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The nature of nausea: prevalence, etiology, and treatment in patients with advanced cancer not receiving antineoplastic treatment

  • Signe HarderEmail author
  • Jørn Herrstedt
  • Jesper Isaksen
  • Mette Asbjoern Neergaard
  • Karin Frandsen
  • Jarl Sigaard
  • Lise Mondrup
  • Bodil Abild Jespersen
  • Mogens Groenvold
Original Article
  • 83 Downloads

Abstract

Background

The prevalence of nausea/vomiting in patients with advanced cancer has a wide range. Due to a very low level of evidence regarding antiemetic treatment, current guidelines recommend an etiology-based approach. The evidence for this approach is also slim and research is urgently needed.

Objectives

(Part One) to elucidate the prevalence of nausea and the possible associations with sociodemographic and clinical variables and (Part Two) to investigate possible etiologies of nausea and antiemetic treatments initiated in patients with nausea.

Methods

Patients with advanced cancer and no recent antineoplastic treatment were included in a prospective two-part study. In Part One, patients completed an extended version of the EORTC QLQ-C15-PAL. Nauseated patients could then be included in Part Two in which possible etiologies and antiemetic treatment were recorded and a follow-up questionnaire was completed.

Results

Eight hundred twenty-one patients were included and 46% reported any degree of nausea. Younger age and female sex were associated with a higher degree of nausea. Common etiologies included constipation, opioid use, and “other,” and treatments associated with a statistically significant decrease in nausea/vomiting were olanzapine, laxatives, corticosteroids, domperidone, and metoclopramide.

Conclusion

Nausea was a common symptom in this patient population and many different etiologies were suggested. Most patients reported a lower degree of nausea at follow-up. More research in treatment approaches and specific antiemetics is strongly needed.

Keywords

Nausea Advanced cancer N/V Etiology Treatment 

Notes

Funding

Funding was obtained from The Danish Cancer Society, the IMK foundation, and the Region of Southern Denmark. The funding sources had no influence on design, conduction, analyses of results, or manuscript writing.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Signe Harder
    • 1
    • 2
    • 3
    Email author
  • Jørn Herrstedt
    • 4
    • 5
  • Jesper Isaksen
    • 6
  • Mette Asbjoern Neergaard
    • 7
  • Karin Frandsen
    • 8
  • Jarl Sigaard
    • 9
  • Lise Mondrup
    • 9
  • Bodil Abild Jespersen
    • 7
  • Mogens Groenvold
    • 8
    • 10
  1. 1.Department of OncologyOdense University HospitalOdense CDenmark
  2. 2.Institute of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
  3. 3.OPEN, Odense Patient data Explorative NetworkOdense University HospitalOdenseDenmark
  4. 4.Department of Clinical OncologyZealand University HospitalRoskildeDenmark
  5. 5.Faculty of Health and Medical SciencesCopenhagen UniversityCopenhagenDenmark
  6. 6.Palliative Team, Department of OncologyOdense University HospitalOdense CDenmark
  7. 7.Palliative Care team, Department of OncologyAarhus University HospitalAarhusDenmark
  8. 8.The Research Unit, Department of Palliative MedicineBispebjerg and Frederiksberg HospitalsCopenhagenDenmark
  9. 9.The Palliative Care TeamHospital of Southwest JutlandEsbjergDenmark
  10. 10.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark

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