About 70% to 80% of patients receiving chemotherapy experience chemotherapy-induced nausea and vomiting (CINV) if it's not
properly prevented. In fact, patient
surveys consistently rank nausea and vomiting as 2 of the worst side effects
from treatment. How do you know if your patients are experiencing CINV? One study
showed that incidence and impact of chemotherapy side effects on patients can be
underestimated
by healthcare providers, especially in the days following treatment.1
Why don't patients receiving chemotherapy share information about how they are feeling?
Many people believe that nausea is a sign that their treatment is working. They
worry that if they tell their healthcare team about feeling sick, they might have
to receive a less effective dose to fight their cancer. The irony is that cancer
patients don’t have to be sick from chemotherapy—not right after nor the days following
chemotherapy. With diet and lifestyle changes and antinausea medications, patients can avoid the nausea and vomiting that often follows
chemotherapy. Preventing CINV can help patients avoid the ups and downs of chemotherapy
to make it through their course of treatment.
As a nurse, you are a key link to education for your patients and their families.
The Stay Strong Patient Support program
provides materials that will support your efforts. You can start by initiating a
conversation with them before they start treatment, discussing risk factors and possible ways to avoid CINV. You may also
want to encourage them to create a list of questions to discuss during their appointment.
To make it easier, they can use a worksheet called Ask your doctor, which can be downloaded for their use. Or
suggest they try out the "I felt"
calendar or the "I felt" checklist
that will help them talk to their treatment team about how they're feeling the week
after chemotherapy.
Your role is critical in your patients' chemotherapy experience. ALOXI® is here to help you.
A nurse is a teacher, too
As early as 1973, the American Hospital Association (AHA) formally recognized the
importance of providing information to patients and families so they could make
informed decisions. In its brochure, “The Patient Care Partnership,” the AHA outlines
the need for discussing medically appropriate treatment choices and encourages patients
to tell their caregivers if they need more information.
Many oncology healthcare providers not only supply education for patients with cancer
and their caregivers, but also access to support programs that can help fill in
the gaps. You can find educational tools about managing chemotherapy-induced nausea and vomiting (CINV) with the
Stay Strong Patient Support program,
but this Web site also links you up with other online resources for many other aspects of cancer care.
The dual role of clinical care provider and educator is a critical one to cancer
patients and their families. Good resources make it easier.
References
1. Grunberg SM, Deuson RR, Mavros P, et al. Incidence of chemotherapy-induced nausea
and emesis after modern antiemetics. Cancer. 2004;100:2261-2268.
2. American Hospital Association. The Patient Care Partnership. 2003.
http://www.aha.org/aha/issues/Communicating-With-Patients/pt-care-partnership.html.
Accessed August 23, 2007.