By Dena McDowell, MS, RD

What causes nausea during cancer treatment?

Nausea is the primary complaint for patients undergoing cancer treatment. Certain chemotherapy agents cause nausea more often than others. These include:

• 5-FU
• Carboplatin
• Carmustine
• Cetuximab
• Cisplatin
• Cyclophsphamide
• Cytarabine
• Docetaxel
• Doxorubicin
• Epirubicin
• Etoposide
• Gemzar
• Herceptin
• Idarubicin
• Ifosfamide
• Methotrexate
• Mitomycin
• Oxaliplatin
• Paclitaxel
• Topotecan
• Valcade.

During radiation therapy, when the treatment area surrounds the gastrointestinal tract, the patient is also likely to have nausea. Those undergoing a combination of chemotherapy and radiation therapy are the most likely to experience nausea.

Some medications calm nausea

Often, medications are given to patients in conjunction with chemotherapy to lessen nausea during treatment. But once the medication wears off, the nausea may return and last for up to a week after treatment ends. The most important thing a patient can do is to inform their doctor of their symptoms. There are many anti-emetic or anti-nausea medications that can be prescribed to lessen the severity and duration of nausea. It is also important to notify your doctor of how much relief the medication provides. In many cases, more than one medication may be prescribed.

Tips to alleviate nausea

Dietary practices can help quell nausea. Although the last thing you want to do is eat when you are feeling nauseous, sometimes eating is the best way to settle your stomach. Here are some helpful tips to calm a queasy stomach:

• Eat small frequent meals. Instead of 3 main meals, try to eat every 2 hours that you are awake.

• Keep snacks handy. Peanut butter and crackers, hard-boiled eggs, pretzels, string cheese, yogurt, pudding, and fruit all work well.
• Ask for help with grocery shopping or meal preparation.
• Browse recipes or recipe websites for new meal ideas.
• Eat with friends and family to provide a welcome distraction from thinking about the nausea.
• Keep frozen and canned foods on hand to make meal preparation easier.
• Change the temperature of the foods. Aim for cool or room temperature foods to decrease the smell.
• Steer clear of the kitchen or open a window during meal preparation to lessen the fumes.
• Eat slowly and chew foods well to aid in digestion.
• Try drinking fluids between meal times. Sip on fluids whenever you are not eating.
• Try water, flat soda, unsweetened juices, sports drinks, and tea for fluid needs.
• Limit caffeine as it is a stimulant and may cause or worsen nausea.
• Try ginger-based tea (slice ginger root and add 2-3 slices to boiling water while steeping the tea bag).
• Ginger based candy and lollipops also work well. Check the Internet or your cancer center for availability.
• Practice relaxation techniques and slow, deep breathing when nausea is at its worse.
• Limit foods that are rich, sugary, and high in fat.
• Eat carbohydrate rich snacks such as saltine crackers, low fat granola bars, or pretzels when you feel nausea coming on.
• Take your nausea medication as prescribed. It is worse to wait until the nausea hits to take your medicine.
• Do not lie flat on your back after eating.
• Eat a light carbohydrate rich meal before treatment. A good example would be toast with jelly, fruit, and tea.
• Bring food with you during all-day treatments. Examples include: gelatin, pudding, crackers, pretzels, lean deli meat sandwiches, fruit, nutritional bars, or drinks.
• Drink fluids during treatment. Aim for water, juice, or sports drinks. If you are short on calories, try commercial nutritional products.

Conclusion: reduce nausea by experimenting with your diet

Nausea can be a debilitating part of cancer treatment. However, with trial and error using different foods and medications, nausea can be lessened. Endeavor to try new foods and be open to eating. Keep in mind that food is the fuel that will get you through the treatment process. Informing your health care provider is also extremely important so he or she can monitor your symptoms and assess the effectiveness of the medications prescribed.

For more information on nutrition during cancer treatment see the following articles from TheDietChannel: Increase Your Calories and Protein during Cancer Treatment and Guidelines for Effective Weight Loss and Weight Gain during Cancer Treatment.