Managing Nausea and Vomiting

The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.

• What Will I Learn By Reading This?
• What Is Nausea And Vomiting?
• Why Do I Have Nausea And Vomiting?
• When May I Have Nausea And Vomiting?
• Are There Medicines I Can Take To Help My Nausea And Vomiting?
• What Can I Do To Manage My Nausea And Vomiting?
• When Should I Call My Doctor?
• What Have I Learned By Reading This?
• Key Words

What Will I Learn By Reading This?

When you have chemotherapy (key-mo-ther-a-pee) to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. In this booklet you will learn:

• What nausea and vomiting are
• Why you have nausea and vomiting
• When you may have this side effect
• What medicines you can take to help with this side effect
• How to manage your nausea and vomiting
• When to call your doctor

It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.

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What Is Nausea And Vomiting?

Nausea and vomiting usually happen together but they can also happen alone. Nausea is an unpleasant feeling in the back of your throat and stomach. This feeling may cause you to vomit. Some words that people use to talk about nausea are “sick to my stomach” or “feeling queasy.” When you have nausea, you may also have some other symptoms (signs of being sick) like having more saliva in your mouth, feeling dizzy or light-headed, having a hard time swallowing, changes in your skin temperature, and your heart might beat faster.

Most people refer to vomiting as “throwing up.” Vomiting is when your stomach muscles tighten powerfully. This causes what is in your stomach to come up through your mouth. You can “throw up” without feeling any nausea.

Sometimes people also have retching. Retching is when you try to vomit but can’t bring anything up from your stomach. Other words people use to talk about retching are “gagging” or “having dry heaves.”.

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Why Do I Have Nausea And Vomiting?

Your brain tells you whether you have nausea and if you need to vomit. Many different things can tell your brain to make you “feel sick” (nausea) or to “throw up” (vomit). Smells, taste, anxiety, pain, or motion can cause you to feel sick or to throw up.

Nausea and vomiting are the second most common side effects of chemotherapy (the most common is feeling fatigue or tiredness). Most chemotherapy medicines will cause you to have nausea and vomiting. How much nausea and vomiting you have depends on:

• The kind of chemotherapy medicines you get
• The amount (or dose) of chemotherapy you get,
• How often you get your chemotherapy medicine
• If you get your chemotherapy medicine through an I.V. (medications that are given to you through a needle in your vein) or by mouth (orally)

If you are taking more than one chemotherapy medicine, you are more likely to have nausea or vomiting.

Before you start your chemotherapy speak with your doctor or health care team about what chemotherapy medicine you will be taking and if it may cause you to have nausea or vomiting. The good news is that there are many medicines that can help prevent or control your nausea and vomiting.

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When May I Have Nausea And Vomiting?

Side effects are different from person to person, and may be different from one treatment to the next. Nausea and vomiting can happen:

• Within the first few minutes to several hours after you get your chemotherapy. This is called acute nausea and vomiting. Acute nausea and vomiting goes away within the first 24 hours.
• Longer than the first 24 hours after you get your chemotherapy. This is called delayed vomiting. Delayed vomiting can last for several days.
• Before you get your chemotherapy treatment. This is called anticipatory (an-tis-uh-puh-tohr-ee) nausea or vomiting. This can happen when you remember that you had nausea and vomiting the last time you had your chemotherapy medicine. Your body remembers and you feel sick again even if you haven’t had your chemotherapy medicine.

Your nausea or vomiting may not bother you or it may be very bad and cause you to be unable to do things that are important to you. Remember there are medicines you can take that will help you feel better.

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Are There Medicines I Can Take To Help My Nausea And Vomiting?

Yes, there are. Today, there are many medicines you can take to prevent or control your nausea and vomiting. These medicines are called antinausea or antiemetics (an-tie-eh-meh-ticks). No medicine will control your nausea and vomiting all the time. This is because chemotherapy affects each person differently. Your doctor and health care team will:

• Find the best anti-nausea medicine for you.
• Watch you closely during and after your chemotherapy to see how much the anti-nausea medicine is helping you.
• Work with you to prevent your nausea and vomiting.

Keeping you from having nausea and vomiting is the goal. Most of the time you will start taking medicine to prevent nausea and vomiting before you start your chemotherapy. You will keep taking this medicine for as long as it is needed.

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What Can I Do To Manage My Nausea And Vomiting?

Just as every cancer patient’s treatment is different, the way each person responds to his treatment is also different. While one person may have nausea or vomiting, another may not. However, there are things you can do to help deal with this treatment side effect.

• Eat several small meals throughout the day rather than two or three large meals. For example, eat breakfast at 8 am, a snack at 10 am, lunch at noon, and another snack at 2 pm, and then dinner at 5 pm.
• Sip liquids one hour or more before or after meals rather than with meals.
• Eat and drink slowly.
• Eat foods that are high in carbohydrates, such as pasta, breads, cereals, and pancakes.
• Eating cold foods or foods at room temperature rather than hot foods may be more enjoyable because they have less smell.
• Keep crackers nearby and eat them when you get up in the morning to help curb feelings of nausea.
• Stay away from spicy foods such as chilies or foods made with chilies or hot sauce.
• Stay away from sweets, fried and fatty foods (like fried fish, fried chicken, French fries, ice cream, or high fat milk products), and acidic foods (like tomatoes and citrus fruits).
• Do not drink coffee, tea, or alcohol.
• Suck on mints or tart candies. Do not use tart candies if you have mouth sores (small cuts or ulcers that appear on your lips or mouth during your chemotherapy treatment).
• Stay away from odors that bother you, such as cooking smells, smoke, or perfumes.
• Wear loose-fitting clothes.
• Try not to eat your favorite foods on the days you get chemotherapy. Your nausea and vomiting may make you stop liking these foods.
• Breathe in deeply and slowly through your mouth when you feel sick.
• Rest but do not lie flat for at least two hours after you finish a meal.
• Speak to your doctor and health care team about medicines you can take to help you.
• If your doctor gives you an anti-nausea medicine, take it one hour before eating a meal. This will help you feel like eating.

Plan For Managing Your Nausea And Vomiting

• What anti-nausea medicine has your doctor given you?
• When do you need to take your anti-nausea medicine?
• What make you feel “sick to your stomach” or “like throwing up?”
• How do you get in touch with your doctor or health care team if you need help?

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When Should I Call My Doctor?

Your nausea and vomiting can be caused by other things besides your chemotherapy medicine. You should call your doctor if you:

• Continue to have nausea and vomiting even if you are taking anti-nausea medicine.
• Have nausea that keeps you from eating.
• Vomit four to five times in a 24-hour period of time.
• Feel bloated.
• Have pain or a swollen stomach before nausea or vomiting.
• What you throw up looks like coffee grounds.

If you have any of these signs talk to your doctor or health care team. There are medicines and treatments that can help you feel better. It is important that you talk to your doctor or health care team about any side effects you may have during or after your treatment. Your health care team can help treat these problems.

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What Have I Learned By Reading This?

You learned about:

• What nausea and vomiting are
• Why you have nausea and vomiting
• When you may have this side effect
• What medicines you can take to help with this side effect
• How to manage your nausea and vomiting
• When to call your doctor

If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.

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Key Words

• Acute nausea and vomiting: nausea and vomiting that happens several minutes to 24 hours after getting chemotherapy treatment.
• Amount: dose.
• Anticipatory nausea or vomiting: nausea or vomiting that happens before you get chemotherapy treatment.
• Antiemetics (or anti-nausea) (an-tie-eh-meh-ticks): type of medicine that prevents or controls nausea and vomiting from chemotherapy treatment.
• Anti-nausea (or antiemetic): type of medicine that prevents or controls nausea and vomiting from chemotherapy treatment.
• Chemotherapy (key-mo-ther-a-pee): a prostate cancer treatment, which treats your whole body with powerful anticancer medicines to kill many of your prostate cancer cells.
• Delayed vomiting: nausea and vomiting that occurs more 24 hours or more after getting chemotherapy treatment.
• Dose: amount of medicine you get.
• Fatigue: mental or physical tiredness.
• IV or intraveneous (in-tra-vee-nuhs) : medications that are given to you through a needle in your vein.
• Mouth sores: small cuts or ulcers that appear on your lips or mouth during your chemotherapy treatment.
• Nausea: an unpleasant feeling in the back of your throat and stomach that may cause you to vomit.
• Retching: when you try to vomit but can’t bring anything up from your stomach.
• Side effects: unwanted changes in your body caused by your prostate cancer treatment.
• Symptoms: a sign of being sick.
• Vomiting: a powerful tightening of your stomach muscles that causes the contents of your stomach to come up through your mouth; Throwing up.

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