Feeling or Being Sick

Some cancer treatments can cause patients to feel sick (nausea) or to actually be sick (vomit). Not all cancer treatments cause sickness, and many people never experience sickness throughout their cancer treatment. Whether you experience nausea or vomiting all depends on the type of treatment and how you react to it. This varies from person to person. Feeling sick can be very unpleasant and distressing but there are some very effective treatments available that can help to prevent and control it. It is often easier to control nausea and prevent vomiting if you deal with it straight away, rather than letting it build up. Sometimes, it may not be possible to completely control the sickness, but there are many things that can be done to help relieve it.

Medication

If you have been prescribed anti-sickness drugs (for example Metoclopramide, Cyclizine or Domperidone) or steroids (for example Dexamethasone) by your doctor, make sure that you take them regularly. It is easier to control nausea and prevent being sick (vomiting) if you take them regularly. Do however make sure you do not exceed the maximum daily dose that you have been prescribed.

You may find it helpful to take anti-sickness drugs about half an hour before eating, so that you feel like eating and do not feel sick during your meal.

If you have nausea or vomiting but have not been prescribed any form of anti-sickness medication, please contact your hospital medical team for further advice.

Eating and Fluid Intake

If you have diabetes, have had oral, stomach or bowel surgery or have difficulty chewing or swallowing this dietary advice may not apply to you. In these situations please contact your hospital medical team for dietary advice.

Sickness can often cause a reduced appetite, and you may go off foods that you would normally enjoy. You may even be put off just by the sight or smell of food. Do not force yourself to eat if you feel sick or are being sick. Small, frequent and simple meals consisting of your favourite foods are likely to be the most tempting. If you do go off food it is important to eat what you feel able to and when you feel like it, to make sure that you have as many calories as possible. If you are really struggling to eat then it is important that you try to drink plenty of fluids (ideally 2-3 litres a day) to prevent dehydration. On days when you are having treatment, try to eat normally before and after you receive your treatment.

Below are some eating and drinking tips that you can try when you have sickness. You may like to try a few of them to see which work best for you:

Eating

You could try:

Small frequent meals and snacks throughout the day instead of 3 big meals.

Chew your food well and only try to eat when you feel less sick. Try and have a small meal a few hours before treatment, but not just before it.

Light, bland and dry foods such as cereals, bread, crackers, bread sticks, plain biscuits or toast are usually better tolerated when you feel sick. You may like to try other types of light foods that are easy to digest such as soups or egg custards.

Cold food or food served at room temperature (such as a sandwich) especially if the smell of hot food makes you feel sick.

Before eating have some fresh air.

When eating wear loose, comfortable clothing that is not tight around your stomach.

After eating, relax in a sitting or slightly reclined position with the upper body raised, instead of lying down.

If you are normally the person responsible for doing the cooking, try to arrange for someone else to do it when you are feeling sick.

You may find it easier to simply heat up a ready made meal from the fridge or freezer instead of cooking a meal from scratch. Some people find supermarket ready meals convenient, or you could have a few small portions of your favourite homemade meals in the freezer ready to defrost and heat up.

Try to avoid:

Foods that are spicy, greasy or salty, are very sweet or have a strong smell or taste.

Eating or preparing food when you feel sick.

Mixing hot and cold foods.

Physical activity straight after eating.

Brushing your teeth straight after eating.

Eating in a room that is very warm or has strong cooking smells.

Fluid Intake

You could try:

Taking small sips slowly throughout the day rather than trying to drink large amounts of fluid all at once. Some people find drinking through a straw helpful.

Some people find the best things to drink are cold, clear, sweet liquids like fizzy drinks.

Take a bottle of water with you when you go out.

Drinking mainly between meals rather than with your food so that you do not get too full.

Some people find ginger to be a good natural remedy for sickness. There are many ways you could try to introduce ginger into your diet, for example:

Sip ginger beer, ginger ale or ginger tea slowly.

You can add freshly ground ginger to hot water or tea to make a soothing drink.

Peppermint is another natural remedy that some people find helpful for sickness. You may like to try drinking peppermint tea.

Try to avoid:

Drinking too much just before you eat or whilst you are eating.

Drinking lots of beverages with caffeine in them such as tea, coffee and some fizzy drinks (for example cola).

Drinking alcohol.

You may find citrus flavoured or fresh juices (such as orange and grapefruit juice) irritate your stomach. Try diluting them with water or try alternative flavours such as blackcurrant, apple or peach.

Tips for Coping with Feeling or Being Sick

There are lots of things that you can do by yourself or with the help of a friend or relative that may help you to cope with feeling and being sick.

Acupressure

Some people use stretchy acupressure bands (that you wear on your wrists) to help them stop feeling sick. Acupressure bands have a hard plastic stud on the cuff that you position in the middle of the inside of your wrist (on an acupressure point). The aim of wearing the bands is to stimulate the acupressure point that helps to control sickness. Many people find these acupressure bands useful if they suffer from travel sickness. Acupressure bands are available from chemists and many health food shops.

Other Tips

If possible, make sure your surroundings are pleasant, quiet and clean so that you feel relaxed. Keep the room at a comfortable temperature with plenty of fresh air. You may like to sit near an open window or outdoors in the fresh air if the weather is nice.

Keep any items that you may need close by, but keep them out of sight so you are not constantly reminded about feeling sick. Items you may like to keep close by include:

An empty bowl in case you need to vomit.

A towel, a cool cloth and a glass of water for rinsing your mouth.

Special Case of Sickness – Anticipatory Nausea or Vomiting

Some people can develop a specific form of sickness called anticipatory nausea and vomiting. This is where nausea and/or vomiting occur before a cycle of treatment. Anticipatory nausea and vomiting happens when your brain makes a connection between specific ‘cues’ (such as sights, tastes, smells and sounds associated with the treatment and treatment area) and the nausea and vomiting that can be caused by chemotherapy. It is similar to what happens when your mouth waters when you see your favourite food. Your brain ‘learned’ to produce saliva in anticipation of eating. With anticipatory nausea and vomiting your brain ‘learns’ that you will experience sickness in anticipation of chemotherapy.

It normally takes several experiences of chemotherapy followed by sickness for the brain to ‘learn’ this response. Not everybody develops this type of sickness, but if you do you might find it helpful to try and disrupt the ‘cues’ when you go for treatment.

Try using a light perfume or aftershave to disguise smells.

Strong flavoured sweets can help to mask any unpleasant tastes.

Listen to music on your phone, iPod, mp3 or CD player.

Take a selection of books and/or magazines with you to read.

Take a friend or relative with you. They may help to distract you while you are waiting for treatment.

If you normally have a set routine of things you do before going for treatment try to swap things around each time e.g. travel a different route to the hospital if possible, try to eat something different, wear different clothes or use a different perfume or aftershave etc.

Disclaimer: On this website you will find advice to help you manage some of the more common but milder symptoms and side effects of cancer and cancer treatment. Please ONLY use this advice if you are currently participating in the eRAPID Lung research project, otherwise you must follow the advice given to you by your medical team. Clicking on the links in the menu will take you to advice on looking after yourself during and after cancer treatment. If after following the advice you don’t feel your symptoms are being successfully managed or relieved, you should contact your Clinical Nurse Specialist Team.

Email: Leedsth-tr.lungcancernurses@nhs.net

Telephone: 0113 2067916