Nausea
Topics covered on this page:
What is cancer-related nausea?
Nausea is a feeling of being sick to your stomach, as if you are going to throw up. Some people in cancer treatment feel some nausea.
- How does it affect me? Mild nausea may make you feel unwell, or worried and this can affect your happiness and well-being. Most of the time, however, you will still be able to eat, drink, and do your everyday activities.
- Does it get better? The nausea may go away, depending on what causes it. There are many things you can do to help you manage your nausea or prevent it (see the section What can I do to help manage my nausea?).
What causes nausea?
There are a number of reasons you may have nausea with cancer, including:
- Cancer treatments (e.g., chemotherapy, radiation therapy, etc.) are the most common causes of nausea.
- Chemotherapy: Some treatments are more likely to cause nausea than others. It usually happens within 24 hours of receiving treatment and can last 2-3 days. In some cases, nausea begins more than 1 day after treatment. This is called delayed nausea.
- Radiation therapy: Your chance of getting nausea from radiation therapy usually depends on the part of the body that is being treated and how much radiation you are getting. Patients usually experience the most nausea with radiation of the abdomen (stomach area), spine and brain.
- Side effects from treatment (e.g., constipation, pain or headache) can also cause nausea.
- The cancer itself. Cancers of the liver, brain, or stomach and intestines raise the chances that you may get nausea.
- Anticipatory nausea. If you have already had nausea after chemotherapy, you may worry that it’s going to happen again. This stress and worry may cause you to feel nauseous before the treatment starts.
- Stress and anxiety. Nausea can be a physical expression of anxiety.
- Some medications, like opioids (for pain) and antibiotics (for infection), can cause nausea.
What are the signs of nausea?
Nausea is an uncomfortable, sick feeling in your stomach. Other signs of nausea include:
- Hypersalivation or more saliva (spit) in your mouth
- Feeling lightheaded or weak
- Sweating
- Loss of appetite
When should I get help for my nausea?
Even mild nausea can affect your everyday life and make you feel stressed. Talk to a member of your healthcare team or pharmacist if any of the following situations are true for you (For tips on talking with your health care team see Talking to your healthcare professional about your symptoms or concerns):
- You are not able to take your medications.
- Your nausea does not get better 24 hours after taking your anti-nausea medication.
- Your nausea stops you from doing your everyday activities.
Talk to someone in your healthcare team or go to the emergency department immediately if:
- You can’t eat or drink anything for 24 hours.
- It does not get better with changes made to the anti-nausea medication dose.
- You have nausea and cramps or diarrhea.
- You have nausea and stomach pain or headache.
- You have nausea and constipation.
- You are weak, dizzy and confused.
What can I do to manage my nausea?
The best way to avoid nausea is to prevent it before it starts (make sure to consult your pharmacist). This is why patients getting chemotherapy are prescribed anti-nausea medication before it starts. Here are a few different strategies to try.
You can keep a record of how your nausea affects you. It will help you and your healthcare team understand your nausea better and how to manage it.
- Make notes about when you feel nauseous (date and time).
- What brings it on?
- What makes it worse?
- What do you do to relieve the nausea?
- For more information see Symptom Diary.
- Follow your healthcare team’s instructions for taking your medication.
- Some people have side effects from their anti-nausea medications, like headaches, constipation, or fatigue. If the side effects bother you, speak with your healthcare team. They may change your medication or suggest other ways to manage your nausea.
Do not force yourself to eat if you feel sick to your stomach. Try having something to drink or eat when you feel a little better.
- Eat small meals instead of big meals.
- Avoid foods that are greasy, sweet, or spicy.
- Try dry foods like crackers or dry toast when you wake up.
- Try light broths (soup).
- Try not to go hungry. Hunger can make nausea worse.
- Try and drink 6-8 glasses of liquids every day to keep hydrated, especially water. Avoid alcohol or caffeinated drinks.
- If smells bother you, eat foods that are cold or at room temperature. This will decrease the food odour.
- Open windows to let fresh air in and let food smells out.
- Ask someone else to cook for you.
- Brush your teeth after eating to keep your mouth fresh.
- Relax. Eat slowly, chew your foods well.
- Stay sitting up for 30-60 minutes after meals. Try not to lie down right after eating, even if you feel tired—this could make you feel nauseous. If you must lie down, put pillows under your head so that you are not lying down flat.
- Don’t wear clothes that are tight around your waist.
- If you have been sitting, get up slowly to avoid feeling sick.
Relaxation strategies are a useful way to help relax your mind and body and reduce anxiety.
- Breathing exercises. This technique focuses on slow, deep breathing. Even a few minutes of deep breathing can help you relax.
- Progressive muscle relaxation. This involves tensing and relaxing a muscle, or group of muscles, one at a time.
- Guided imagery or visualization. Some people find that visualization relaxes them. This technique helps them imagine being in a place or setting where they feel calm in real life. Guided means someone talks you through the process in person or through a recording.
- Meditation. Meditation is a practice of quieting the mind, often done by focusing attention on breathing in and out. You can meditate sitting, lying down and even walking.
- Massage therapy. Use a certified massage therapist who has experience working with cancer patients if allowed by your health team.
- Relaxation activities. Yoga (some types) and tai chi involve slow, meditative movements that help relax the mind and body.
- Music therapy. Music can help you relax and reduce the stress you may be feeling.
- For more information see Relaxation strategies.
⚠ Important information about cannabis
Some patients do use cannabis to reduce pain, help with relaxation or as a sleeping aid. However, the research is still unclear about the use of cannabis to manage cancer-related symptoms, including nausea. It is important to talk to your doctor before trying cannabis. For more information on what cancer patients should know about cannabis, go to: www.bccancer.ca/health-info/coping-with-cancer/medical-cannabis.
Resources
For more information on cancer-related nausea, self-management strategies and support organizations, check out the resources below.
Centre hospitalier de l’Université de Montréal (CHUM) – Chemotherapy-Related Nausea and Vomiting
BC Cancer – Practical tips to help manage nausea
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- CHUM – Nausées et vomissements lies à la chimiothérapie. 2018.
- BC Cancer Agency Care + Research – Symptom Management – Nausea and Vomiting. 2016.
- BC Cancer – Practical Tips to help Manage Nausea. 2011.
- COSTaRS Team – Remote Symptoms Practice Guides for Adults on Cancer Treatment. 2020.
- Cancer Care Ontario – Nausea and Vomiting. 2016.
- Cancer Care Society – Nausea and Vomiting. 2020.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
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