New Way to Manage Chemo-Related Nausea and Vomiting

Nausea and vomiting are among the most-dreaded side effects of cancer treatment, but research published in the June 2009 online edition of Lancet Oncology, has given doctors an additional tool in the battle against chemotherapy-induced nausea and vomiting.

For this study, the researchers focused on better ways to manage acute and delayed nausea and vomiting. Acute side effects are those that occur within the first 24 hours of receiving chemotherapy, whereas delayed effects are those that occur 24 to 120 hours (5 days) after chemotherapy. Delayed effects can be more difficult to manage.

The study included 810 people from 77 cancer treatment facilities in 22 countries. Patients who were receiving highly emetogenic (likely to cause nausea and vomiting), cisplatin-based chemotherapy were treated with one of the following side effect management options:

• dexamethasone and ondansetron alone, standard anti-nausea and anti-vomiting medications
• dexamethasone and ondansetron plus one oral (by mouth) dose of an additional medication, casopitant mesylate
• dexamethasone and ondansetron plus casopitant mesylate both orally and for three days intravenously after chemotherapy

Study participants who received the extra medication, casopitant mesylate, either as a single dose or in multiple doses, had less nausea and vomiting than those who did not receive this drug. Sixty-six percent of people in the dexamethasone and ondansetron group had complete control of both acute and delayed nausea and vomiting vs. 86% complete control in the single dose casopitant mesylate group and 80% complete control in the multiple dose casopitant mesylate group.

Does this mean casopitant mesylate is the right anti-nausea drug for you? It is possible that casopitant mesylate can help you get through chemotherapy with less nausea and vomiting, but it isn't right for everyone who is being treated for cancer. These medications are appropriate for use only with certain types of chemotherapy. If you aren’t receiving these chemotherapy regimens, you may not need casopitant mesylate.

The most important take home message is that there are new and better options for managing chemotherapy side effects being discovered all the time. Working with your doctor, you can find the best treatment plan for you. You don’t have to accept that nausea and vomiting are a natural part of colon cancer treatment.