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Nausea and vomiting are the most common acute side effects of mesothelioma chemotherapy, experienced by three fourths of cancer patients. Patients regularly report that this side effect concerns cancer patients almost more than any other (even hair loss) and it can be significant enough that patients sometimes delay treatment or even elect not to be treated because of it. Fortunately, it’s one that can be relatively well managed by a number of different means.

What drugs you are treated with will in large part determine how severe this side effect will be. Some drugs, like vincristine, vinblastine and methotrexate, are associated with very low levels of nausea and vomiting. Others, like cisplatin are more likely to be associated with nausea and vomiting, and if so, it’s more likely to be severe. Nausea and vomiting can occur within the first 24 hours (acute), after a few days (delayed) or even before therapy is given in patients who have undergone treatment before and know what to expect (anticipatory). Your physician may pre-medicate you with any of a number of drugs designed to interrupt the brain pathways that mediate the vomiting reflex, or may include such medication in the infusion itself. There are several excellent drugs that can be given to suppress nausea and vomiting at home, and your physician may prescribe more than one depending on how you respond and how severe your symptoms are. Many of these drugs have side effects of their own, including constipation, insomnia and drowsiness. Making certain that you avoid tasks that require concentration (like driving), drinking plenty of fluids and avoiding stimulants like caffeine will help manage these complications.

You can help manage nausea and vomiting by some relatively “home” remedies. Many patients find that taking small meals several hours apart rather than eating three large meals helps prevent nausea. You will probably find that certain foods and smells are likely to trigger nausea, and it’s best to avoid them. Don’t force yourself to eat when you are feeling queasy, or if you do, take only a few bites of food or sips of liquid at a time, allowing a few minutes between to settle your stomach. If vomiting is a problem, contact your physician promptly: excessive vomiting can lead to dehydration and imbalance in electrolytes that, if severe enough, can lead to hospitalization. Sipping electrolyte replacement (sports) drinks can help prevent these problems. Liquid diet replacements (high calorie, not diet) can help you maintain calorie intake even when you don’t feel like eating.

Management of chemotherapy side effects

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