BURLINGTON, Vermont—Despite the availability of effective antiemetics, oncologists and oncology nurses often fail to recognize chemotherapy-induced nausea and vomiting. This finding was based on a study comparing predictions of physicians and nurses to the experiences of patients as recorded in their diaries and reported in questionnaires (ASCO abstract 996).
"We’ve made a huge amount of progress over the last few years in emesis control," said Steven M. Grunberg, MD, professor of medicine and pharmacology at the University of Vermont Medical Center in Burlington. "But the problem persists for many patients and we tend to underestimate it, especially after they leave the hospital."
In the Anti-Nausea Chemotherapy Registry study, known as ANCHOR, 24 doctors and nurses from six oncology practices estimated the frequency of acute (0 to 24 hours) and delayed (2 to 5 days) nausea and vomiting after chemotherapy.
After receiving chemotherapy for the first time, 68 patients from nine oncology practices, including the six practices already surveyed, recorded nausea and vomiting in a 5-day diary. They also completed a Functional Living Index—Emesis questionnaire on day 6, which was designed to determine the actual incidence and impact of nausea and vomiting on nine different aspects of daily living, including ability to enjoy meals, to spend time with family and friends, and to complete usual hobbies.
Moderately Emetogenic
In 72 patients enrolled to date, mean patient age was 54 years; 82% were female; 71% had breast cancer. None used alcohol(Drug information on alcohol). Chemotherapy was moderately emetogenic, defined as causing nausea and vomiting in 30% to 60% of patients who receive no antiemetic therapy, and did not contain cisplatin(Drug information on cisplatin) (Platinol). Mean number of chemotherapeutic agents was 3.4 per regimen.
All patients received a 5HT3 receptor antagonist antiemetic, and 89% received a corticosteroid, with mean number of antiemetics at 2.6 per patient.
