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Cancer can nausea both directly and indirectly. 

Directly, tumours can cause nausea. Nausea can be triggered via the stomach or gut and in the brain. Cancers that obstruct or put pressure on these areas, such as the bowel passage, or brain, can cause persistent nausea; this persistent nausea can be the symptom that causes people seek a specialist. 

Indirectly, there a multitude of ways that can cause nausea in a cancer setting. 

Anxiety caused by a cancer diagnosis can you feel uneasy and sick. Relaxation techniques and mindfulness have been found to alleviate nausea caused by anxiety. Radiotherapy and Chemo, treatments for many cancers, can cause the side-effect of nausea. If having radiotherapy to the stomach or area around the stomach, damage to the tissue can cause nausea. The same can occur for those requiring whole brain radiotherapy or total body irradiation. Chemo causes nausea as the body identifies it as something that should be not there. Fortunately, in the last ten years, there have medical advances in anti-emetic drugs. Anti-emetic drugs are a group of drugs designed specifically to inhibit and decrease the feeling of nausea. They have been developed so people are able to tolerate treatment better.

Cancer and its treatments can also cause underlying problems with your health, such as pain, poorly controlled blood sugars, or issues with your heart. This may require you to start medications that you have not had before. Some of these can lead to feeling queasy. Morphine, a commonly prescribed medication for pain relief, for example, can cause nausea if the dose is not properly titrated. 

Lastly, cancer can cause something called anticipatory nausea. Anticipatory nausea occurs when you expect to become nauseous, for example, before treatment. Knowing you have been nauseous during a previous experience causes you to become nauseous even if the trigger (such as chemotherapy), has not been administered yet. 

Nausea management will depend on what is making you feel sick. Distraction therapy, mindfulness and relaxation techniques are helpful to improve nausea caused by anxiety or anticipation.

There are medications, called anti-emetics, that can help relieve nausea. There are different sub-groups of anti-emetics, so if you find one type of medication doesn’t alleviate your nausea, switching, or adding another medication to your regimen can help. 

Ginger has been known to have anti-nausea properties. Ginger chews and drinks can complement your treatment regime and keep nausea under wraps. Anti-sickness bracelets have also been found to improve nausea. 
Always speak up, and tell your doctor if you become nauseous.

Smells of food or perfume can sometimes cause people to feel sick (whether the smells themselves are pleasant or unpleasant).

Are there any smells I should avoid to reduce nausea?

If you are finding there is a specific smell that is causing you to feel unwell, try removing it (if feasible). Otherwise, if you do find you are having treatment and still becoming nauseous, speak to your treatment team about changing anti-emetic medications, or trying alternative non-medical techniques (such as mindfulness) to help ease the symptoms of nausea. 

Persistent nausea and vomiting can be difficult to live with but with the development of new anti-sickness medications, people are finding they can manage better now than a few decades ago. However, occasionally and unfortunately you may find yourself in the situation of having uncontrolled nausea, with or without vomiting. 

Nausea is your body’s way to tell you something is in it, which is not meant to be. The act of vomiting then leads you to remove what is in your body. Sometimes vomiting helps relieve the feeling of nausea, but more often than not it does not. If this is the case, you may find yourself becoming dehydrated. It is important when experiencing nausea and vomiting to keep your fluid levels up. This can be counterintuitive if you are unable to hold any fluids down. 

Prolonged dehydration can take it toll on other organs in the body, and can make you end up very unwell. Your kidneys, liver and heart can start not working properly if you become dehydrated (suddenly or over a long period of time). If you find yourself in this situation, it is imperative that you contact your health care provider immediately. 

Nausea and vomiting can also be a sign of infection. When having chemotherapy, you are more at risk of developing infections. If you begin to feel nauseous, remember to also keep a track of your temperature as well. A temperature above 37.5 could be indicative of an infection, and a temperature above 38 needs to treated immediately, especially if your white blood cells are low. 

The feeling of nausea is created via receptors in your brain and in your stomach. As chemotherapy is not ingested (besides when taken orally), key medications work on targeting the receptors in your brain.

What are the different types of nausea medications?

There are many new medications being developed to help reduce nausea and vomiting in people living with cancer. The main group of these medications (and the most popular) are Serotonin Reuptake Antagonists (5HT-RA). There are different drugs that belong to this group, but the two most common are known as Granisetron and Ondansetron. Both work on your serotonin receptors in your brain and in your stomach, to help reduce the feeling of nausea. When having chemotherapy, you will usually find that you’ll be prescribed these medicines during and after treatment.

Other nausea medicines work by stimulating your stomach to make it work a bit quicker. The theory behind this type of medication is that if there’s something in your stomach that doesn’t make you feel well, removing it will improve the feeling of nausea. However, as stated, this may not work as well if your nausea is related to chemotherapy.

People who experience anticipatory nausea may benefit from anti-anxiety medications. Being relaxed and calm may prevent nausea returning, however as these medications can cause you to become drowsy at times, it may be best to try non-medical alternatives (such as meditation or practising mindfulness), before being prescribed them.