Coping with Nausea

Heal - Article 01

Nausea is without a doubt one of the most debilitating side-effects of cancer treatment and can impact nutritional status significantly! It puts you right off your food, your appetite goes out the window, and your weight starts to plummet as a result.

However, the good news is that there are a number of ways to combat these symptoms.

What is nausea?

First off, the basics: what is nausea? Nausea results from the irritation of nerve endings in the digestive tract which in turn stimulates centres in the brain that control nausea and vomiting. It can come and go or linger for weeks severely affecting quality of life.

Nausea can be a common side-effect of cancer-related treatments including chemotherapy, radiotherapy, immunotherapy and surgery. It can occur due to constipation and some people even become nauseous in anticipation of an event that previously made them feel sick such as chemotherapy; we call this anticipatory nausea. Anticipatory nausea and vomiting (ANV) is a learned response and is common during cancer treatments.

What you can do

Try not to let nausea put you off your eating completely as it is important to maintain your weight to avoid malnutrition.

Instead, try one of the following ways to counteract and minimise your nausea and vomiting:

  • Portion size: go ‘Michelin star’ – adopt a ‘little and often’ eating pattern rather than the old-school ‘3 meals a day’.
  • Good days: Make the most of days or times that you feel less nauseous and try to eat a bit more then.
  • Eat before you get hungry: A lot of people find their nausea is worst first thing in the morning. Hunger (and an overnight fast) can actually increase nausea. Try starting off with something plain and dry like a biscuit and continue with little and often throughout the day.
  • Ginger: Ginger root contains compounds that may help relieve or prevent nausea by increasing the flow of saliva and digestive juices. They may also help calm the stomach and intestines. Ginger tea, ginger cordial, ginger biscuits (and so on) have all been reported to help people struggling through nausea.
  • *Medication: There are lots of different anti-sickness tablets on the market. Try to take what you are given as recommended (read the instructions on the box).
    • Compliance: anti-sickness tablets can help prevent the onset of nausea altogether – don’t try to be brave by holding off. This will make your life a lot harder later.
    • Timing: Often they can take at least 30mins to kick in so leave enough time between taking the tablet and your meal.
    • No one-size-fits-all: If you are not finding them helpful, ask your doctor whether there is another you can try. Some treatments require 2-3 different anti-sickness medications to control the nausea.
  • Cravings: Don’t fight food cravings. A little of what you fancy is fine, especially when struggling to eat at all. Whether it’s a pork pie or a scoop of ice-cream, right now you need those calories.
  • Best foods: Whatever you find works! Lots of people find foods that are salty, dry (pretzels, crackers), plain (bananas, rice, apples, toast), cold, acidic (grapefruit, fizzy lemonade) easier.
  • Fresh air: Don’t underestimate the power of fresh air and a walk before meals. If you are cooped up in your room and really can’t face going outside, throw open the window for a bit.
  • Smells: Strong smells from cooking coming from the kitchen can really leave you feeling pretty peaky when you are most vulnerable. Try to keep away from the cooking zone where possible and choose cold or room temperature foods over hot foods.
  • Fluids: Hydration is key. Try to sip fluids regularly between meals. Use a straw if this helps. Set an alarm for every hour or create a checklist /use a diary to track how much you have consumed each day.
  • Psychological techniques: If you suspect that you might suffer from anticipatory nausea and vomiting, you should come up with a list of distractive strategies or muscle relaxation techniques that might work for you e.g. yoga, breathing, exercise, listening to music, calling a friend, watching a funny YouTube video etc. Try to incorporate these at times you feel you are most prone to becoming nauseous.