Sickness (nausea and vomiting)

What is it? 

Feeling sick or getting sick because of your cancer or cancer treatments.  

What causes it?

• The cancer itself
• Medications such as chemotherapy drugs or painkillers
• Constipation
• An imbalance of minerals and salts (electrolytes) in the blood
• Infections
• Anxiety
• The expectation of vomiting due to past vomiting in the same setting (this is called anticipatory vomiting)
• Other diseases or illnesses

What are the symptoms?

• Feeling sick or that you want to vomit
• Getting sick (vomiting)
• Increased saliva (spit)
• Dizziness or light-headedness
• Trouble swallowing
• Skin temperature changes
• Fast heart rate

How is nausea treated?

• Anti-sickness drugs (anti-emetics). There are various anti-sickness drugs to help with nausea and vomiting. 
• If your chemotherapy or other drug treatment is likely to make you feel sick, your doctor will give you medicine to prevent it before your treatment. You will also be given tablets to take at home after treatment. It’s important to take these drugs as they are prescribed. Anti-sickness drugs work better when you take them regularly, or before you start to feel sick.
• Tell your doctor if the medicine isn’t helping – they can prescribe a different one. You may need more than one medication. 
• Steroids. Low doses of steroids can help to reduce nausea and vomiting too. Given in this way, the steroids will not do any lasting harm. They can make you feel better overall and help with any loss of appetite too. 

What should I do if I have symptoms?

Talk to your doctor if you’re feeling sick. There are medicines to help. Take them as directed.

Tips to help with nausea and vomiting

• Take any anti-sickness as they are prescribed. Anti-sickness drugs work better when you take them regularly, or before you start to feel sick. 
• If chemotherapy is causing your symptoms, try to find out when is best for you to eat and drink before treatment. Some people need a light snack, while others feel better with an empty stomach.
• If nausea or vomiting are stopping you from eating enough, tell your medical team. They can give you advice to help and refer you to a dietitian, if necessary.
• Eat before you get hungry, as hunger can make nausea worse.
• Eating little and often may help, rather than having 3 bigger meals. Eat slowly and chew food well.
• If you are sensitive to the smell of cooking, try using ready meals or avoid being in the kitchen while food cooks – If you have a friend or family member, ask them to help with cooking.
• Sip on clear liquids to avoid getting dehydrated between meals.
• Take plenty of nourishing fluids if you miss a meal or two.
• Rest after eating.
• Try the following foods and drinks, as they might help:

  – Cold, bland foods like yoghurt, desserts, boiled potatoes, rice, noodles, breakfast cereal or cheese

  – Dry food like toast, scones, crackers or breakfast cereals. This can help in the morning before you get up

  – Herbal teas like mint

  – Foods containing ginger, such as ginger ale or tea, ginger nut biscuits, ginger cake or fresh ginger in hot water

• Some people find the following foods make nausea worse:

  – Fatty, greasy or fried foods

  – Spicy foods

  – Very sugary foods

  – Foods with a strong smell, like onions and garlic

• Eat foods that you like or are able to tolerate. When your nausea subsides, try other foods for variety (if you can tolerate them).
• Some people find relaxation exercises, aromatherapy or meditation help with their nausea. Check with your medical team first, to make sure the therapy you’re thinking about is safe for you.

Ongoing vomiting can lead to dehydration. You should contact your medical team for advice if:

• You can’t keep fluids down.
• You can’t take the medicines you need.
• You’re vomiting for 24 hours or longer.