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Folake Ajose-Adeogun

Medical manager, Chugai Pharma UK Ltd 

As many as 40% of cancer patients continue to experience nausea or vomiting following chemotherapy despite advances in the range of effective treatments.1 Clinicians and patients should be educated on how to minimise these side effects.

Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared side effects experienced by patients with cancer receiving chemotherapy treatment.2 Uncontrolled and/or prolonged chemotherapy-induced nausea and vomiting can also lead to dehydration and malnutrition.3 Moreover, it can negatively impact a patient’s quality of life4 and lead patients to consider discontinuing anti-cancer therapy.5

Patients endure CINV side effects 

Folake Ajose-Adeogun, Oncology Medical Manager at Chugai Pharma UK, provides support materials to patients going through chemotherapy treatment. “The chemotherapy agents are very effective at killing the cancer cells but, as a side effect, they cause nausea and vomiting.”

She adds: “Advances in treatment mean CINV has been reduced in the short-term. However, effects are seen in the delayed phase (day one to five post-treatment); when patients are trying to recover, perhaps going back to their normal daily activities, some experience nausea and vomiting.” 

Reporting is a key factor in making
sure patients are supported.

Patients are reluctant to report symptoms 

According to patient healthcare market research conducted by Chugai Pharma UK, more than half (52%) of patients who had nausea and vomiting with IV chemotherapy (n=81) did not always report their symptoms to their doctor, nurse or healthcare team.6 “There are big misconceptions about what these symptoms mean,” explains Ajose-Adeogun.

“Patients expect that nausea and/or vomiting will be part of their chemotherapy journey. Some also feel that if they report the symptoms, the treatment might be stopped. They also don’t want to bother healthcare professionals, so they think they have to put up with it and nothing can be done when, actually, it can be avoided,” she adds.

Symptoms can last up to five days every three weeks, depending on the type of chemotherapy treatment and frequency of each cycle. Their nutrition is affected, and they feel fatigued. It can also influence mental health and attitude towards treatment. 

“Reporting is a key factor in making sure patients are supported. It’s vital that they feel able to raise their issues, then they can receive appropriate support from clinicians,” she insists.

Support and education for CINV management 

It is essential to get the nausea and vomiting managed as early as possible. If CINV is not managed properly in the first cycle, it becomes a significant predictor for CINV in the following cycle, increasing the risk by 6.5 times in cycle 2 and 14 times by cycle 3.7 It can also lead to Anticipatory CINV, where a patient starts to feel nauseous or vomit before they even begin their chemotherapy. This becomes even more difficult to treat.7 

“We must increase our efforts in enlightening patients about the significance of communicating their symptoms. Equally important is strengthening the knowledge base of clinicians regarding optimal CINV prevention according to different types of chemotherapy, aligned with established best practices. With this dual-focus approach, we can create a healthier dialogue around CINV, better addressing the needs of patients,” she concludes. 

June 2023

[1] Aapro M. CINV: Support Care Cancer. 2018;26(Suppl 1):5-9;
[2] Aapro M. CINV: Support Care Cancer. 2018;26(Suppl 1):5-9;
[3] Curran MP and Robinson DM. Drugs 2009;69(13):1853-1878.
[4] Aapro M, et al. Ann Oncol. 2012;23:1986-1992. 
[5] Janelsins MC, et al. Expert Opin Pharmacother. 2013;14(6):757-66.
[6] Data on file – CINV Patent Research Outcomes Report. September 2022.*
*Data is from results obtained from responses to a self-reporting survey and is based on a sample of N=100 cancer patients who have had or expect to receive IV chemotherapy. Self-selecting sample was obtained from invitation sent by Panelbase to their members. In total, there were 12,166 click-throughs to the survey between 30th June and 2nd September 2022 and fieldwork stopped once 100 complete responses were received. Survey excludes patients below 18 years of age, therefore does not reflect the paediatric population. Survey was funded by Chugai Pharma UK.
[7] Molassiotis A, et al. J Pain Symptom Manage 2016;51(6): 987-9

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