Understanding nausea and vomiting

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on April 29, 2022.

Nausea and vomiting are among the most prevalent side effects stemming from certain cancer treatment, as well as certain cancers.

Vomiting may lead to side effects like dehydration, and affect your eating plans and weight management if it gets out of control. Because of this, you and your cancer care team should discuss nausea and vomiting—and take steps to manage them as an important part of your care plan.

Why nausea and vomiting happen

Sometimes, nausea and vomiting may occur from the cancer itself, such as those of the gastrointestinal tract such as stomach cancer, or from tumors in the brain and liver. But most often, they’re side effects of treatment.

The severity of symptoms depends on many factors, such as your specific cancer treatment and whether you’re more prone to nausea and vomiting in general. For some, just going back to the same setting where an episode of nausea and/or vomiting occurred triggers a repeat event. This is called anticipatory nausea and vomiting. The best way to help with this is to make sure your concerns are addressed after the first episode.

Certain chemotherapy medications may cause more severe symptoms than others. Your care team is familiar with their potential side effects, so they’ll usually have a specific plan for controlling nausea and vomiting built into your treatment. In fact, chemotherapy medications are classified based on their potential to cause nausea and vomiting, and anti-nausea meds, called antiemetics, are chosen based on this classification.

Adults are typically given a combination of two, three or four different antiemetics to prevent nausea and vomiting, depending on which type of treatment is at hand.

Make sure you take your medication as prescribed, and don’t skip doses. Tell your care team if the first medications for nausea and vomiting aren’t helping. You may have to try a few different ones to find what ultimately works for you.

Radiation therapy that targets just one area of your body usually won’t make you experience nausea and vomiting. However, these may occur if the radiation is delivered over large areas or targeted to the gastrointestinal tract, liver or brain. Bigger doses of radiation may cause more issues than smaller doses, as can how often you’re getting radiation treatment. The more frequent your appointments, the greater the risk. As with chemotherapy, your doctor may prescribe medications to minimize these effects.

How to manage or prevent nausea and vomiting

If medications aren’t helping enough, or if you’d like to try other therapies, there are many available. Just make sure to let your care team know first, especially in the case of herbals, to be sure they won’t interfere with your treatment or have any other negative effects.

Acupressure and acupuncture: Both of these modalities have shown to be effective in managing nausea. With acupuncture, very thin needles are placed in the skin in specific areas based on the type of result you want. Acupressure has similar benefits, but instead of needles, pressure is applied to specific points on the body.

Relaxation therapies: Mind-body practices such as mindfulness, meditation, breathing exercises and yoga may help decrease your symptoms. Some people also find hypnosis helpful when it’s administered by a trained professional.

Herbals: Ginger and peppermint products provide a natural way to help with nausea. These may include teas, hard candies or chews. If ingesting them isn’t recommended by your care team, you may be able to get soothing benefits by inhaling the scent of ginger or peppermint.

Consult with an oncology dietitian: Oncology dietitians are not only experts in nutrition, but also in answering the unique needs of cancer patients. If your symptoms are putting you at risk for weight loss or nutrient deficiencies, one of these specialists may create a diet plan, focusing on foods that won’t worsen symptoms.

Tips for eating despite nausea

When you’re able to eat, these steps may help prevent or lessen nausea and vomiting.

Adjust the timing of your meals: When you’re experiencing nausea and/or vomiting, you may think it’s easier to just skip meals, but often nausea may occur if you don’t have food in your stomach. It may help you feel better if you have small meals throughout the day, about every two hours.

Make different food choices: Bland foods such as Jell-O, toast and crackers may help alleviate symptoms. Spicy, fatty or salty foods may make nausea worse. You may find that you tolerate cold foods better than hot ones. Also, try to modify the consistency and taste of your food to see if these adjustments keep your symptoms away.

Eat more calorie-dense foods: Calorie-dense foods deliver nutrition in smaller packages when you can’t stomach eating the volume you used to. Olive and other plant-based oils provide extra calories and healthy fats. Many proteins are nourishing and calorie-dense, such as full-fat yogurt and chicken breast. Your care team may say it’s fine to splurge on thick shakes (add a banana), puddings and ice cream.

Stay hydrated: This is especially important if you’ve been vomiting a lot and losing fluids. Sip liquids throughout the day, such as ginger ale, broths, tea (hot or iced, herbal or caffeinated) or cool water. Cold liquids may be better tolerated than hot ones. Popsicles are a good choice—frozen fruit bars may taste less sweet if that’s a problem.

Be kind, gentle and patient with yourself and your body. You don’t have to grin and bear nausea and vomiting. Together, you and your team may craft a plan to treat, or even prevent, them.

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