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Fighting nausea and vomiting caused by chemotherapy using
New drugs and alternative therapies can help reduce or eliminate the side effects of chemotherapy
More recently, a painful nausea and vomiting were also common for people undergoing chemotherapy. But thanks to new drugs and other treatments, this problem is solved.
"We have achieved great success" - said Karen Siryala (Karen Syrjala), Ph.D., director of the Center of Science biopovedencheskih Cancer Research. Fred Hutchinson in Seattle. "Now, nausea and vomiting occur less often, even if the dose used chemotherapy is much more than before." Dr. Siryala said that because now you can control the side effects of cancer treatment has become much more intense.
Antiemetic drugs are so effective that they were used not to treat the symptoms, and for their intensive prevention.
"Usually, I set myself the task to prevent the nausea, rather than waiting for its appearance and then cure" - says Christy Russell (Christy Russell), MD, chairman of the Advisory Council on breast cancer at the American Cancer Society (ACS).
Of course, not always nausea and vomiting can be prevented - 70 - 80% of people who are taking chemotherapy, still to some degree at risk. But because the treatment was more effective, most of these patients can lead a normal life, work and care for their families.
"Maybe you will not feel good all the time" - says Carmen Escalante (Carmen Escalante), MD, head of the department of general therapy Cancer Center. Dr. Anderson at the University of Texas. "But you hold on. And it's much better than what was a chemotherapy before. "
How difficult side effects of chemotherapy?
For people who experience nausea and vomiting caused by chemotherapy, is more than just side effects. They become unbearable, and you can not think about anything else.
Chemotherapy causes several types of nausea and vomiting:
If nausea and vomiting is not treated, it can have serious consequences. Nausea exhausts the patient, he becomes restless.
"It is important to control nausea" - said Dr. Russell, who also is an assistant professor of medicine at the medical school of the University of Southern California in Los Angeles. "If you do not do this, you may have to reduce the dose of chemotherapeutic drugs." She said that the uncontrolled nausea and causes people to stop treatment.
Chronic vomiting may also have direct serious consequences. Vomiting can upset the balance of electrolytes. The loss of fluids increases the toxicity of chemotherapy, and it may interfere with further treatment.
Who is at risk to get side effects of chemotherapy?
The risk of side effects of chemotherapy depend on what drugs the patient takes, because some of them cause side effects more likely.
For example, without preventive treatment, chemotherapeutic drugs such as Adriamycin (doxorubicin) and Platinol (cisplatin) cause nausea and vomiting, with a probability of 90%. But in the case of receiving such drugs as methotrexate or Navelbin (vinorelbine), the risk is less than 10%.
Type the drug is the most important factor, but other factors also affect the likelihood of nausea and vomiting. Here are some of them:
If you think you have a high risk of side effects, tell your doctor. He may prescribe you receive antiemetics prior to chemotherapy.
Prior nausea - waiting for the appearance of side effects
After the start of treatment in about one out of three patients treated with chemotherapy, appears earlier, or due to nausea. You may find that everything that reminds you of chemotherapy - the smell of the doctor's office, the road leading to the clinic, can cause nausea. Approximately one in ten patients appeared earlier vomiting.
"Sometimes people are ashamed of this" - said Dr. Siryala. "They think that the occurrence of nausea before the medical procedure - a sign of weakness." But it is not.
Dr. Siryala says it's just a natural reaction to anything that can cause nausea. For the same reason it is a persistent aversion to food that caused food poisoning you, even if it happened many years ago. "Your body is just trying to protect you" - she said.
According to Dr. Siryala, this relationship can break even after it is installed, but it is better to prevent it. She recommends that people with high risk of nausea, take antiemetic drugs before starting treatment. You can also change their behavior.
"The best thing you can do is escape" - says Dr. Siryala. For example, before and while taking chemotherapy, focus on something that will distract you from the treatment. This can be a fascinating conversation, video games, audio books.
New antiemetic drugs
Chemotherapy drugs cause nausea in many ways. Some of them stimulate the vomiting center of the brain, while others act on the part of the esophagus, stomach, intestines. Most antiemetics block chemical stimulation of receptors vomiting.
Experts say that a breakthrough in treatment occurred in the early 90s, with the advent of serotonin antagonists 5NT3 receptors. "These drugs - a huge step forward" - said Dr. Russell. These include Anzemet (dolasetron), Kytril (granisetron) and Zofran (ondansetron).
According to Dr. Russell, effective, and two new drugs. It's Emend (aprepitant) and ALOXE (palonosetron), the second generation of antagonists of serotonin receptors 5NT3. Specialists also use other drugs.
More effective drugs have improved patients quality of life. According to Dr. Escalante, 15 years ago, antiemetic drugs did not work so well, and many people were forced to stay in the hospital during chemotherapy. Patients had severe nausea and vomiting. Now, in most cases, patients undergo chemotherapy outside the hospital, partly because of the success of new antiemetic drugs.
Behavioral therapy and alternative treatments
Some alternative therapies can also help control nausea and vomiting, especially if they are used in combination with drugs. These methods include:
"I have had patients who were treated with acupuncture in addition to antiemetic drugs" - says Dr. Russell. "Some of them showed significant improvement." She urges patients to talk to your doctor about new techniques of treatment if they feel that medication is not enough.
Dr. Siryala, in general, not against those of alternative treatments if their use is not risky. But she and other experts caution against the use of herbs and supplements without first talking to your doctor.
According to her, herbs and supplements - these are real drugs, and they can negate the effect of treatment.
Dr. Russell points out that there is no evidence for the effectiveness of additives. "In addition, if you feel sick, the last thing you want - it's swallow the pill" - she said.
Should I use marijuana as a remedy for nausea?
It has long been known that marijuana makes nausea. Synthetic version of its active ingredient, tetrogidrokannabinol (THC), is a prescription drug (Marinol (dronabinol)).
But in most countries, the use of marijuana is to say the least trouble with the law. Dr. Siryala believes that among other things it is not safe.
"You take into substance, the purity of which is unknown, while your immune system broken" - she said. "If, for inhaling marijuana, you pick up a fungal infection, your immune system can not cope with it."
However, Dr. Russell said that marijuana - an effective remedy.
"Of course, I can not assign a pot and do not do that" - says Dr. Russell. "But it makes sick." Although ideally she wants her patients something smoked, she said that the inhalation of marijuana - a fast and efficient way to deliver drugs to the site of action.
"Most important for patients to chemotherapy was without symptoms of nausea and vomiting, and they need to find the best way to prevent their appearance" - says Dr. Russell.
Which diet will help ease the nausea?
There is a special diet during chemotherapy. But, according to experts, spicy with a strong smell of food are more likely to cause nausea. According to Dr. Siryala, bland diet is transferred more easily, but each person is different. Necessary to choose a diet that would be effective in your case.
"Ideally I would like people to make healthy eating during chemotherapy and were receiving a sufficient amount of vitamins and minerals" - says Dr. Russell. "But the most important thing to take chemotherapy at the designated doses. Fit any food that will guide you through this treatment. "
There is one very important point - your body should not lose fluid. Dehydration prevents the treatment and the other is fraught with consequences. "If you do not drink enough fluid in, you can go to the emergency room" - said Dr. Escalante.
"You can see that eating little and often than you did before, you can prevent nausea" - says Dr. Estalante. However, do not force yourself to eat if you feel sick. According to Dr. Russell, it is important to eat regularly.
"Never take chemotherapy on an empty stomach" - says Dr. Russell. "It increases the risk of nausea. And you will not know whether this happened because of drugs or because of hunger. "
Dr. Siryala warns that if you eat foods that you enjoy when you feel bad, it could be an unexpected consequence - you begin to associate her with nausea.
"I advise patients to avoid eating their favorite foods such as chocolate, if they are prone to nausea" - she said. "You do not want to lose the pleasure of eating these products by linking them with nausea."
Prevention of nausea caused by chemotherapy.
Of course, some people taking chemotherapy still experience nausea and vomiting. But these symptoms can be a lot easier than you expect.
"Many people have inspired fear before chemotherapy," - says Dr. Escalante. "They remember how hard it is transferred to her relatives at the time." But now, in most cases it is not.
"Before, we were given sleeping pills to patients to prevent nausea" - says Dr. Russell. "Now they are feeling is normal after chemotherapy - without sleeping and nausea."
Dr. Siryala notes that now is treatment of vomiting and nausea, has a new goal: prevention.
"We are not just trying to control nausea and vomiting," - says Dr. Siryala. "We have to prevent it. We have drugs that allow us to prevent these symptoms. This is a sign that we have made great strides. "
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