouth removing <strong>and</strong> cleaning dentures, brushing your teeth, or<br />
sucking on hard c<strong>and</strong>y such as peppermint.<br />
• Open a window to get fresh air.<br />
• Avoid strenuous exercise <strong>and</strong> sudden movements that may<br />
interfere with your sense of balance.<br />
• Distract yourself by talking, reading, listening to music, playing<br />
games, doing h<strong>and</strong>work, watching TV, or working on a hobby.<br />
• Learn how to do relaxation <strong>and</strong> guided imagery techniques (ask<br />
your nurse to teach you).<br />
• Try to rest or take a nap during the nausea.<br />
• To increase calories <strong>and</strong> maintain or gain weight, ask for the<br />
booklet Eating Hints from the National Cancer Institute. See your<br />
nurse or dietitian for this booklet or for more information or you<br />
may call 1-800-4-CANCER <strong>and</strong> request a copy, free of charge.<br />
• Even if you cannot eat foods, try to drink at least 1 to 2 quarts of<br />
fluid a day to avoid dehydration. Consider taking vitamins <strong>and</strong><br />
nutritional supplements.<br />
• If you have mouth pain:<br />
Try blended, smooth, creamy foods (eggs, soup, cheese cake,<br />
ice cream, pudding<br />
Try shakes made from oral nutritional supplements such as<br />
Carnation Instant Breakfast®, Ensure®, or Boost®<br />
Avoid hot foods<br />
Avoid acidic foods<br />
• Take a mild laxative if you are constipated. Sometimes<br />
constipation can cause or add to your nausea. Do not take a<br />
laxative if you are having belly pain. Call your doctor or nurse.<br />
• Take medicines to keep pain under control.<br />
• Provide comfort after nausea <strong>and</strong> vomiting by placing a cool cloth<br />
to the forehead or back of neck <strong>and</strong> by resting.
Page 5<br />
• Sit up or turn on your side when vomiting so you will not get any<br />
of it into your lungs.<br />
When to call your doctor or nurse:<br />
• Call your doctor or nurse if vomiting lasts longer than 2 days.<br />
• Be prepared to answer these questions:<br />
How often do you have nausea <strong>and</strong> vomiting?<br />
About how much is coming up?<br />
Does the vomit ever have blood or coffee ground looking stuff<br />
in it?<br />
Is the nausea <strong>and</strong> vomiting related to activity, food, medicines,<br />
pain or coughing?<br />
Do you feel better after vomiting?<br />
Are your bowels moving? Are you passing water as usual?<br />
What have you tried to decrease the nausea <strong>and</strong> vomiting?<br />
What usually works best to control your nausea <strong>and</strong> vomiting?<br />
Can you keep any food or fluid down?<br />
• Weigh yourself once a week. Report a loss of more than 5<br />
pounds in a week or 10 pounds in a month.<br />
• Report any of these signs of too much water loss (dehydration):<br />
Dry eyes<br />
Cracked lips/dry mouth<br />
Dry, limp skin<br />
Dizziness, especially when you st<strong>and</strong> up<br />
Talk to your doctor or others on your health care team if you<br />
have any questions. You may request more written<br />
information from the Library for Health Information at (614)<br />
293-3703 or email: health-info@osu.edu.