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Cancer and nausea
Cancer and nausea are associated in about fifty percent of people affected by cancer. This may be as a result of the cancer itself, or as an effect of the treatment such as chemotherapy, radiation therapy, or other medication such as opiates used for pain relief. While seventy to eighty percent of people undergoing chemotherapy experience nausea and/or vomiting, they may also occur in people not receiving treatment, mostly as a result of the disease involving the gastrointestinal tract or other metabolic disorders such as hypercalcaemia and renal failure or as a result of anxiety.〔 Nausea and vomiting may be experienced as the most unpleasant side effects of cytotoxic drugs and may result in patients delaying or refusing further radiotherapy〔 or chemotherapy.〔 The strategies of management or therapy of nausea and vomiting depend on the underlying causes.〔 Medical treatments or conditions associated with a high risk of nausea and/or vomiting include chemotherapy, radiotherapy and malignant bowel obstruction.〔 Anticipatory nausea and vomiting may also occur.〔 Nausea and vomiting may lead to further medical conditions and complications including: dehydration, electrolyte imbalance, malnutrition, aspiration pneumonia, esophageal tears, a decrease in the ability to self care, and a decrease in quality of life.〔
Nausea may be defined as an unpleasant sensation of the need to vomit, which is often accompanied by symptoms such as skin pallor, cold sweat, salivation, and tachycardia. Vomiting is the forceful ejection of stomach contents through the mouth.〔(【引用サイトリンク】url=http://cks.nice.org.uk/palliative-cancer-care-nausea-vomiting )〕 Although nausea and vomiting are closely related, some patients experience one symptom without the other and it may be easier to eliminate vomiting than nausea.〔 The vomiting reflex (also called emesis) is thought to have evolved in many animal species as a protective mechanism against ingested toxins. In humans, the vomiting response may be preceded by an unpleasant sensation termed nausea, but nausea may also occur without vomiting. The central nervous system is the primary site where a number of emetic stimuli (input) are received, processed and efferent signals (output) are generated as a response and sent to various effector organs or tissues, leading to processes that eventually end in vomiting. The detection of emetic stimuli, the central processing by the brain and the resulting response by organs and tissues that lead to nausea and vomiting are referred to as the emetic pathway or emetic arch.
==Causes==
Some medical conditions that arise as a result of cancer or as a complication of its treatment are known to be associated with a high risk of nausea and/or vomiting. These include malignant bowel obstruction (MBO), chemotherapy induced nausea and vomiting (CINV), anticipatory nausea and vomiting (ANV), and radiotherapy induced nausea and vomiting (RINV).
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