Treatment Side Effects - Nausea and Vomiting

Nausea and vomiting are common side effects from many lung cancer treatments, including several chemotherapy drugs and targeted therapies.

Nausea is an unpleasant queasy sensation that may be felt in the stomach, abdomen, or back of the throat and may or may not lead to the urge to vomit. Vomiting is throwing up the contents of the stomach through the mouth. Nausea and vomiting may be caused by viral infections, bacteria in food, or as a side effect of cancer treatment.^1-3

In addition to being distressing, nausea and vomiting can be a serious side effect of cancer treatment, causing dehydration and weakening of the patient. There are several techniques and medications that can help manage nausea and vomiting from cancer treatment.³

Nausea and vomiting from cancer treatment

Chemotherapy drugs work by targeting rapidly dividing cells, such as cancer cells. Because chemotherapy drugs attack all cells that are dividing quickly, they affect cancer cells as well as normal cells that divide quickly, such as cells in the bone marrow, the lining of the mouth and intestines, and hair follicles.²

Targeted therapy focuses on key features present in cancer cells, which hopefully provides treatment with less effect on normal cells. However, targeted therapies still can cause side effects. Side effects are specific to the medication given, but some treatments can cause nausea and vomiting.³

Radiation therapy may also cause nausea and vomiting, particularly if the radiation therapy is directed to a point on the body where the digestive organs are also found.³

Some people may be more susceptible to experiencing nausea and vomiting from cancer treatment, including those who:³

• Are female
• Are younger than 50 years of age
• Have had nausea and vomiting from chemotherapy in the past
• Have had a history of motion sickness
• Have had a history of morning sickness
• Are dehydrated or malnourished
• Have had recent surgery or radiation therapy

Medication for nausea and vomiting

Fortunately, there are several anti-nausea medications that can be given to patients undergoing cancer treatment to prevent nausea and vomiting. Some of these medications may be given prior to a chemotherapy treatment, while others may be given following treatment to prevent delayed nausea and vomiting. Medications used to prevent nausea and vomiting include:³

• Phenothiazines, such as prochlorperazine
• Butyrophenones, such as droperidol and haloperidol
• Substituted benzamides, such as metoclopramide
• Serotonin receptor antagonists, such as dolasetron, granisetron, ondansetron, and palonosetron
• Substance P/NK-1 antagonists, such as aprepitant, fosaprepitant, and netupitant
• Corticosteroids, such as dexamethasone and methylprednisolone
• Benzodiazepines, such as alprazolam, lorazepam, and midazolam
• Antipsychotic/monoamine antagonists, such as olanzapine
• Cannabinoids, such as marijuana and nabilone

Complementary therapies

In addition to medication, many patients find that complementary therapies can help ease or prevent nausea and vomiting, including acupuncture, acupressure, hypnosis, and relaxation techniques. Dietary modifications may also help, such as drinking clear liquids (like ginger ale, apple juice, broth, or tea), sucking on hard candies, and eating bland foods (like toast or crackers).^2,3