Nausea in Patients With Cancer

Nausea is common in people with cancer. It can be caused by the cancer itself, treatment, or other factors. 

Severe or prolonged nausea can take a toll on your appetite, energy, and well-being. Medications, diet, and lifestyle strategies can help manage nausea and improve your quality of life.

Nausea is the sensation of feeling as if you might vomit.  It can lead to vomiting, but not always. 

Nausea affects each person differently. You might experience:

• Loss of appetite that can last for a day or 2 to several weeks or months.
• Morning nausea that improves through the day.
• Nausea after eating, but settles between meals.
• Nausea just before mealtimes or before certain events in the day (anticipatory nausea) that then resolves after the mealtime or event.
• Persistent or occasional nausea with or without vomiting.
• A metallic taste that accompanies nausea.
• Feeling clammy or sweaty.

Medicines called antiemetics can help prevent or control nausea and vomiting. The medicine your healthcare team recommends will depend on what is causing your nausea and the cancer treatment you are receiving. Sometimes, more than one type of anti-sickness medicine is used. Take these medicines exactly as your healthcare team advises, and let them know if your nausea is not improving.

Sometimes these medications cause mild side effects such as fatigue, dizziness, headaches, or constipation. Taking them with food can help. Tell your doctor if side effects are bothersome. 

When used alongside medications, diet, lifestyle, and other supportive strategies can be a helpful part of your strategy while you experience cancer nausea.

• Eat smaller, higher-calorie meals and avoid heavy, greasy foods and those with strong flavours or smells. 
• Your medical team may recommend using oral nutritional supplements (ONS)* if you struggle to meet your nutritional needs with normal food/normal diet alone. These are specially designed to help patients meet their specific nutritional needs when normal food cannot, with, for instance, ONS providing significant energy and protein quantities in very small volumes. They can come in the form of milkshakes, juices, soups, smoothies, puddings and more. They must always be used under the guidance of a medical professional.
• Stay hydrated by sipping clear liquids, such as juices, broth, teas, and hydration beverages throughout the day.
• Suck on sour, ginger, or peppermint sweets or try peppermint or ginger tea. Ginger cordial/ ale/ beer can sometimes help too. 
• Some people find certain scents, such as peppermint or lemon, helpful, although there is limited evidence that aromatherapy reduces cancer-related nausea. 

*Oral nutritional supplements are food for special medical purposes and must be used under medical supervision.

Contact your healthcare team if nausea or vomiting is making it difficult to eat or drink, if you are losing weight, or if your anti-nausea medicine is not working. Seek urgent medical advice if you have severe abdominal pain, signs of severe dehydration, or blood in your vomit. 

As a carer, you can help someone with nausea by: 

• Tracking their symptoms to help identify and avoid triggers.
• Assisting with meals to ensure access to nourishing food. This might include preparing meals as well as keeping the person with cancer-related-nausea away while preparing meals and cooking (so smells and the sight of food don't cause nausea).
• Encouraging regular fluids to prevent dehydration.
• Helping manage their medication.
• Offering emotional support and reassurance.

Before cancer treatment starts, ask your doctor about your risk of nausea and how to manage it if and when it happens. These questions can guide your conversation:

• What anti-sickness drug is best for me?
• Should I take it before symptoms start, or is it helpful during bouts of nausea?
• What should I do if it stops working?
• What foods/meals should I focus on? 
• When should I call urgently?

Nausea is a common side effect of cancer and some cancer treatments, and medicines can often help prevent or manage it. If nausea makes it difficult to eat or drink enough, your healthcare team can also advise you on ways to support your nutritional needs.

Talk to your healthcare team before treatment starts, so you have a plan in place from the start. With the right support, nausea does not have to disrupt your treatment or life.