The Causes Chemotherapy-Induced Nausea and Vomiting
Chemotherapy drugs impact specific areas of the brain and digestive system, leading to CINV. These drugs can trigger the release of neurotransmitters like serotonin, which then activate the vomiting centre in the brain. Additionally, chemotherapy can irritate the stomach lining, resulting in nausea and vomiting. Patients’ responses to chemotherapy differ, with some drugs being more likely to cause CINV than others.
Symptoms of Chemotherapy-Induced Nausea and Vomiting
Patients experiencing CINV may face various symptoms, including:
- Nausea: A queasy or sick feeling in the stomach
- Vomiting: Frequent episodes that may occur without warning
- Loss of appetite
- Fatigue or weakness: This results from dehydration and nutrient loss
These symptoms can manifest during or after chemotherapy treatments and may last several hours or days.
The Different Types of Chemo-Related Nausea and Vomiting
- Acute CINV: Occurs within the first 24 hours after chemotherapy, usually peaking within the first few hours.
- Delayed CINV: Happens more than 24 hours after chemotherapy, often peaking two to three days after treatment and lasting up to a week.
- Anticipatory CINV: Develops before chemotherapy begins as a conditioned response from previous nausea and vomiting experiences. The brain associates chemotherapy with these symptoms, triggering them before treatment starts.
- Breakthrough CINV: Occurs despite taking medication to prevent nausea and vomiting, necessitating additional treatment for management.
- Refractory CINV: Refers to CINV that does not respond to previously effective treatments.
Treatments for Nausea and Vomiting
Doctors primarily treat CINV with antiemetic medications, specifically designed to prevent or reduce nausea and vomiting. Commonly used medications include serotonin receptor antagonists (like ondansetron), NK1 receptor antagonists, and corticosteroids. Healthcare providers may prescribe these alone or in combination, based on the severity of symptoms. Dietary adjustments, proper hydration, and relaxation techniques can also contribute to managing CINV.