Acute and anticipatory emesis in breast cancer patients

Abstract

A group of 90 breast cancer patients undergoing chemotherapy were assessed prospectively to estimate the prevalence of acute (post-treatment) and anticipatory emesis in the 1990s. For this purpose, two protocols of chemotherapy were analysed separately: cyclophosphamide/methotrexate/5-fluorouracil (CMF) and 5-fluorouracil/doxorubicin/cyclophosphamide (FAC). All patients were treated with antiemetic therapy, which included one corticoid plus ondansetron (in the FAC regimen), or one corticoid plus thiethylperazine (in the CMF regimen). For at least one cycle of chemotherapy 86.1% and 91.7% patients in the FAC protocol presented vomiting and nausea respectively: 11.1% had anticipatory vomiting and 30.6% had anticipatory nausea. In the CMF protocol, 79.6% had post-chemotherapy vomiting and 71.7% had post-chemotherapy nausea associated with at least one cycle. In this group, 7.4% had anticipatory vomiting and 16.6% had anticipatory nausea. A high proportion of patients suffered anticipatory anxiety in both groups (75% in FAC, 74.1% in CMF). The stimuli most frequently associated with the appearance of anticipatory emesis were olfactory stimuli and cognitive stimuli. In summary, as a result of the advances made in antiemetic control during the last decade, the severity of chemotherapy-induced emesis seems to have significantly decreased, but the prevalence of these symptoms along the course of the treatment still remains high.

Olfactory modulation of nausea during early pregnancy?

“…The present results do not exclude the facts that (1) the cognitive processing of odorous sensations appears to change during early pregnancy 18–21 , and that (2) many odours may trigger nausea and vomiting especially when considering the different hedonic perception of odours during pregnancy. For example, odours appear to play an important role in the anticipatory nausea which is frequently observed during chemotherapy 22–24 . In addition, data from Mattes and Cowart 25 indicate that the prevalence of food aversions are particularly low in anosmic patients (approximately 11%) compared with the general population (approximately 26%).…”

Anticipatory nausea and vomiting

“…A high proportion of patients suffered anticipatory anxiety in both groups (75% in FAC, 74.1% in CMF). The stimuli most frequently associated with the appearance of anticipatory emesis were olfactory stimuli and cognitive stimuli [15]. …”

Nausea control during the application of chemotherapy in patients with colorectal carcinoma-sister intervention // Kontrola mučnine tokom primene hemioterapije kod pacijenata sa kolorektalnim karcinomom-sestrinske intervencije

“…Dok jedna studija iznosi podatke o nižoj incidenci mučnine i povraćanja, druge tri, navode da je incidenca povraćanja nakon primena 5-HT3 lekova u hemoterapiji, niža, ali ne i incidenca posthemoterapijskih mučnina. 8,9 Mučnina i povraćanje se često javljaju u isto vreme, u toku hemoterapije ali to mogu biti i dva različita problema koja se javljaju nezavisno. 10 Na osnovu istraživanja koje je sprovedeno na intrenacionalnom nivou.…”