Chemotherapy-Induced Nausea and Vomiting

Abstract

Despite treatment advances, nausea and vomiting, especially anticipatory nausea and vomiting, delayed nausea and vomiting and nausea alone, are still the most common, expected and feared side effects among patients receiving chemotherapy. Of the 70 to 80% of cancer patients who experience chemotherapy-induced nausea and vomiting many will delay or refuse future chemotherapy treatments and contemplate stopping all treatments because of fear of further nausea and vomiting. The purpose of this chapter is to provide an overview of the patho-psychophysiology of CINV, the recommended guidelines for standard treatment, and highlight newer targeted treatment approaches.

Figures

Figure 1

Classical Conditioning of Nausea and Vomiting

Figure 2

Proportion of patients reporting anticipatory nausea before cycle three by pre-treatment degree of certainty for expecting nausea.

Figure 3

Pharmacological Treatment Guidelines for Chemotherapy-Induced Nausea and Vomiting