What are the types of nausea and vomiting linked to chemo?

Each person is different, and so is their reaction to treatment. You may have severe, mild, or no side effects. Talk with your cancer care team about possible side effects and what can be done about them. Try to do this before treatment begins.

Nausea is when you feel sick, like you might throw up. Vomiting is when you throw up. The medicines used to control and prevent them are called antiemetics, or antinausea medicines.

According to the National Cancer Institute, these are the types of nausea and vomiting linked to chemo:

Anticipatory nausea and vomiting

After a few treatments, some people feel nauseous and begin vomiting in anticipation of the next treatment. Or they may feel sick before they even start it. Nausea is more common with this type than vomiting. This reaction is often triggered by something related to the treatment. It could be the smell of an alcohol swab, the sight of a medical uniform, or the sounds in the treatment room.

Antinausea medicines don't always prevent this kind of nausea and vomiting. But they may help. Anti-anxiety medicine seems to help relieve it. Actions that calm or distract the person tend to work more often. These may include guided imagery, hypnosis, relaxation, music, or video games. Anticipatory nausea is often a learned response. The best way to keep it from happening is to prevent or treat acute and delayed nausea.

Acute nausea and vomiting

This physical reaction happens within 24 hours of getting chemo. It can be mild, moderate, or severe. Your health care provider can give you medicines to help control it.

Delayed nausea and vomiting

For some people, nausea and vomiting may happen more than 24 hours after getting chemo, usually 1 to 7 days. This is also called late nausea and vomiting. It's more common in people getting high doses of chemo, those who have acute nausea and vomiting, women, people who drink little or no alcohol, and young people. Medicines that are used for acute nausea and vomiting can also be used in treating this.

Nausea and vomiting in advanced cancer and chronic nausea and vomiting

In people with advanced cancer, nausea and vomiting may become chronic (long-term) and not linked to chemo. The nausea may be related to other medicines used for pain or depression. Or it may be the direct result of a brain or abdominal tumor.

People with advanced cancer may also have constipation, abnormal levels of certain substances in the blood, dehydration, and stomach ulcers. All of these can lead to nausea and vomiting.

What causes nausea and vomiting?

The brain controls nausea and vomiting. Nausea is controlled by autonomic nerves. These nerves control involuntary body functions like heartbeat and breathing. Many irritants, such as smells, taste, anxiety, pain, motion, or digestive chemicals, can trigger the vomiting center. This starts the vomiting as a reflex.

Whether a person will have nausea and vomiting depends on many factors. Some chemo medicines are more likely to cause it. Women and people younger than age 50 are more likely to have it. People who are prone to motion sickness or anxiety are also more likely to react to chemo with nausea and vomiting.

Managing nausea and vomiting

Uncontrolled nausea and vomiting are serious problems. They must be managed to prevent malnutrition, dehydration, and mental changes. In most cases, antinausea medicines, sometimes along with alternative therapies, can help to reduce nausea and vomiting. It's very important to maintain the body's electrolyte balance and to make sure that vomiting doesn't lead to the loss of vital nutrients.

The American Cancer Society and National Cancer Institute provide these tips:

Eating and drinking

• Eat foods that sound good to you.

• Eat and drink slowly.

• Eat many small meals throughout the day instead of 3 full meals. Have a snack at bedtime.

• Don't skip meals or snacks. You may feel more nauseated when your stomach is empty.

• Stay away from strong smells by eating food that is cold or at room temperature.

• Drink clear liquids served cold. Sip them slowly and often throughout the day to prevent dehydration.

• If you are nauseated in the morning, keep dry foods, such as cereal or crackers, at your bedside. Eat them before you get up. But don't do so if you have throat or mouth sores or a lack of saliva.

• Don't eat sweet, fatty, spicy, or fried foods.

• Chew food well to help with digestion.

• Drink an hour before or after, instead of with, each meal.

• Rest but don't lie down for at least an hour after eating.

Eating before treatment

A light meal before treatment is helpful unless you become nauseated during chemo. If nausea is a problem, don't eat for at least several hours before treatment.

Other tips

• Your health care provider will likely prescribe antinausea medicines. Be sure you know how they work and how to take them.

• Take your "as needed" antinausea medicine as soon as you feel nausea. Don't wait until you're throwing up.

• Stay away from strong smells that may be unpleasant for you, such as cooking smells, perfume, and smoke.

• If you are feeling nauseated, distract yourself.

• Breathe deeply and slowly when you are feeling nauseated.

• Wear loose-fitting clothes.

Tell your providers about any nausea or vomiting you have. Be sure to report vomiting that lasts more than a day. Also contact your health care team if you can't keep liquids or medicines down. There are a lot of different antinausea drugs that can be used to control these side effects. Let your provider know if the medicine you're using doesn't work. These medicines work in different ways. So you may need more than one. Or you may need to try a few to find one that works best for you.