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Anticipatory nausea and vomiting.

Joseph A Roscoe¹, Gary R Morrow, Matti S Aapro

¹James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA. joseph_roscoe@urmc.rochester.edu

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Summary

Anticipatory nausea and vomiting (ANV) affects many chemotherapy patients. Preventing nausea and vomiting during initial treatments is key to avoiding ANV, with behavioral therapies offering effective solutions.

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Area of Science:

Oncology
Psychology
Clinical Medicine

Background:

Anticipatory nausea and vomiting (ANV) is a common adverse effect following chemotherapy.
Nausea occurs before chemotherapy administration in approximately 20% of patients during the first cycle, rising to 25-30% by the fourth cycle.
Existing research suggests classical conditioning plays a significant role in ANV development in adult patients.

Purpose of the Study:

To review the evidence on the development and management of anticipatory nausea and vomiting (ANV) in patients undergoing chemotherapy.
To highlight effective strategies for preventing and treating ANV.

Main Methods:

Literature review of published studies on anticipatory nausea and vomiting.
Analysis of evidence supporting classical conditioning as a mechanism for ANV.
Evaluation of treatment modalities for ANV.

Main Results:

Adequate prevention of nausea and vomiting during initial chemotherapy exposure is the most effective method to prevent ANV.
Behavioral treatment techniques, such as systematic desensitization, are effective for managing established ANV.
Pharmacological interventions, including benzodiazepines in conjunction with behavioral techniques or antiemetics, may also be beneficial.

Conclusions:

Preventing initial nausea and vomiting is crucial for avoiding anticipatory nausea and vomiting (ANV).
Behavioral therapies and potentially benzodiazepines offer effective management strategies for patients who develop ANV.
This review consolidates evidence for these conclusions in chemotherapy patients.