Patients with advanced cancer commonly experience nausea, vomiting, and/or
retching (NVR) as a result of the malignant process and its treatment, Rece
ntly, increasing attention is being focused on end-of-life care, which incl
udes relief or reduction of symptoms such as NVR.
Pre-chemotherapy preparation and patient education in the palliative care s
etting are essential to preventing acute and delayed distress from NVR, as
well as anticipatory symptoms. Careful assessment of chemotherapy-related s
ymptoms should distinguish between the three phenomena rather than taking a
global approach. Strategies for preventing anticipatory nausea, for instan
ce, may differ significantly from those designed to reduce frequency of vom
iting.
Management of anticancer treatment-related NVR should incorporate both phar
macologic and nonpharmacologic approaches, whenever appropriate, with the o
verall goal of improving and/or maintaining the patient's quality of life.