Treatment of nausea and vomiting in advanced cancer

Nausea and vomiting unrelated to chemotherapy is common in advanced cancer patients. The etiology of nausea and vomiting may from evident by the patte rn of vomiting, associated symptoms, review of medications and physical exa mination. Radiographic studies are particularly helpful if bowel obstructio n is suspected or central nervous system metastases are a possibility. Labo ratory studies are helpful in a minority of cases. Multiple classes of medi cations are available to palliate nausea and vomiting. Classes of agents ar e discussed, pharmacology and cost being among the aspects covered. A four- step approach to the medical management of nausea and vomiting is presented .