Perception vs Reality
Question: Is it important for your treatment team to know you are
experiencing nausea and vomiting?
Answer: It is in your best interest to tell them if you feel nauseous
right after chemotherapy or even days later. A study showed that many healthcare
providers may not be aware of how often their patients become nauseous or vomit
after chemotherapy. But that does not mean their patients are not getting sick.
Physician-predicted and observed rates of
chemotherapy-induced nausea and vomiting (CINV)during the acute phase (0-24
hours after treatment) and the delayed phase (24 to 120 hours after treatment) can
be quite different from what patients actually experience (Figure 1).
Given what we know about how much
patients dread CINV, this is cause for concern.
(Figure 1) Predicted nausea and vomiting compared to actual patient experience*1
*These patients received moderately emetogenic chemotherapy, or chemotherapy that
is moderately likely to cause nausea and vomiting.
Question: What is the best way to close the perception/reality gap
about CINV?
Answer: First, patients need to be aware of their risk for CINV. Discussing risk factors with your healthcare
provider may help you find ways to prevent symptoms from occurring in the first
place.
Second, if symptoms do occur, patients should bring it to the attention of their
treatment team. It may help to keep a daily calendar or checklist of symptoms to discuss during appointments.
That way, your treatment team will know what you are dealing with and can create
a treatment plan accordingly.
Third, patients need to know that they may not have to feel nauseous from chemotherapy.
They can make diet and lifestyle changes and talk to their healthcare team about
antinausea mediations that can help prevent
nausea and vomiting on the day of chemotherapy and even days after.
Whether it's your first experience with chemotherapy or you've been through it before,
talking with your healthcare provider about preventing CINV is important.
Reference:
1. Grunberg SM, Deuson RR, Mavros P, et al. Incidence of chemotherapy-induced nausea
and emesis after modern antiemetics. Cancer. 2004;100:2261-2268.