YOU MAY EXPERIENCE NAUSEA AND VOMITING WHILE YOU ARE GOING THROUGH CANCER TREATMENT. Nausea is the feeling of being queasy or sick to your stomach and can happen with or without vomiting. These side effects can vary widely and depend on the person and the type of treatment received. Some people going through cancer treatment have nausea and vomiting, while others have only nausea. Others have neither.

The most common causes of nausea and vomiting are chemotherapy and radiation therapy to the stomach, abdomen, or brain. Other causes of nausea and vomiting may include recovery from cancer-related surgery, pain, medications, illness, or being overly tired or anxious.

If your cancer treatment is causing nausea or vomiting, controlling it with the proper medication is very important. If you are prescribed anti-nausea medication, take it as directed. Many anti-nausea medications are meant to be taken on a schedule, not just when nausea occurs. If you are taking medicine as directed and are still nauseated, talk to your doctor about whether a different medication might be more beneficial. No matter the cause of your nausea and vomiting, this may be a time of trial and error as you and your doctor work to find the best way to deal with these side effects.

Managing Vomiting

If you are vomiting and cannot keep liquids down, dehydration can occur easily. Though it may be difficult, try to take in small amounts of liquid throughout the day to keep your body hydrated. Try sucking on ice chips or juice bars; eating small amounts of gelatin, sherbet, fruit ices, or slushies; or sipping clear liquids such as water, fruit juices (like apple or white grape juice), cool broths, sports drinks (oral rehydration drinks), coconut water, decaffeinated or herbal teas, and decaffeinated sodas (like ginger ale and lemon-lime) that have gone flat. Your doctor may be able to prescribe medicines in the form of dissolving tablets or suppositories.

Managing Nausea

Here are some tips that may help you manage nausea:

  Eat a small, light meal or snack before chemotherapy treatment.

  Focus on bland, easy-to-digest foods on scheduled treatment days.

  Sip on cool, cold, or room temperature clear liquids in small amounts.

  Keep something in your stomach by eating small, frequent snacks throughout the day —about every three hours. Snack ideas include smoothies, trail mix, fruit, or half a sandwich.

  Try starchy foods like pretzels, crackers, noodles, rice, potatoes, bagels, cereal, and toast.

  Eat food cool or cold to decrease its smell and taste. Sometimes strong odors and tastes can trigger nausea.

  Suck on frozen fruit, such as watermelon, peaches, grapes, berries, and cherries or tart hard candies, such as lemon drops (unless they irritate your mouth).

  Avoid eating your favorite foods when you do not feel well. If you eat your favorite foods when you are nauseated, you may associate them with feeling sick and find them unappealing when treatment is over.

  Avoid high-fat, greasy, spicy, and overly sweet foods.

  Tart or sour foods may be easier to keep down (but avoid if you have mouth sores).

  Try to rest quietly while sitting upright for at least an hour after each meal.

  Distract yourself with soft music, a favorite TV program, or the company of others.

  Avoid taking medications (especially pain medications) on an empty stomach unless the pharmacist directs you otherwise.

  Keep your mouth clean. Brush your teeth (with a soft bristle toothbrush) and rinse your mouth frequently with the homemade mouth rinse found on page 160 of this book.

  If your nausea is triggered by overtiredness or anxiety, ask your health care team for ideas for relaxation or coping techniques.

Managing Sensitivity to Smells

Smells can trigger nausea in some people or make it worse. People may not be aware that smells can make nausea worse. If certain smells bother you (such as perfumes, colognes, air fresheners, candles, etc.), explain their effect and ask for others’ understanding. These additional tips can help you manage nausea caused by food or other aromas:

THE CLEAR LIQUID DIET

Clear liquids typically contain a small amount of calories and some electrolytes (sodium and potassium). Clear liquids are easy to digest and contain almost no fiber. These foods are typically allowed in a clear liquid diet:

Water (plain, carbonated, or flavored)

Clear fruit juices, such as white grape, cranberry, cranberry-apple, apple

Lemonade, limeade, and orange juice that is strained, with no pulp remaining

Clear sports drinks

Oral rehydration solutions (see recipes on pages 70–71)

Clear carbonated beverages, such as lemon-lime soda or ginger ale

Clear protein-containing nutrition supplements, such as Ensure Enlive or Boost Breeze

Broth, bouillon, or consommé

Decaffeinated or herbal tea

Decaffeinated coffee with no milk or cream (honey and sugar are okay)

Gelatin

Fruit ices made without fruit chunks or milk

Popsicles or frozen ice pops

Clear hard candy, such as lemon drops, root beer barrels, lollipops

  If the smell of food bothers you, try eating cold foods. Foods that are served cool or cold often have less odor and are milder tasting. In contrast, foods served hot or simmering often have stronger odors.

  Choose foods that do not need to be cooked, such as cereal and milk, cheese and crackers, a sandwich, gelatin, or pudding.

  Reheat foods in the microwave where cooking odors are contained, rather than simmering or cooking foods on top of the stove. Go to a different part of the house when cooking is happening, or ask others preparing food in your home to grill outdoors or use a slow cooker on the back porch or in the garage.

  Try using a straw for cold drinks or a covered cup or mug for soups to block odors.

  Eat in a well-ventilated area. Avoid eating in rooms that are stuffy or too warm. If someone else is cooking for you or bringing food, ask that they remove any food covers to release aromas before entering your room or eating area.

CONTACT YOUR DOCTOR IN THESE SITUATIONS:

  You vomit blood or material that looks like coffee grounds.

  You think you have inhaled vomit.

  You vomit more than three times an hour for three or more hours.

  You cannot consume more than four cups of liquid or ice chips in a 24-hour period.

  You are unable to eat food for more than two days.

  You are weak, lightheaded, or dizzy when changing position or standing up.

  You are unable to take medications as directed.

For more information about managing nausea and vomiting, visit the American Cancer Society website at cancer.org or call 800-227-2345.