Searching for Evidence to Support the Use of Ginger in the Prevention of Chemotherapy-Induced Nausea and Vomiting

Abstract

Patients with cancer frequently use dietary supplementation and herbal therapies to control symptoms of disease and adverse effects of cancer therapy. Despite the widespread use of dietary supplementation and herbal therapies in oncology, robust scientific evidence in this area is lacking. Not only do these products need to be tested in large and well-designed observational or randomized studies, but their manufacturing process must be improved to achieve higher levels of standardization in product quality. Ginger is frequently used to counteract chemotherapy-induced nausea and vomiting (CINV), and some suggestions that it might be effective against CINV come from randomized and/or crossover clinical trials. However, several limitations in the methods of these studies limit their power and generalizability. The authors are conducting a randomized, double-blind study with a large sample size and homogeneous inclusion criteria in order to evaluate the efficacy of a wellstandardized ginger extract in reducing nausea in patients with cancer. The widespread use of standardized herbal therapies and natural components among patients requires that scientific and rigorous research strategies are applied in this field to guide the physicians and the patients in safer use.

Benefits of ginger in the control of chemotherapy-induced nausea and vomiting

“…The use of nutritional supplementation and plant-derived treatments was frequent among patients with neoplasms (2,3) . Approximately 80% of cancer patients already consume vitamin and mineral supplements, while 14% to 32% start using supplements after the diagnosis of neoplasms (2,4) .…”

“…The use of nutritional supplementation and plant-derived treatments was frequent among patients with neoplasms (2,3) . Approximately 80% of cancer patients already consume vitamin and mineral supplements, while 14% to 32% start using supplements after the diagnosis of neoplasms (2,4) . These complementary therapies may help in the management of adverse effects (such as nausea, emesis, and mucositis) of pathology and treatment (2,5) .…”

“…Approximately 80% of cancer patients already consume vitamin and mineral supplements, while 14% to 32% start using supplements after the diagnosis of neoplasms (2,4) . These complementary therapies may help in the management of adverse effects (such as nausea, emesis, and mucositis) of pathology and treatment (2,5) . The area of integrative oncology systematizes the provision of complementary evidence-based treatments associated with traditional neoplasm therapy.…”

“…Ginger Rhizome has a diversity of bioactive elements, including gingerols, shogaols, zingiberene, zingerone and paradol, which can encourage oral and gastric secretions, normalize gastrointestinal motility, communicate with the 5HT3 and NK1 receptors related to the nausea reflex and emesis resulting, for example, from chemotherapy treatment, in addition to acting on free radicals. However, it can also cause adverse reactions, such as dermatitis and poor digestion, which can be confused with the permanence of nausea (2) .…”

“…Some authors have observed that ginger can influence the control of nausea and vomiting induced by chemotherapy, however, divergences in the methodologies employed and contradictory results hinder the convergence of conclusions (2) . The different evidence in the literature is also due to the performed evaluation of symptoms at different stages of treatment, including: anticipatory (before chemotherapy), acute (up to 24 hours after administration of antineoplastic agent) and delayed (from 24 hours after administration up to 4 or 5 days later) (9) .…”