How to combat CINV: Strategies from anti-nausea warriors

Author: Wang Ping, Shanxi Bethune Hospital. The article highlights how effective interventions can reduce chemotherapy-induced nausea and vomiting, improving patients' quality of life.

Although chemotherapy-induced nausea and vomiting (CINV) is a common challenge in cancer treatment, healthcare professionals can help patients alleviate this discomfort and improve their quality of life through scientific methods and effective treatment strategies.

Prevention is key.

Doctors will select appropriate prophylactic antiemetic medications, such as 5-HT3 receptor antagonists, NK-1 receptor antagonists, and dexamethasone, before chemotherapy based on the patient's specific situation. These medications reduce the occurrence of CINV by blocking the action of neurotransmitters. Studies have shown that the combined use of these drugs can significantly lower the incidence of both acute and delayed CINV.

Pathogenesis diagram of delayed CINV.

Ensure sufficient sleep.

Adequate sleep is crucial for alleviating CINV. Deep sleep at night promotes the body's self-repair and boosts immunity, enhancing resistance to adverse reactions from chemotherapy drugs. Additionally, growth hormone and other restorative hormones are secreted mainly during deep sleep, supporting the body's recovery.

Balanced nutrition is essential.

A balanced diet is the foundation for maintaining health. Patients should ensure they consume enough protein, vitamins, and minerals, particularly from antioxidant-rich foods like fruits and vegetables. These nutrients support immune function and assist in repairing cell damage caused by chemotherapy.

Risk Assessment Decision Tree for Delayed CINV in Highly Emetogenic Chemotherapy.

Moderate exercise is beneficial.

Moderate exercise can help improve blood circulation and boost metabolism, alleviating symptoms of nausea and vomiting. Research indicates that gentle aerobic activities, such as walking and yoga, can relieve fatigue and depression caused by chemotherapy, enhancing overall patient health.

Psychological support is vital.

Psychological stress and anxiety can exacerbate CINV symptoms. Support from family and friends, in addition to professional counseling, can help patients maintain a positive mental state and alleviate psychological burdens. Cognitive Behavioral Therapy (CBT) and relaxation techniques, such as deep breathing and meditation, have proven effective in relieving anxiety and depression.

Avoid spicy foods.

Spicy, greasy, and heavily flavored foods may worsen feelings of nausea. Patients should choose light, easily digestible foods, such as rice porridge and vegetable soup. A low-fat, high-fiber diet can lessen the burden on the gastrointestinal tract and alleviate digestive discomfort.

References

Cheng Ying, Liu Jingjing. Interpretation of the "Expert Consensus on the Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in China (2022 Edition)" Journal of Clinical Internal Medicine, 2023, 40(05): 351-353.

Guidelines for the Prevention and Treatment of Delayed Nausea and Vomiting: Chinese Expert Consensus (2022 Edition) Journal of Clinical Oncology, 2023, 28(05): 442-458.

Shanghai Anti-Cancer Association Cancer Rehabilitation and Palliative Care Professional Committee, Shanghai Anti-Cancer Association Clinical Research Professional Committee for Oncology Drugs, China Association of Gerontology and Geriatrics Professional Committee for Tumor Prevention and Treatment, and Clinical Research Management. Full Management of Nausea and Vomiting Caused by Anti-Tumor Treatment: Consensus of Shanghai Experts (2024 Edition) Chinese Journal of Oncology, 2024, 34(01): 104-134. DOI: 10.19401/j.cnki.1007-3639.2024.01.008.

Chinese Anti-Cancer Association Clinical Chemotherapy Professional Committee, Chinese Anti-Cancer Association Supportive Care Professional Committee. Expert Consensus on the Prevention and Treatment of Chemotherapy-Related Nausea and Vomiting in Cancer Patients in China (2022 Edition) Chinese Medical Journal, 2022, 102(39): 3080-3094. DOI: 10.3760/cma.j.cn112137-20220810-01724.