Patients Under 40 Noted to Have Higher Chemo-Induced Nausea/Vomiting

Patients between the ages of 18 to 40 who were chemotehrapy-naive were noted to have higher rates of chemotherapy-induced nausea/vomiting (CINV) compared with counterparts who were 40 years or older, according to a presentation from the 2026 American Psychosocial Oncology Society Annual Meeting.

These findings, presented as a late-breaking poster at the conference, highlight a critical gap in supportive care for the YA population. For oncology nurses and advanced practice providers (APPs), these data underscore the necessity of more aggressive and proactive symptom management for younger patients, who often face unique challenges during treatment.

CINV-Focused Study Design and Methodology

The single-center study out of Moffitt Cancer Center included a large sample of 1,609 participants, of which 159 (approximately 10%) were classified as YAs. All participants were scheduled to receive their first infusion of moderate- to highly-emetogenic chemotherapy.

Researchers utilized the Multinational Association for Supportive Care and Cancer Antiemesis Tool to measure the incidence and severity of acute CINV (within 24 hours of the first infusion) and delayed CINV (5 days after the first infusion). Additionally, the study explored the various symptom management strategies employed by patients who endorsed CINV.

Key Data: Acute vs Delayed Symptoms

The study results showed a stark contrast in the experiences of young and older adults. In the acute phase, 69% of YAs reported nausea vs 40% of older adults (P <.001). Nausea was also more severe in the acute setting, with YAs reporting a mean severity of 3.9 out of 5 compared with 3.0 in the older group (P <.001).

While vomiting was relatively rare in the acute phase for both groups, it remained more frequent in the YA cohort (7% vs 4%; P = .03). The disparity became more pronounced during the delayed phase. Delayed nausea was reported by 80% of YAs, whereas only 69% of older adults experienced this symptom. The severity of delayed nausea was also markedly higher in YAs (mean, 4.5 vs 3.7; P <.001). The incidence and frequency of delayed vomiting did not show a significant difference between the age groups.

Symptom Management Discrepancies

The study also investigated how patients attempted to mitigate these symptoms. During the acute phase, management strategies were largely similar across both groups, with 64% of all patients taking prescription anti-nausea medications and 27% reporting that they ate less food.

However, for delayed CINV, YAs were significantly more likely to utilize a wider variety of interventions (P <.01). Specifically:

• 84% of YAs took prescription anti-nausea medications compared with 73% of older adults
• 26% of YAs changed their diet or ate different foods compared with 16% of older adults
• 17% of YAs used vitamins, supplements, or other home remedies vs. 7% of older adults
• 13% of YAs reported using marijuana to manage symptoms compared with only 6% of the older group

Although 65% of YAs were receiving guideline-consistent antiemetic care, the prevalence of nausea remained high. Crucially, the researchers found that no specific patient or disease-related characteristics were associated with the increased risk of acute or delayed CINV among YAs.

Clinical Implications for Oncology Nursing

Because up to 85% of YAs experience CINV and the symptoms are consistently more severe than in older patients, proactive intervention is essential. Nurses and APPs should prioritize thorough education for YAs before their first infusion, emphasizing that they are at a higher risk for both acute and delayed nausea.

Providers should also be prepared to discuss the diverse range of management strategies YAs are using, including the use of marijuana and supplements, to ensure these do not interfere with other aspects of their treatment plan.

Ultimately, these findings suggest that clinical approaches must be tailored to the patient’s age. By anticipating higher symptom burdens in the YA population, oncology teams can work toward more effective, personalized antiemetic regimens that improve the quality of life for these patients during active treatment.

Reference

Oswald LB, Hoogland AI, Welniak TL, et al. Chemotherapy-induced nausea and vomiting is worse among young adult vs. older adult cancer patients. Presented at: 23rd Annual American Psychosocial Oncology Society Conference; March 18-20, 2026. New Orleans, LA. Abstract W17.