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Biobehavioral Factors in Chemotherapy-Induced Nausea and Vomiting

Joseph A. Roscoe, Gary R. Morrow, Jane T. Hickok, Karen M. Mustian, and Abhay R. Shelke

Although emesis can be considered a reflex to clear toxins from the body and involves mostly lower brain structures, nausea's purpose appears to be a warning signal to the individual to not engage in behaviors that he or she was doing at the time. As such, it involves the functioning of cognition and memory from higher developed neural structures. Given this, it should not be surprising that biobehavioral factors are important in predicting and controlling nausea. This article reviews the individual characteristics that are clinically useful in predicting which patients will have an increased probability of experiencing nausea or emesis during chemotherapy treatment, and also briefly review psychologic and biobehavioral treatments that can be useful in managing chemotherapy-related nausea.

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Behavioral Interventions in Treating Anticipatory Nausea and Vomiting

Colmar Figueroa-Moseley, Pascal Jean-Pierre, Joseph A. Roscoe, Julie L. Ryan, Sadhna Kohli, Oxana G. Palesh, Elizabeth P. Ryan, Jennifer Carroll, and Gary R. Morrow

Anticipatory nausea and vomiting (ANV) is associated with a significant reduction in the quality of life for many chemotherapy patients. The use of 5-hydroxytryptamine type 3 receptor antagonists provides some relief for chemotherapy-induced nausea and vomiting, but does not seem to control ANV. Nonpharmacologic approaches, which include behavioral interventions, may provide the greatest promise in relieving symptoms. Little evidence supports the use of complementary and alternative methods, such as acupuncture and acupressure, in relieving ANV. Behavioral interventions, especially progressive muscle relaxation training and systematic desensitization, should be considered important methods for preventing and treating ANV.