What comes first – the chicken or the egg? Can you have one without the other? Same riddle with Nausea and Vomiting. One often leads to the other, which sometimes starts the whole darn cycle again. Nausea and vomiting may be a problem throughout your treatment. Others, depending on their treatment and their own reactions, may have little or no problem. But if you are one of those who just hear the word chemo and throw up, here a few things to know:

The Warning Signs…

NauseaNausea is that queasy, yucky feeling in your stomach that tells your brain – “Get to the bathroom and quick!” You might begin to feel a little dizzy or warm. Your throat might start to feel funny, your knees a little wobbly. The room may begin to spin. If you can’t get to the bathroom, at least reach for the puke bucket. You know what usually comes next. Sometimes you may only feel nauseous and not actually vomit, but some kids say they feel better when they do. At least you get it out of your system. Of course, throwing up is gross and may make you feel more nauseous. And so it goes…

What Causes Nausea and Vomiting…

Nausea and vomiting are two common side effects of various cancer treatments:

* Chemotherapy

Chemotherapy affects the parts of your stomach and your brain that detect toxic or poisonous substances. (How comforting is that?) This causes you to feel sick. (Surprise, Surprise). Your body tries to rid itself of these toxins. (It’s so smart.) Because chemo is given through your veins, it cannot be expelled out of your body like food, and stays in your body to treat the cancer. Unfortunately, everything else that is in your stomach is purged – sometimes very unpleasantly.

* Radiation

Radiation can also cause nausea and vomiting, especially if it is given near your gastro-intestinal tract (small intestines and stomach) or to you brain. The nausea/vomiting cycle works the same as above.

* Other things to blame

Certain other drugs used to treat the side effects of cancer may cause nausea and vomiting. Some pain meds, like Demerol, as an example, might make you feel sick. Constipation and diarrhea can also make some teens feel nauseous. This is not cool when you are switch-hitting from both sides of home plate! General anxiety and emotions, as well as other triggers like certain odors (especially hospital food) can make you sick to your stomach… Anesthesia before a surgical procedure also may make you sick. Unfortunately, you don’t know what is going to make you throw-up until it happens. All you can do, sometimes, is try to not let it happen again.

Do’s and Don’ts

Anti-nausea Drugs:

* Be sure you take an anti-nausea drug before chemo or radiation. * At the first sign of nausea, tell your nurse you need drugs. Don’t be too proud to ask. That’s what they’re for. Sometimes you can prevent nausea before it hits. * Keep the trusty puke bucket nearby in case you’re too late! * Keep a record of what makes you sick as well as what drugs worked well to prevent nausea.


* Don’t eat just before treatment. Try to eat a few hours before and then eat frequent, light meals throughout the day. Good nutrition is important to keep your strength. * Avoid greasy, fried foods, dairy products, and acidic things like orange juice and Italian salad dressing. They are hard to digest. * Try to stay away from food smells. One of two things will happen: they will either make you sick or make you hungry for things you can’t eat. Neither is a good thing! (Tip: foods that are cold or at room temperature have fewer odors than warm foods.) * Try eating hard candy (Altoids work great!) or chewing gum to cover up any bad tastes of chemotherapy. * Be gentle on your stomach after you’ve thrown up. Start with ice chips or “de-fizzed” soda (stir it vigorously to release the carbonation). * Have someone (mothers are good for this!) taste test all your hospital food. Don’t even let it in the door if it looks, tastes, or smells suspect!

Rest and Relaxation:

* Whenever possible, get lots of fresh air. Open a window or go outside, if you can. * Get good at distraction therapy – do something, anything, to keep your mind off puking. For some teens, playing video games before a treatment session helps ward off anticipatory nausea (getting sick just thinking about it!). * Have friends visit when you’re getting chemo; play games or watch TV together. * Visualize yourself not throwing up – the old “mind over matter” strategy. Sometimes it works. * BREATH! Breathing deeply and focusing your attention may help relax you. The more relaxed you are, the better your chances of not losing your dinner. * Try to sleep during and after your treatment. Some anti-nausea meds will make you sleepy anyway. You need all the energy you can get.

Side effects of the side effect

If your nausea and vomiting get really bad, you might not be able to eat or drink adequately. Preventing dehydration and keeping your electrolytes in balance is important. Your medical team might recommend extra fluids to be given intravenously (IV). You might also be given supplemental nutrition to give you an extra boost.