Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients

Abstract

Purpose

Despite the widespread use of antiemetics, nausea continues to be reported by over 70% of patients receiving chemotherapy.

Methods

In this double blind, multicenter trial, we randomly assigned 744 cancer patients to four arms: 1) placebo, 2) 0.5 g ginger, 3) 1.0 g ginger, or 4) 1.5 g ginger. Nausea occurrence and severity were assessed at a baseline cycle and the two following cycles during which patients were taking their assigned study medication. All patients received a 5-HT3 receptor antagonist antiemetic on Day 1 of all cycles. Patients took three capsules of ginger (250 mg) or placebo twice daily for 6 days starting 3 days before the first day of chemotherapy. Patients reported the severity of nausea on a 7-point rating scale (“1” = “Not at all Nauseated” and “7” = “Extremely Nauseated”) for Days 1–4 of each cycle. The primary outcomes were to determine the dose and efficacy of ginger at reducing the severity of chemotherapy-induced nausea on Day 1 of chemotherapy.

Results

A total of 576 patients were included in final analysis (91% female, mean age = 53). Mixed model analyses demonstrated that all doses of ginger significantly reduced acute nausea severity compared to placebo on Day 1 of chemotherapy (p = 0.003). The largest reduction in nausea intensity occurred with 0.5 g and 1.0 g of ginger (p = 0.017 and p = 0.036, respectively). Anticipatory nausea was a key factor in acute chemotherapy-induced nausea (p < 0.0001).

Conclusions

Ginger supplementation at a daily dose of 0.5 g–1.0 g significantly aids in reduction of the severity of acute chemotherapy-induced nausea in adult cancer patients.

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Acknowledgements

This research was supported by the National Cancer Institute of the National Institutes of Health PHS grants 1R25CA10618 (Cancer Control Research) and U10CA37420 (Community Clinical Oncology Program). None of the authors have conflicts of interest to disclose.

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Correspondence to Julie L. Ryan.

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Ryan, J.L., Heckler, C.E., Roscoe, J.A. et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer 20, 1479–1489 (2012). https://doi.org/10.1007/s00520-011-1236-3

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Keywords

  • Chemotherapy
  • Cancer
  • Nausea
  • Ginger