Psychogenic nausea and vomiting associated with termination of cancer chemotherapy

Psychogenic (pretreatment) nausea with or without vomiting develops in many patients undergoing chemotherapy for cancer. This phenomenon can be understood as classical aversive conditioning of the gastrointestinal system. Most patients tolerate this side effect of chemotherapy treatment. The author reports 4 patients who were non complaint or discontinued chemotherapy; each patient alleged that the pretreatment symptoms prompted this behavior. Closer examination revealed that these patients avoided chemotherapy because of multiple issues and used the pretreatment symptoms to explain their behavior. The cases illustrate the phenomenon of pretreatment nausea and methods of working therapeutically with oncologists and their patients.