Nausea/vomiting cancer patients

Cetuximab monotherapy has been used in patients with advanced non-small-cell lung cancer after prior therapy with an epidermal growth factor (EGF) receptor tyrosine kinase inhibitor [108 ]. Common adverse reactions were mild and included fatigue, rashes, and nausea/vomiting. Two patients developed interstitial lung disease, which was life threatening in one case. 

Combination therapy Nausea, vomiting, diarrhea, in patients with Dukes stomatitis, anorexia stage C colon cancer... 

A variety of other common etiologies have been proposed for the development of nausea and vomiting in cancer patients. These are presented in Table 27-3. 

Nonchemotherapy Etiologies of Nausea and Vomiting in Cancer Patients... 

In the headache evaluation, diagnostic alarms should be identified. These include acute onset of the first or worst headache ever, accelerating pattern of headache following subacute onset, onset of headache after age 50 years, headache associated with systemic illness (e.g., fever, nausea, vomiting, stiff neck, and rash), headache with focal neurologic symptoms or papilledema, and new-onset headache in a patient with cancer or human immunodeficiency virus infection. 

Cancer patients in chemotherapy - Adverse reactions greater than 3% were consistent with the underlying disease state pyrexia, diarrhea, nausea, vomiting, edema, asthenia, fatigue, shortness of breath, paresthesia, upper respiratory infection, dizziness, and trunk pain. 

The most frequently reported serious adverse events reported with cancer chemotherapy patients included death, fever, pneumonia, dehydration, vomiting, and dyspnea. The most commonly reported adverse events were fatigue, edema, nausea, vomiting, diarrhea, fever, and dyspnea. The most frequently reported reasons for discontinuation of darbepoetin alfa were progressive disease, death, discontinuation of the chemotherapy, asthenia, dyspnea, pneumonia, Gl hemorrhage, thrombotic events, rash, dehydration. 

Irinotecan treatment schedules differ from 125 to 150 mg/m2 once a week for 4 wk followed by a 2-wk drug free interval (United States), to 350 mg/m2 once every 3 wk (Europe), or 100 mg/m2/wk or 150 mg/m2 every 2 wk (Japan). Differing intermittent treatment schedules using cytokine support for neutropenia, or intensive loperamide to counteract diarrhea, have also been reported (14). These tolerable CPT-11 regimens have produced median durations of response that range from 5.6 to 10.6 mo in colorectal patients disease stabilization occurs in 30 to 71 % (40). Response rates of 26% and 32% have been reported for previously untreated colorectal cancer patients higher response rates have been reported for non-5-FU-refractory patients (only 7-21%). Symptoms of diarrhea, nausea, and vomiting are common toxicities other side effects are asthenia, abdominal pain, leukopenia, and neutropenia. In the US trials at least one of these adverse... 

Morphine s effects in the digestive tract can also be severe, especially for cancer patients already rendered nauseous by chemotherapy. Nausea and vomiting are commonly encountered at therapeutic doses of morphine... 

Therapeutic THC is called dronabinol (Marinol) and has been marketed with approval by the Food and Drug Administration to reduce nausea and vomiting in patients undergoing cancer chemotherapy and to stimulate appetite in AIDS patients. It has also been shown to reduce intraocular pressure in glaucoma. Levonantradol, an analog, may be useful as an analgesic. 

Other recent reports indicate that THC "is far more effective than any other drug in relieving the vomiting and nausea that plague thousands of cancer patients undergoing chemical therapy. ... 

Over the last few years, and in particular, during the months preceding the 1996 USA general election, a heated public discussion took place over the legalization of marijuana for medical use - in particular for amelioration of nausea and vomiting in cancer patients, for appetite stimulation in AIDS pa-... 

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