Supportive Oncology
surface of the wrist between the tendons of the flexor corpi radialis and the Palmaris longus. In 2005, Ezzo et al. published a meta-analysis concluding that acupressure significantly reduced acute chemotherapy- induced nausea when combined with standard antiemetics.40
Common
modalities for P6 stimulation include wristwatch-like devices consisting of an elastic band with an embedded stud, such as Relief-bands® or Seabands®. Although the overall effect of acupressure strongly suggests effectiveness against acute and delayed chemotherapy- induced nausea, the data are not conclusive.
New Approaches and Conclusions Research studies suggest that a major factor in preventing or reducing nausea is treating the symptom before it occurs. Successful interventions for chemotherapy-induced nausea, such as ginger, are those that are administered before exposure to chemotherapy. Starting interventions a few days before chemotherapy allows the patient to prepare for chemotherapy and potentially minimise anxiety. Furthermore, the preventative approach provides the patient with a sense of control over the symptom. It is possible that antiemetic drugs would be more effective against nausea if given a day or two before chemotherapy. For example, a commonly
prescribed serotonin (5-HT3) receptor antagonist antiemetic, granisetron (Kytril®), is now available in a transdermal patch (Sancuso®, ProStraken, Inc.).41
Patients apply the patch one to two
days before chemotherapy and leave it on for a total of five to seven days. According to research performed by ProStraken, Inc., Sancuso is more effective against chemotherapy-related nausea than the current standard antiemetic treatments. Sancuso is not yet readily available in the clinic setting, but has been approved by the FDA.
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Additionally, the most effective interventions for chemotherapy- induced nausea have been combination treatments. Recently, olanzapine, an antipsychotic that blocks several receptors such as dopamine, serotonin, muscarine cholinergic, adrenergic and histamine receptors, has demonstrated effectiveness against acute and delayed nausea and vomiting when combined with palonosetron and dexamethasone on day 1.42
Promising and extensive research studies have identified two non-invasive and cost-effective techniques, ginger supplementation and acupressure, to aid in the reduction of nausea and improve quality of life in cancer patients receiving chemotherapy.9,10,40
Although
there have been many medical advances in the field of vomiting and chemotherapy-induced nausea, the pathophysiology of chemotherapy- induced nausea is complex and remains unclear. Additional clinical trials are warranted to further understand the mechanism and obtain complete control of chemotherapy-induced nausea. n
Julie L Ryan is an Assistant Professor in the Departments of Dermatology and Radiation Oncology and a member of the Community Clinical Oncology Program (CCOP) Research Base at the University of Rochester Medical Center. She is a translational researcher combining the fields of cancer control, dermatology and radiation oncology. She has expertise in cancer pathobiology, virology and clinical research and trial design, with publications in lung cancer, breast
cancer, gastric cancer, Epstein–Barr virus and cancer treatment-related symptoms. The primary focus of Dr Ryan’s research is cancer treatment symptom management, specifically radiation dermatitis and chemotherapy-related nausea.
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