Sickness (nausea) and cancer drugs

About sickness from cancer drugs

There are many different types of cancer drugs. Some of them may make you feel sick. This is also called nausea.

If a drug can cause sickness, it doesn't mean it will make you sick (vomit). Everyone reacts differently. All cancer drugs have side effects, but they don’t affect everyone.

The reasons why drugs cause sickness are complex. Sickness and being sick involves many processes in the:

• brain and spinal cord (central nervous system)

• stomach

• small bowel

It's not possible to tell in advance who will feel or be sick or how bad it will be. It can depend on:

• the drug or combination of drugs you are having

• the dose

• how you react to the drug

• how you reacted to drug treatment in the past

Drugs that cause sickness

Cancer drugs that can cause sickness include:

• chemotherapy drugs

• targeted cancer drugs

• immunotherapy

• hormone therapies

• bisphosphonates

• painkillers

• radioisotope therapy

Chemotherapy drugs

Sickness caused by some chemotherapy drugs is the most difficult side effect for many people. Uncontrolled sickness can affect your quality of life on many levels.

But not all chemotherapy drugs make you sick. If they do, it generally starts from a few minutes to several hours after having the drug. With some drugs, the sickness lasts for a few hours, or until the next day. Sometimes it can last for several days.

There are risk factors for sickness caused by chemotherapy. You are more likely to feel sick if you:

• are female

• are younger than 60

• have a first cycle of chemotherapy

• have a history of being sick on previous chemotherapy

• have a history of feeling sick and being sick such as motion sickness or sickness during pregnancy

• feel and are sick before chemotherapy starts, also called anticipatory nausea and vomiting

Other risk factors are the:

• type of chemotherapy, for example, platinum or anthracycline chemotherapy

• dose

• rate at which you have it

• route through which you have it

Let your doctor, nurse or pharmacist know if you are struggling with sickness while having chemotherapy drugs. There are several different anti sickness medicines they can prescribe.

Read more about chemotherapy

Targeted cancer drugs and immunotherapy

Some targeted cancer drugs, and immunotherapy can make you feel or be sick.

Find out more about targeted cancer drugs and immunotherapy

Hormone therapies, bisphosphonates, painkillers

Hormone therapies, bisphosphonates or painkillers, can make you feel sick when you first start taking them. This might wear off within days or weeks. It’s possible to have longer-term sickness, particularly with stronger painkillers.

Radioisotope therapy

Radioisotope therapy uses radioactive medicines to treat some types of cancer. You have the radioisotope as a drink, capsule or injection.

The radioisotope travels around your body in the bloodstream to the area where the cancer is. There are different types of radioisotopes, but it is often a treatment for thyroid cancer and cancer that has spread to the bone. Some of these radioisotopes can make you feel or be sick.

Find out more about having radioisotope therapy

Taking anti sickness drugs (anti emetics)

Anti sickness drugs usually control sickness well. They are also known as anti emetics. Your healthcare team prescribes them if your cancer treatment is likely to make you feel or be sick.

It is best to take your anti sickness drugs regularly, whether you feel sick or not. It is easier to prevent sickness rather than treat it once it has started.

How you have anti sickness medicine

Anti sickness drugs can come as:

• a tablet or capsule that you swallow

• an injection or drip into a vein (intravenous)

• a patch you put onto your skin

• a liquid that you swallow

• a film you put on your tongue, this dissolves with your saliva and you swallow the medicine

You usually take your anti sickness medicine before your treatment starts. Or the nurse will give it to you just before you have your cancer drugs.

In some situations, you can have anti sickness through a patch that sticks on your skin. This lasts for a few days.

You usually take anti sickness medicines home for a few days after your treatment. Your healthcare team can explain how often and how long to take anti sickness medicines for.

Types of anti sickness drugs

The type of anti sickness drug you have depends on:

• the type and dose of your cancer drug you’re having

• how you are having the drug, for example, by mouth or through a vein

• how likely it is that the cancer drug would cause you to feel sick

There are many different anti sickness drugs and each one works in a specific way. So, if one doesn’t work for you, your healthcare team can prescribe another one to try.

Find out more about the different types of anti sickness

Other ways to manage sickness

The following methods can be helpful to help control sickness. You can use them in combination with anti sickness drugs:

• acupuncture or acupressure

• aromatherapy

• cognitive behavioural therapy (CBT)

• distraction, for example, playing video games or listening to music

• guided imagery

• yoga

• muscle relaxation training

• exercise

• hypnosis

Read about the types of complementary therapies

What you can do to reduce sickness

If a drug causes your sickness, you could try some of the following tips:

• Avoid eating or preparing food when you feel sick.

• Avoid fried foods, fatty foods or foods with a strong smell.

• Eat cold or slightly warm food if the smell of cooked or cooking food makes you feel sick.

• Eat several small meals and snacks each day and chew your food well.

• Drink plenty to stop you from becoming dehydrated, but avoid filling your stomach with a large amount of liquid before eating.

• Fizzy drinks can help some people with nausea.

• Use relaxation techniques to help control sickness.

• Sucking on boiled sweets or mints can help some people.

• Try crystallised stem ginger, ginger tea or ginger ale.

• Some frozen foods such as ice lollies, ice pops and sorbets can help people. It can also help to suck on an ice cube to refresh your mouth.

Find out more about other ways to control sickness

If you are sick after your treatment you could also try the following:

• Drinking high calorie drinks might be easier than eating, ask your doctor or nurse about these

• Have a small meal a few hours before treatment, not just before

• Avoid your favourite foods when having treatment as you might associate them with treatment

Read more tips on what you can do to help you cope with sickness

Patient stories on sickness and cancer treatment

People react differently to cancer drugs. Here are some stories from cancer patients.

JP always gets sick after chemotherapy and anti sickness tablets don’t seem to help

"I seem to get sickness more than other people I know. I start to feel sick 2 days after getting home from hospital after a chemotherapy course. It starts with a foul taste in my mouth and throat and I can feel the tablets lying on my stomach, a sort of greasy feeling.

I'm always sick, and then I feel better for a while. I'm often sick 3 to 5 times a day but am OK at night. It is worse for the first few days after I leave hospital and then it gradually gets better until my next course of chemotherapy. I take anti sickness tablets but for me they don't seem to help. My doctor is concerned about me getting dehydrated so I drink plenty of fluids.

I find bitter tasting things like bitter lemon and grapefruit very refreshing but I find sweet things have no taste. I avoid bread and potatoes and stodgy things."

JR gets sick after chemotherapy but anti sickness tablets help – and so does eating little and often

"I have never been sick with my chemotherapy. However on day 2 of a chemotherapy course I do feel sick. I have a heavy feeling in my stomach a bit like an overeaten feeling and it won't go unless I lie down. Eating sometimes makes it worse although not eating may bring it on. Therefore I eat little and often.

The nausea lasts for 5 or 6 days, day 4 being the worst. The anti sickness tablets are great and work within 15 to 20 minutes of taking them. In hospital I'm given the tablets regularly and this seems to work well."

PV only got sick after the third course of chemotherapy. Anti sickness drugs seem to make it worse

"I felt fine after my first two courses of chemotherapy but after my third course I did feel sick and I have felt worse again after my fourth course. I have only vomited a few times but since my 3rd chemotherapy I have felt sick most of the time and I often retch. It seems to get worse when I am waiting for something like a scan which I am worried about. And I felt much worse in hospital than at home.

I've gone right off crisps and beer (not that I used to drink much!) and I prefer marmite on toast and milky things like ice cream. I have taken anti sickness drugs but I feel these may have made it worse. My doctors have said it is normal to have this sickness and not to worry but that I can ring at any time if I am concerned."

Mr K never feels sick

"I haven't had any nausea or vomiting at all."