How to manage nausea and vomiting while undergoing cancer treatment

While going through cancer treatment you may find you are not able to eat as much as you could prior to your diagnosis for a variety of reasons. Stress, anxiety, fatigue, or side effects from your treatment may create added barriers to eating adequately. This often concerns many of my patients, but conversely many find the weight loss desirable. Many cancer survivors know that it may not be coming off the best way, but enjoy the ease of finally being able to lose weight quickly. However, eating adequately during treatment is key to improved outcomes. Research shows that people who are well nourished during chemo, radiation, and surgery tend to have less side effects, tolerate their treatments better, and have less treatment delays, which usually translates to better survival outcomes.

Are you at risk for nausea and vomiting?

If you are receiving radiation therapy to the stomach, abdomen, or brain then this may cause issues with eating from nausea. A number of chemotherapies are also known to commonly cause nausea such as Carboplatin (Paraplatin), Cisplatin (Platinol), Chyclophosphamide (Cytoxan), Doxorubicin (Adriamycin), Irinotecan (Camptosar), Oxaliplatin (Eloxatin), Streptozocin (Zanosar), Temozolomide (Temodar), along with other’s. Talk with your oncology team to see if you may be at risk prior to starting treatment so that you can be prepared.

If you aren’t feeling well and are experiencing nausea or vomiting, you will likely find it difficult to eat adequately. When this happens you can start losing weight and will typically lose muscle before you do any of your fat stores. This can make you even more fatigued and weak. I recommend making nutrition a part of your cancer treatment plan if you haven’t already considered this. With this in mind, let’s dive into some tips that may help you eat better and keep food down if you are experiencing any nausea or vomiting.

1. Cook with ginger, sip on gingerale or ginger tea, or eat ginger chews.

Have you tried ginger before? It pairs well with Asian foods such as stir fry’s, Indian foods such as curry, ham, carrots, broccoli, among many other foods. You can try gingerale or ginger beer (which is a stronger version of gingerale), eat gingerbread cookies or ginger snaps, sip on some ginger tea, or find ginger chews (candies) at the grocery store. Any form of ginger may help. Experiment with some options to see what works best for you.

2. Add mint to your foods or drinks. Try peppermint hard candies or make peppermint tea.

Mint can pair well with peas, fruit salads, chicken, fish, or Mediterranean dishes. If you don’t have the energy to cook or have fresh mint, you can make peppermint tea or suck on peppermint hard candies.

 3. Try Seabands.

Have you heard of these? Seabands are bracelets that have an acupressure bead that sits on your wrist. Many people use these when they are on ships to prevent from getting motion sick. Most drug stores carry them and are fairly inexpensive. They can be used over and over. They don’t work for everyone, but may be worth trying.

4. Go for a walk or get moving.

Believe it or not this may help with controlling nausea and fatigue. You may not feel up to it, but if you feel that you can safely go for a walk or ride a stationary bicycle and if your doctor says it’s okay for you to exercise. Even 5 minutes can make a difference.

5. Start with clear liquids, then full liquids, then to soft and bland foods as tolerated.

If you try broth, juice, jello, popsicles, and sprite or gingerale and all goes well, then try something with a little more nutrition to see how you do. You want to advance your food options slowly. Full liquids are things like smoothies, nutrition supplements (such as Ensure, Boost, Organ, Equate, or Carnation Instant Breakfast), ice cream, sherbet, or milk. If you feel okay, transition to soft and bland foods like grits, oatmeal, pudding, yogurt, custards, eggs, rice, canned fruit, chicken, tofu, cold sandwiches, angel food cake, potatoes, smoothies, and cottage cheese. You want to see what your body will allow you to tolerate and don’t push it too hard to fast.

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 6. Along with bland foods, make sure your foods are lukewarm.

These types of foods are typically better tolerated when you aren’t feeling well, as things that are too cold or too hot may make your nausea worse.

 7. Avoid hot and spicy, fried, high fat-greasy, or foods that are overly sweet.

Foods that have strong smells, strong flavors, or sit in your stomach longer tend to make nausea and vomiting worse.

 8. Avoid foods with strong odors and open up a window while cooking or eating. Have someone cook for you if possible.

Avoid things like strong smelling fish, onions, garlic, etc… Opening a window or turning on a fan while cooking and eating may help if your area feels stuffy. Fresh air can help relieve nausea. Be sure not to eat in rooms that are too warm or stuffy.

 9. Have easy prepared and convenient snacks, foods, and nutrition supplements  available. Eat small frequent meals.

If you have low energy or fatigue and smelling food makes your nauseous, then having access to quick and convenient food options will likely help you stay better nourished if you can’t cook for yourself or have someone to help with cooking.

 10. Take your anti-nausea meds as prescribed.

It’s easier to prevent nausea and vomiting when you take your meds as prescribed. It’s hard to play catch up once you stop taking them and sometimes you may not be able to get your nausea under control. Many pharmacists and oncologists I’ve worked with have reported it’s better to take your meds as prescribed before your nausea starts. I’ve had patients stop taking their medicine because they felt fine, only to realize that it was preventing the nausea from starting and getting it back under control was difficult. If you prevent nausea you will eat better and feel better. If your medicine is not working for, let your team know—you made need an adjustment.

 11. Eat sitting up right and keep head raised for about an hour after eating. Don’t eat until your vomiting has stopped.

 12. Try lemon, lime and other tart flavored foods.

 13. Don’t skip snacks or meals even if you don’t feel hungry as many people who have an empty stomach may make their nausea worse.

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 14. Avoid your favorite foods.

You don’t want to associate your favorite foods with nausea after your treatment is complete and not be able to enjoy these foods in the future.

 15. Plan when it’s best for you to eat.

Maximize when the times when you are able to eat more. This will help you meet your overall nutrition goals.

 16. Salty foods may be helpful for some.

 17. Wear clothes that are lose and comfortable.

 18. Rest after you eat.

 19. Try lemon drops (if you don’t have mouth sores) or chamomile tea.

What works for one person with nausea and vomiting may not work for someone else. Find what works for you and try to stick with a personalized plan based off this. If you have access to a dietitian then meet with them regularly to see if there is anything else that you could do to maximize your nutrition intake.

20. Sip on beverages in between meals.

Drinking liquids with your meals can make you feel fuller quicker. Maximize you nutrition intake by doing this.

Every person is different and what works for one person during treatment, may not work for someone else. Some people feel better when they have treatment on an empty stomach, while others feel better eating 2-3 hours prior. Do what feels right for you and experiment a little with some of these suggestions to see if they might be helpful for you. The goal is to meet your nutrition needs as best as you can, while at the same time not pushing yourself too hard that you make yourself more nauseous and unable to meet your goals. Also, what works one day may not work the next day. Be open-minded and try not to get discouraged if you have a bad day. It can be easy to feel discouraged, but having a positive attitude can help you feel better and eat better!

For more updates, you can follow Survivors’ Table on Facebook. Thanks for joining me on this journey! – Danielle

 

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