Vol 10, No 3 (2016)
Review paper
Published online: 2017-03-13
Nausea and vomiting in cancer patients — clinical practice recommendations
Medycyna Paliatywna w Praktyce 2016;10(3):98-111.
Abstract
Nausea and vomiting (NV) are frequent symptoms form the gastrointestinal system in cancer patients, especially in advanced disease. Chronic NV are most frequently evoked by the cancer progression, metabolic disturbances, oncologic treatment, opioids and other drugs administration. Significant group of causes of NV are cytotostatic drugs and other systemic therapies, local treatment: radiotherapy and surgery. The most difficult therapeutic challenge concerns NV in the course of inoperable bowel obstruction. According to a receptor theory NV are induced by numerous neurotransmitters that activate receptors located on the vagus nerve endings and in the CNS, thus the treatment should effectively block receptors involved. In cancer patients suffering from chronic NV unrelated to oncology treatment few randomized studies were conducted to date and in consequence there is a lack of therapeutic recommendations for the management of symptoms based on a high level of scientific evidence. Therapeutic interventions in patients with chronic NV should encompass possible causes, pathophysiology, meticulous clinical assessment (including detailed history, physical examination and if necessary laboratory and/or imaging investigations), which allows to introduce effective treatment and in consequence improve patients’ quality of life. In this article causes, pathophysiology and treatment are discussed including more frequently used antiemetics and therapeutic recommendations of the Multinational Association for Supportive care in Cancer (MASCC) and European Society of Medical Oncology (ESMO).
Keywords: Treatmentbowel obstructionnauseagastrointestinal symptomsvomiting
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