A client with cancer experiences severe nausea and vomiting from chemotherapy

Frequent vomiting can be dangerous because it can lead to dehydration. It can also lead to inhaling food or liquids, which can cause choking and other problems.

Be sure to tell your cancer care team if you have nausea or are vomiting because there are medicines that can help. These medicines should be taken on a regular schedule, or as needed, as prescribed by your doctor. And if a certain drug doesn’t work, your cancer care team may be able to recommend another one. It may take a few tries to find the medicines that work best for you. Talk with your cancer care team about what's causing your nausea and vomiting and what you can do about it.

What to look for

• Changes in eating habits
• Foul mouth odor
• Yellow or green foul-smelling fluids on bedclothes
• Feeling queasy or having an upset stomach
• Increased saliva, clamminess, and sweating that may come before vomiting

What the patient can do

For nausea

• Eat the foods you like and those that sound good to you. For example, some people develop a dislike for red meat and meat broths during treatment. In that case, try other protein sources, such as fish, chicken, beans, and nuts.
• If the nausea only happens between meals, keep something in your stomach. Eat frequent, small snacks throughout the day. Snack ideas include smoothies, trail mix, and fruit.
• Do not skip meals or snacks. If your stomach is empty, your nausea might be worse.
• On chemotherapy treatment days, eat a small meal or snack before treatment.
• Try to avoid eating your favorite foods when you have nausea. If you eat foods you like when you are nauseated, you could find them unappealing when treatment is over because you associated them with feeling sick.
• Sip liquids slowly throughout the day. You may find it easier to tolerate cold and clear liquids (Clear liquids are those you can see through, such as ginger ale, apple juice, broth, tea, etc.)
• Also try popsicles or gelatin. Suck on hard candy with pleasant smells, such as lemon drops or mints, to help get rid of bad tastes. (Don’t eat tart candies if you have mouth sores.)
• Eat bland foods, such as dry toast and crackers.
• Eat food cold or at room temperature to decrease its smell and taste. 
• Avoid fatty, fried, spicy, or very sweet foods.
• Try small amounts of foods high in calories that are easy to eat (such as pudding, ice cream, sherbets, yogurt, and milkshakes) several times a day. 
• Use butter, oils, syrups, sauces, and milk in foods to raise calories. 
• Avoid low-fat foods unless fats upset your stomach or cause other problems.
• Tart or sour foods may be easier to keep down (unless 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.
• Tell your cancer team about the nausea, because there are many drugs that can help it.
• Take your anti-nausea medicine at the first signs of nausea to help prevent vomiting.
• While waiting for your nausea medicine to work, relax and take slow, deep breaths.
• Try some non-drug treatments for nausea and vomiting

Complementary or alternative (non-drug) treatments for nausea and vomiting

Anti-nausea and vomiting drugs (anti-emetics) are the main treatments for nausea and vomiting, but some non-drug treatments can also be used. These involve using your mind and body with the help of a qualified therapist.

Non-drug treatments may be used alone for mild nausea, and are often helpful for anticipatory nausea and vomiting. These methods can be used with anti-nausea and vomiting medicines for a person whose cancer treatment is likely to cause nausea and vomiting. If you’d like to try one or more of these methods, ask a member of your cancer care team if the methods are safe for you and to refer you to a therapist trained in these techniques.

These methods try to decrease nausea and vomiting by:

• Helping you feel relaxed
• Distracting you from what’s going on
• Helping you feel in control
• Making you feel less helpless

Below are some non-drug methods that have helped some people. Most of them have few or no side effects. Before using any of these treatments, check with your cancer care team to see if they are safe for you. Ask your cancer care team what non-drug treatments they may have available and which ones they can recommend.

Hypnosis

Hypnosis can be used to make behavior changes to control nausea and vomiting. It creates a state of intense attention, willingness, and readiness to accept an idea. It is done by a trained specialist.

Relaxation techniques

Relaxation techniques such as meditation (focusing the mind), breathing exercises, or progressive muscle relaxation (tensing and relaxing the muscles) can help decrease nausea and vomiting.

Biofeedback

Biofeedback helps people reach a state of relaxation. It uses monitoring devices to help people gain conscious control over physical processes that are usually controlled automatically. Using biofeedback, a person learns to control a certain physical response of the body, such as nausea and vomiting. This is done by tuning in to the moment-to-moment body changes that are linked to the physical response. For example, biofeedback can be used to prevent skin temperature changes, such as those that often happen before nausea and vomiting starts. Biofeedback alone has not been found to work as well as for nausea and vomiting as the combination of biofeedback and progressive muscle relaxation.

Guided imagery

Guided imagery lets people mentally remove themselves from the treatment center and imagine that they are in a place that’s relaxing for them. The place can be a vacation spot, a room at home, or some other safe or pleasant place. While trying to imagine what they usually feel, hear, see, and taste in the pleasant place, some people can mentally block the nausea and vomiting.

Systematic desensitization

Systematic desensitization helps people learn how to imagine an anxiety-producing situation (such as nausea and vomiting) and reduce the anxiety related to the situation. In most cases, what a person can imagine without anxiety, they can then experience in the real world without anxiety.

Acupuncture or acupressure

Acupuncture is a traditional Chinese technique in which very thin needles are put into the skin. There are a number of different acupuncture techniques, including some that use pressure rather than needles (acupressure). Acupuncture or acupressure can help with nausea.

Music therapy

Specially trained health professionals use music to help promote healing.. Music therapists may use different methods with each person, depending on that person’s needs and abilities. There’s some evidence that, when used with standard treatment, music therapy can help to reduce nausea and vomiting due to chemo.

What to eat or not eat on days that you have nausea*

Eat

Foods that may cause problems

Protein foods

Boiled or baked meat, fish, and poultry; cold meat or fish salad

Well cooked eggs

Cream soups made with low-fat milk

Non-fat yogurt

Juice-type commercial protein supplements (for example, Ensure Clear) blended with ice and eaten with a spoon

Cottage cheese

Cold sandwiches

Fatty and fried meats, like sausage or bacon

Fried eggs

Milk shakes (unless made with low-fat milk and ice cream)

Breads, cereals, rice, and pasta

Saltines, soda crackers, bread, toast, pretzels, cold cereal, English muffins, bagels

Plain noodles, white rice 

Doughnuts, pastries, waffles, pancakes, muffins 

Fruits and vegetables

Potatoes (baked, boiled, or mashed)

Canned or fresh fruits, vegetables as tolerated (do not eat if appetite is poor or nausea is severe)

Potato chips, fried potatoes such as french fries or hash browns

Breaded, fried, or creamed vegetables; vegetables with strong odor 

Drinks, desserts, and other foods

Ginger ale, cold fruit drinks, caffeine-free and noncarbonated soft drinks such as fruit punch and sport drinks, caffeine-free iced tea

What helps chemotherapy

Which class of drugs is helpful for nausea and vomiting associated with chemotherapy?

How chemotherapy causes nausea and vomiting?

Which is the most beneficial nursing action to prevent or minimize chemotherapy associated nausea and vomiting?