Nausea: How to curb this cancer treatment side effect quickly

One of the most common side effects of cancer treatment is nausea. It can be caused by chemotherapy, radiation therapy and even anesthesia. Dehydration and constipation can play a big part, too.

Several medications are available now to help you manage nausea. But is there anything else you can do to control this uncomfortable and unpleasant side effect? Which one works the fastest?

We spoke with Clinical Dietitian Trisha Rosemond for answers.

Why do chemotherapy and radiation therapy even cause nausea?

Chemotherapy is a systemic treatment, which means it affects your whole body. And many chemotherapy drugs are designed to attack fast-growing cells, like cancer. But some types of healthy cells grow just as quickly as cancerous ones do. One of those lines the entire gastrointestinal tract. And when that system becomes irritated or inflamed, nausea can be the result.

Radiation therapy is a site-specific treatment, meaning it tends to only affect the area being irradiated. But when your central nervous system gets involved, that can cause nausea, too. That’s why patients who are being treated with radiation therapy for brain and spine tumors are more likely to see nausea as a side effect.

What else can make cancer patients feel nauseous?

A lot of people don’t realize that dehydration and constipation can contribute to nausea — and that one can lead to the other, or even amplify it. So, it's vital to stay adequately hydrated.

When your body doesn’t get enough water, your bowels slow down. This causes stools to become firmer and harder to pass. If your body isn’t eliminating solid waste regularly, you can start to feel “backed up,” because nothing is moving or going out. So, whenever you eat, it can feel like there’s no room for anything new, and that can trigger nausea — and even vomiting.

Sometimes, constipation can be a side effect of pain medicine or anti-nausea medication. So, it’s important to discuss these issues with your care team as soon as you notice them. That way, they can suggest alternatives.

How can my doctor help me manage nausea?

Medication

Several medications are available to help you control nausea. The main one — and probably the most frequently prescribed to cancer patients — is ondansetron (Zofran). But if that doesn’t work on its own, or you just can’t tolerate it, doctors may add or substitute an additional medication, such as prochlorperazine (Compazine) or promethazine (Phenergan).

Complementary therapies

To control nausea without medication, you can try either acupuncture or acupressure. Both are based on an ancient form of Chinese medicine that stimulates certain parts of the body to foster healing.

Acupuncture uses tiny needles placed strategically around the body, while acupressure achieves the same results using just the fingertips. Both can be effective against nausea as well as other side effects, such as pain, neuropathy and even fatigue.

If you're a UT MD Anderson patient, ask your care team for a referral or contact the Integrative Medicine Center for details,.

Is there anything else I can do to manage nausea myself?

Yes. Sometimes, simple lifestyle changes can make a big difference:

• Stay hydrated. Drinking enough fluid doesn’t just help you fight nausea. It also counteracts fatigue, kidney damage, and other side effects.
• Eat small, frequent meals throughout the day. They put less strain on your stomach than trying to finish a big meal if it’s already feeling unsettled.
• Avoid spicy, fried, or greasy foods. Fat takes longer to digest than protein and carbohydrates, so anything containing a lot of added fat will sit in your stomach for longer. If you’re already nauseous, the slower transit time can make you more prone to vomit.
• Try tart foods, such as lemons or pickles. These can be especially useful when patients experience changes in the way food and beverages taste. Some patients squeeze lemon juice into their water to make it easier to drink. Others suck on the lemon wedge itself.
• Try cold foods. Just the smell of certain foods can be enough to make some cancer patients feel queasy. So, if food or cooking odors trigger a gag reflex in you, consider eating more cold foods, or not heating leftovers before you eat them.
• Consider meal replacement shakes. We prefer patients to get as much of their nourishment as possible from real food, but if your appetite is poor, you’re losing a lot of weight, or you’re having a hard time swallowing, meal replacement shakes might make sense for you. You can add flavor or texture by blending in fresh fruits, yogurt, ice cream or even ice cubes.

What stops nausea the fastest?

The strategies above are best for long-term nausea management. For more immediate relief, try these three options.

Crackers or dry toast

A staple of the BRAT diet (which stands for bananas, rice, applesauce and toast), crackers and dry toast are simple carbohydrates that are easily digested and absorbed by the stomach. An empty stomach can make nausea feel even worse, so just getting a little something in there can help. Avoid slathering butter, cream cheese, nut butter or seed butter on your toast, though. Fats take longer than carbohydrates to digest, so it’s best to keep the toast dry. 

Flat, clear soft drinks

Carbonated drinks, such as lemon-lime-flavored soda, can sometimes help settle an upset stomach. To reduce burping, open the can or bottle and let it sit out on the counter for about 10 minutes before drinking it. This will release some of the carbonation. Avoid the darker cola drinks, though; many contain caffeine, which is an irritant to the gastrointestinal tract. If it's hard for you to get enough fluids, try taking small sips throughout the day.

Ginger root

Ginger has been used as a natural remedy to settle upset stomachs for years. It has a very distinct and potent flavor, though, so some people can’t tolerate it. If you like the taste, there are many ways you can use it. You can chew candied ginger, drink ginger ale, or even add some sliced, fresh ginger root to a vegetable stir fry. You can also peel and cut a piece about the size of your thumb into slivers and then boil it in water for a few minutes or add it to your tea and let it steep alongside the leaves.

Who can I contact for more help with nausea?

If you're still struggling to get enough calories or maintain a balanced diet, ask your care team and ask for help. UT MD Anderson patients may also request a referral to one of our clinical dietitians, who can make recommendations based on your specific situation.

Request an appointment at UT MD Anderson online or call 1-877-632-6789.