Managing Nausea During Cancer Treatment
Nausea and vomiting may occur during your treatment, a few hours after your treatment (acute), or much later (delayed). Not everyone will experience this side effect, but it is most common in people who:
- have had general anesthesia (for surgery)
- are taking certain medications
- are receiving chemotherapy or radiation treatments
Cancer cells reproduce very quickly, and many chemotherapy medications work by attacking cells that are reproducing rapidly. The cells that line your digestive tract also reproduce rapidly, and so they are likely to be affected by chemotherapy. The good news is that your body will replace these cells with new, healthy cells when treatment ends. In the meantime, you may have nausea and vomiting. Other treatments may cause nausea by irritating your mouth, esophagus, or stomach; or by affecting your sense of balance.
It is important to keep in contact with your doctors and nurses about how you are feeling. There are medications your doctor can prescribe to prevent, lessen, or treat nausea and vomiting. Anti-nausea medications can be taken by mouth, through an IV (intravenously) or intramuscular injection, by wearing a patch, by using a rectal suppository, or by placing a dissolvable strip under your tongue or inside your cheek. Follow your doctor’s instructions carefully on when and how to take your medications.
Here are some foods and drinks that are generally easier on the stomach:
- Ice pops
- Clear soups, clear sodas such as ginger ale (drink flat soda or stir it well before drinking to get rid of the carbonation), Kool-Aid® and Gatorade®
- Weak tea, fruit juices and nectars (avoid citrus and acidic juices)
- White bread, white rice, cooked white potatoes, white pastas, creamed rice or wheat cereals, crackers, and dry toast
- Bananas, applesauce and cooked fruits
- Yogurt, pudding and cottage cheese
- Scrambled or soft boiled eggs
- Smooth peanut butter
- Cooked chicken or turkey (no skin), lean beef and fish (not fried)
- Liquid supplements, such as Ensure®
Foods to Avoid
These foods and drinks are more likely to cause nausea and stomach upset:
- Greasy, fried and fatty foods
- Spicy foods
- Acidic foods and drinks
- Coffee, tea, energy drinks and candy that includes caffeine (including chocolate)
- High fiber foods: bran, oatmeal, fresh fruits, whole-grain breads, broccoli, corn and beans
If your nausea only lasts an hour or two, you may want to avoid eating and just take a few sips of water, juice or tea to prevent becoming dehydrated (excessive loss of fluids from your body). If nausea lasts longer, you will need to find ways to get the nutrients and fluids your body needs. Here are a few helpful tips to manage nausea:
- Try eating small meals or snacks frequently, rather than large meals
- Eat and drink foods at room temperature
- Eat bland foods
- If you cannot eat or drink very much, try a salty, bland food (such as pretzels), as the salt will help you retain bodily fluids
- Drink most of your fluids between meals; only drink enough to keep food moist at meals
- If you are vomiting, wait an hour or so and then try clear liquids. If you do not vomit, try a small amount of food from the Helpful Foods list.
- Nibble on dry crackers throughout the day
- Rinse your mouth frequently to rid your mouth of unpleasant tastes
- Avoid foods with strong or unpleasant odors (including during cooking)
- Rest often
- Distract yourself with calm activities, such as reading
- Try taking a slow walk; the fresh air might decrease your nausea
- Avoid clothes that press against your stomach and throat areas
If you are having difficulty eating or drinking enough to meet your nutritional needs, ask your nurse for a referral to a Roswell Park dietitian who can work with you to design a food plan that meets your needs.
When Should I Call My Doctor?
If you have nausea and/or vomiting, it is very important to stay hydrated and avoid dehydration. Dehydration can result in kidney failure, neurological symptoms, arthritis, skin problems, confusion, and disorientation. Severe dehydration leads to changes in your body’s chemistry, such as potentially life-threatening electrolyte imbalances. Call your doctor right away if you have any of the following:
- Nausea that is not responding to prescribed medication, lasts more than two days, and is interfering with your daily activities
- Severe stomach pain
- Blood in your vomit (may appear red or black)
- You cannot keep food, liquid, or anti-nausea medication in your stomach
- Vomiting three or more times per hour for more than eight hours, projectile vomiting (vomiting with extreme force), or vomiting with dizziness or confusion
- Weight loss of 2 lbs. or more in one day due to vomiting
For more information, ask you nurse for the Managing Nausea and Vomiting patient education brochure or find a copy in the Resource Center for Patients and Families, located on the 1st floor, inside the Sunflower Café.