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15

NCCN Guidelines for Patients

®

Nausea and Vomiting, Version 1.2016

2

Causes

What are the types of nausea and vomiting?

What are the types of nausea

and vomiting?

Cancer treatments like chemotherapy and radiation

therapy can bring on nausea and vomiting. The risk

of having these side effects depends on the specific

treatment type and area it reaches in your body. The

types of nausea and vomiting related to treatment

are called CINV (

c

hemotherapy-

i

nduced

n

ausea and

v

omiting) and radiation-induced nausea and vomiting.

CINV

Chemotherapy is a systemic therapy that attacks

fast-dividing cancer cells. It can also damage normal

cells in the process. This damage to the normal cells

causes side effects. When nausea and vomiting are

caused by chemotherapy it is called CINV. The term

"induced" means "to bring on something."

The types of CINV are called acute, delayed,

anticipatory, breakthrough, and refractory.

See

Guide 2

for detailed information on the types of

CINV.

Radiation-induced nausea and vomiting

Radiation therapy can be given from a machine

outside the body. This is called external beam

radiation therapy. Nausea and vomiting are more

likely to happen when radiation is used to treat the

upper abdomen or whole body. The risk for nausea

and vomiting gets higher as the doses of radiation get

larger and reach more areas of tissue in the body.

Upper abdomen radiation:

The digestive organ

that absorbs nutrients from food you eat is called

the small intestine. It has rapidly diving cells, which

makes it sensitive to a treatment like radiation

therapy. Radiation aims to kill the cancer cells that are

rapidly dividing. The radiation may reach and damage

healthy tissue, causing side effects.

Whole body radiation:

Radiation may be given

to someone who is preparing for a bone marrow

transplant. A bone marrow transplant is a cancer

treatment that destroys the soft tissue in the middle

of your bones (bone marrow) with chemotherapy

or radiation. The damaged bone marrow is then

replaced with healthy bone marrow. Side effects like

nausea and vomiting can happen during this whole

body treatment.

Chemoradiation:

Nausea and vomiting can happen

when chemotherapy and radiation are given together.

If this happens, anti-nausea and vomiting drugs can

be given. The type, dose, and timing of these drugs

is based on how likely the chemotherapy will cause

these side effects.