Caring for the Patient With Cancer at Home

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Nausea and vomiting

Nausea is having a sick or queasy feeling in the stomach, and vomiting is throwing up food or liquids from the stomach. Nausea can occur even when a person is not thinking about food. A person can vomit even if they have not eaten anything and haven’t had any nausea. Nausea or vomiting can be caused by eating something that disagrees with you, by bacteria in food, by infections, or by radiation or chemo treatments for cancer. Many people have little or no nausea and vomiting with these treatments. For others, just thinking about going for one of the treatments can cause nausea or vomiting. Cancer by itself can cause nausea and vomiting.

Frequent vomiting can be dangerous because it can lead to dehydration. (See the section called “Fluids (lack of) and dehydration.”) It can also cause choking or inhaling food or liquids. Talk with your doctor about what’s causing your nausea and vomiting and what you can do about it.

What to look for

  • Changes in eating habits
  • Foul mouth odor
  • Yellow or green foul-smelling fluids on bedclothes
  • Feeling queasy or having an upset stomach
  • Increased saliva, clamminess, and sweating that may come before vomiting

What the patient can do

For nausea

  • If the nausea only happens between meals, eat frequent, small meals and have a snack at bedtime.
  • Drink clear liquids served cold and sipped slowly. (Clear liquids are those you can see through, such as ginger ale, apple juice, broth, tea, etc.) Also try Popsicles or gelatin.Suck on hard candy with pleasant smells, such as lemon drops or mints, to help get rid of bad tastes. (Don’t eat tart candies if you have mouth sores.)
  • Eat bland foods, such as dry toast and crackers.
  • Eat food cold or at room temperature to decrease its smell and taste. Avoid fatty, fried, spicy, or very sweet foods.
  • Try small amounts of foods high in calories that are easy to eat (such as pudding, ice cream, sherbets, yogurt, and milkshakes) several times a day. Use butter, oils, syrups, sauces, and milk in foods to raise calories. Avoid low-fat foods unless fats upset your stomach or cause other problems.
  • Eat the foods you like. Many people develop a dislike for red meat and meat broths during treatment. Try other protein sources, such as fish, chicken, beans, and nuts.
  • Tart or sour foods may be easier to keep down (unless you have mouth sores).
  • Try to rest quietly while sitting upright for at least an hour after each meal.
  • Distract yourself with soft music, a favorite television program, or the company of others.
  • Tell your doctor about the nausea, because there are several drugs that can help it.
  • Take your anti-nausea medicine at the first signs of nausea to help prevent vomiting.
  • While waiting for your nausea medicine to work, relax and take slow, deep breaths.
  • If you have nausea just before chemo or doctor visits, ask about medicines, hypnosis, relaxation, or behavioral treatment to lessen this problem.

For vomiting

  • If you are in bed, lie on your side so that you won’t inhale the vomit.
  • Ask that medicines be prescribed in the form of dissolving tablets or suppositories, if possible. To prevent vomiting, take the medicine at the first hint of nausea.
  • Try liquids in the form of ice chips or frozen juice chips, which can be taken slowly.
  • After vomiting stops, start taking in 1 teaspoon of cool liquid every 10 minutes. Gradually increase to 1 tablespoon. If you are able to keep that down after an hour or so, try larger amounts.

What caregivers can do

  • When the patient feels nauseated, offer to make meals or ask others to make meals to reduce bothersome food odors. Use kitchen vent fans to reduce smells.
  • Cover or remove foods with strong or unpleasant smells.
  • Try plastic forks and spoons rather than metal ones, which may cause a bitter taste.
  • If the patient is vomiting over a period of days, weigh them at the same time each day to help decide if dehydration is getting severe.
  • Talk to the doctor about medicines to help prevent vomiting.
  • Watch the patient for dizziness, weakness, or confusion.
  • Try to help the patient avoid constipation and dehydration. Either of these can make nausea worse.

Call the doctor if the patient:

  • Might have inhaled some of the vomited material
  • Vomits more than 3 times an hour for 3 or more hours
  • Vomits blood or material that looks like coffee grounds
  • Cannot take in more than 4 cups of liquid or ice chips in a day or can’t eat for more than 2 days
  • Can’t take medicines
  • Becomes weak, dizzy, or confused
  • Loses 2 or more pounds in 1 to 2 days (This means they are losing too much water and might be dehydrated.)
  • Develops dark yellow urine and doesn’t have to urinate as much

Last Medical Review: 11/05/2013
Last Revised: 11/05/2013