Question – what treatment is available for nausea?
Answer: Jeni Jones, Support
Manager
Nausea can be difficult to control in pancreatic
cancer, as there are a number of factors which can contribute to
it. Patients experiencing jaundice, chemotherapy drugs and blocked
or infected stents can contribute to feelings of nausea, or even
cause vomiting.
There are many effective anti-sickness medications
on the market. These can be prescribed as needed as part of your
pancreatic cancer care. The key is to aim to prevent queasiness and
help you to continue to feel well. It will be helpful to take the
anti-sickness medication regularly, and from the start. Do not wait
for the feelings of nausea to start. If this happens, you may have
waited too long, and it will be harder to treat
it.
Nausea is made worse by having an empty stomach. If
at all possible, try to have some form of food in your stomach,
even if it is a small snack, such as a banana, ice-cream, jelly or
toast. When the stomach is empty the gastric juices still act, and
it can cause an empty and nauseated feeling, or a churning
sensation.
Some medication can also cause nausea, so it is
important to take your medication as instructed by the pharmacist
or nurse. In particular follow instructions about taking tablets
with or after food. This will help to alleviate the feelings
of nausea. Bear in mind that some antibiotics can cause
nausea.
Medications commonly used for
nausea:
- Metoclopramide: a very useful,
safe and commonly used drug. It is taken three times a day, about
half hour before food. It also helps with motility of the gut,
helping food to pass through. Can also be given via a syringe
driver pump.
- Domperidone: a good and effective
anti-emetic (anti-sickness) drug. Also good for
indigestion.
- Cyclizine: a slightly stronger
drug. It is often given when milder drugs stop
working.
- Ondansetron: a very strong and
effective drug, but causes constipation. Usually given for the
first 2 days post-chemotherapy. It is not as effective after this
time, and because of the constipation caused is not advised to use
for longer. A dose is usually given prior to administration of
chemotherapy.
- Aprepitant: a very strong and
effective drug. Only given for 2 days post chemotherapy. A dose is
also usually administered before chemotherapy, for severe nausea
and vomiting.
- Dexamethasone: a steroid which is
very effective for the control of nausea and vomiting. Short term
use only, or given in low doses for longer periods under medical
supervision. May cause elevated blood sugar levels, and weight
gain.
- Lorazepam: a drug usually used for
anxiety. Given in a low dose it is very good for anticipatory
nausea i.e. if the smell of the chemotherapy unit makes a person
feel sick.
- Levomepromazine: also called
Nozinan. Used for a variety of reasons, but for nausea and vomiting
in oncology patients. Very effective and can also be given via a
syringe driver pump.
These are a selection of the medications available
for the control of nausea. Your consultant or hospital team will be
able to advise which one may work best for you. There may also be
other drugs which may be used.
Non-medication remedies:
- Ginger is good for nausea - try
ginger ale or ginger beer sipped, ginger biscuits, and ginger
crystals, which can be dissolved to make a
drink.
- Lavender has the ability to settle
the stomach - a few drops of lavender oil on the pillow can ease
the feeling of nausea.
- Peppermint is good for nausea -
peppermint cordial, peppermint tea or even sucking mints can
help.
- Nausea bands can help - such as
travel sickness bands.