Nausea induced by mental images of chemotherapy

Although anecdotal reports indicate that patients with cancer undergoing chemotherapy can become nauseated outside the chemotherapy clinic when they think or talk about treatment, this phenomenon has not been investigated systematically.

A series of experimental analyses with individual patients was conducted to explore the possibility that mental images of chemotherapy can elicit nausea in patients who, during the course of their treatment, experienced nausea in anticipation of chemotherapy infusions. Occurrence and intensity of nausea were examined in each patient in response to three imagery scenes: pastoral, a nonchemotherapy medical procedure, and chemotherapy.

Eight of 10 patients with clinically documented histories of anticipatory nausea to clinic stimuli experienced nausea when they imagined chemotherapy. They did not become nauseated when they imagined non-chemotherapy medical procedures. For the four patients without prior anticipatory nausea, imaginal reexposure to chemotherapy did not elicit nausea.

Results provide evidence that mental images of chemotherapy elicit nausea in patients with histories of anticipatory nausea and suggest that cognitive factors may play a more important role in the occurrence of chemotherapy side effects than previously recognized.