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Treating Chemotherapy Nausea

Posted 12/26/2014

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  For most of us, the worst side effects of chemotherapy are hair loss and nausea--sometimes in one order and sometimes in the other. Over the course of my decades in this work, there has been enormous progress made on drugs to treat nausea. I remember when we handed patients little basins as they headed home, knowing that some of them wouldn't even get to their cars before the vomiting began. It was truly horrific; all those fables of people spending 24 hours on the bathroom floor were all too true. Now, blessedly, many people never once vomit through the course of chemotherapy treatment. Some people don't even, thanks to drugs, experience any nausea, but others do still have persistent, unpleasant low grade nausea that the drugs don't eliminate.

  There are a number of non-drug suggestions that sometimes help with that yucky queasy feeling. Nibbling and preventing an empty stomach usually helps. Although eating something won't necessarily make you feel better, you likely feel worse if you don't eat. Carbs often go down and sit there better than most other things; there is a joke about the ideal chemo meal being mashed potatoes, white bread, and mac and cheese. Saltines, of course; I kept a package by my bed and ate a few first thing in the morning, before even moving my body. Some people swear by chicken broth or Coca Cola.

  And then there is ginger: warm ginger ale (that some people prefer after the bubbles have gone), ginger tea, candied ginger and a wonderful old Indian remedy: keep a jar of equal portions of grated fresh ginger, grated lemon peel in the refrigerator. Add honey/sugar to taste and swallow either by the spoonful or stir into tea.

  This is an interesting article from Cancer Network about the value of ginger:

Ginger for Preventing Chemo-Induced Nausea: What Is the Evidence?

One of the more frequent questions I am asked by patients is whether
they can continue to take, or should start taking, certain vitamins,
herbals, or other complementary medications with their cancer therapy.
It is estimated that at least 60% of cancer patients engage in
complementary or alternative medical practices and with an increase in
availability of both products and information, this is likely on the rise.
Limitations in quality literature and concerns over lack of US Food and
Drug Administration (FDA) oversight, along with questionable product
purity and accurate labeling, have made many healthcare professionals
rightfully hesitant to make helpful recommendations to patients beyond
“use at your own risk.”
Fortunately, more research initiatives, including the National Institutes of
Health’s National Center for Complementary and Alternative Medicine
(NCCAM), are becoming available to assist practitioners in helping patients make informed
decisions about these treatments. My preferred site for assessing risk and benefit from herbal
products and other dietary supplements is the Memorial Sloan Kettering Cancer Center database
available here. The free-to-access website is easily searchable, and supplements general
information with excellent clinical summaries, discussion of pharmacokinetics, and herb-drug
interactions and safety. The information is all cited, with PubMed links accessible, and literature
summaries and critiques are often provided.


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