The Management of Nausea and Vomiting Caused by Anticancer Chemotherapy

  • Christopher J. Williams
Part of the Developments in Oncology book series (DION, volume 23)


Although other side effects of cytotoxic therapy are potentially more serious and can be life threatening, nausea and vomiting is by far the most unpleasant toxicity from the patients’ perspective. It may be severe enough to cause some patients to default treatment, even when they have a potentially curable tumour. However, the neuropharmacology of emesis is extremely complicated and not fully understood. The way the cytotoxic drugs induce ones is is variable and different antiemetics have different modes of action. When it is also remembered that cytotoxics are commonly used in combinations of 3 or 4 drugs and that studies of antiemetics to prevent chemotherapy associated emesis are a recent phenomenon (table 1), it is not surprising that no definitive statements can be made about the best ways to manage it. This chapter reviews the current state of the art.


Cancer Chemotherapy Motion Sickness Cytotoxic Therapy Antiemetic Effect Antiemetic Regime 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1).
    Moertel CG, Reitemeier RS and Gage RP. Controlled clinical evaluation of antiemetic drugs. JAMA 186: 116–118, 1963.PubMedGoogle Scholar
  2. 2).
    Lucas VS. Phenothiazines as antiemetics. In: Laszlo J (ED). Antiemetics and cancer chemotherapy. Williams and Wilkins. Baltimore. 1983 p 93–107.Google Scholar
  3. 3).
    Kahn T, Elias E, Mason G. Single dose of metoclopramide in the control of vomiting from cisdichlorodiammineplatinum in man. Cancer Treat. Rep. 62: 1106–1107, 1978.Google Scholar
  4. 4).
    Williams CJ, Bolton A, de Pemberton R, Whitehouse J. Antiemetics for patients treated with antitumour chemotherapy. Cancer Clin Trials 3: 363–367, 1980.PubMedGoogle Scholar
  5. 5).
    D’Souza DP, Reyntjens A and Thornes R. Domperidone in the prevention of nausea and vomiting induced by antineoplastic agents: a three-fold evaluation. Curr. Ther. Res. Clin Exp. 27: 384–387, 1980.Google Scholar
  6. 6).
    Penta J, Poster D, Bruno S. The pharmacologic treatment of nausea and vomiting caused by cancer chemotherapy: a review. In Laszlo J (ED). Antiemetics and cancer chemotherapy. Williams and Wilkins. Baltimore 1983 p 53–92.Google Scholar
  7. 7).
    Mehrotta S, Rosenthal C, Barile B. A comparison between Droperidol and prochlorperozine in combination with Trimethobenzamide as antiemetics for antineoplastic combination chemotherapy (Abstract). Proc. ASCO 22: C-335, 1981.Google Scholar
  8. 8).
    Moertel C, Schitt A, Hahn R, Oral benzquinamide in the treatment of nausea and vomiting. Clin. Pharmacol. Ther. 18: 554–557, 1976.Google Scholar
  9. 9).
    Sallan S, Zinberg N, Frei E. Antiemetic effect of delta-9-tetra-hydrocannabinol in patients receiving cancer chemotherapy. N. Engl. J. Med. 293: 795–797, 1975.PubMedCrossRefGoogle Scholar
  10. 10).
    Ekert HW, Waters K, Jurk I. Amelioration of cancer chemotherapy-induced nausea and vomiting by delta-9-tetrahydrocannabinol. Med. J. Aust. 2: 657–659, 1979.PubMedGoogle Scholar
  11. 11).
    Frytak S, Moertel C, O’Fallon J, Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. Ann. Intern. Med. 91: 825–830, 1979.PubMedGoogle Scholar
  12. 12).
    Chang A, Shiling D, Stillman R. A prospective evaluation of delta-9-tetrahydrocannabin or as an antiemetic in patients receiving adriamycin and Cytoxan chemotherapy. Cancer 47: 1746–1751, 1981.PubMedCrossRefGoogle Scholar
  13. 13).
    Herman T, Einhorn L, Jones S. Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N. Engl. J. Med 300, 1295–1297, 1979.PubMedCrossRefGoogle Scholar
  14. 14).
    Steele N, Gralla R, Braun W. Double-blind comparison of the antiemetic effects of nabilone and prochlor perazine on chemotherapy-induced emesis. Cancer Treat. Rev. 64: 219–224, 1980.Google Scholar
  15. 15).
    Citran M, Herman T, Fossieck B. Double lined, randomized, cross over study of the antiemetic effect of levonantradol versus Tetrahydrocannabinol (Abstract) Proc. AACR 24: 652, 1983.Google Scholar
  16. 16).
    Cronin C, Sallan S. Delta-9-THC and Marijuana in: Laszlo 5 (ED) Antiemetics and cancer chemotherapy. Williams and Wilkins, Baltimore 1983. p 108–115.Google Scholar
  17. 17).
    Laszlo J, Lucas V. Synthetic cannabinoids in: Laszlo J (ED) Antiemetics and Cancer Chemotherapy. Williams and Wilkins, Baltimore 1983, p 116–128.Google Scholar
  18. 18).
    Gralla R. Antiemetic studies with metochlopramide in chemotherapy- induced nausea and vomiting. In: Laszlo J (ED) Antiemetics and Cancer Chemotherapy. Williams and Wilkins, Baltimore 1983. p 129–141.Google Scholar
  19. 19).
    Ellerton J, Myers A, Graze P. Control of frequent extrapyramidol effects of high dose metoclopramide by anticholinergics (Abstract) Proc. ASCO 2: C-328, 1983.Google Scholar
  20. 20).
    Kris M, Tyson L, Gralla R. Extrapyramidal reactions with high-dose. Metoclopramide. New. Engl. J. Med 309: 309–310, 1983.Google Scholar
  21. 21).
    Aapro M, Plezia P. Alberts D. Double-blind cross-over study of the antiemetic efficacy of high dose dexamethasone vs. high dose metoclopramide (Abstract) Proc. ASCO 2: C-364, 1983.Google Scholar
  22. 22).
    Laszlo J, Hanson D, Lucas V. Lorazepam as an antiemetic against cisplatin (Abstract) Proc. ASCO 2: C-369, 1983.Google Scholar
  23. 23).
    Plezia P, Alberts D, Aapro M. Immediate termination of intractable cisplatin induced vomiting with an intensive 5-drug antiemetic regime (Abstract). Proc. ASCO 2: C-363, 1983.Google Scholar
  24. 24).
    Artim R, DiBella N. Tetrahydrocannabinol plusprochlorperazine for refractory nausea and vomiting (Abstract) Proc. ASCO 2: C-330, 1983.Google Scholar
  25. 25).
    Tyson L, Gralla R, Clark R. Combination antiemetic trials with metoclopramide (Abstract) Proc. ASCO 2: C-356, 1983.Google Scholar
  26. 26).
    Cotanch P. Relaxation training for control of nausea and vomiting in patients recieving chemotherapy. Cancer Nursing 4: 277–283, 1983.Google Scholar
  27. 27).
    Dennis V. Fluid and electrolyte changes after vomiting, in Laszlo J (ED) Antiemeics and cancer chemotherapy, Williams and Vilkins, Baltimore 1983 p 34–42.Google Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston 1984

Authors and Affiliations

  • Christopher J. Williams

There are no affiliations available

Personalised recommendations