The role of patients' expectations in the development of anticipatory nausea related to chemotherapy for cancer

Although anticipatory nausea (AN), which is reported by one-third of patien ts receiving chemotherapy for cancer is thought to develop primarily by cla ssical conditioning, response expectancies may also be important. The role of patients' expectations of nausea in the development of AN was examined i n 63 female cancer patients receiving their first course of chemotherapy. T wenty women (32%) expected to experience nausea and twelve (19%) reported A N before the third cycle. Pretreatment expectations predicted AN at cycle t hree (Spearmans r = 0.41, P = 0.001). AN developed in 40% of patients who e xpected nausea, 13% of those who were uncertain whether they would develop it, and no patients who did not expect nausea. Logistic regression indicate d that expecting nausea was the strongest predictor (chi (2) = 13.15; P < 0 .001). Results support a role for cognitive factors in the development of c hemotherapy side effects and suggest testing psychologic interventions to m odify Patients' expectations. (C) US. Cancer Pain Relief Committee, 2001.