Abstract
Introduction
Posttreatment nausea (PTN) is a common side effect of cytotoxic cancer chemotherapy. Previous retrospective research has suggested that the severity of PTN may be, in part, related to pretreatment psychological factors (e.g., emotional distress and expectations for nausea).
Materials and methods
The purpose of the present study was to examine these relationships prospectively, with distress and nausea expectations assessed by validated self-report measures completed in the clinic before the participants’ first outpatient treatment infusion and with PTN (0–100) assessed by end-of-day diaries completed at home on each of the first 5 days after treatment. The participants were chemotherapy-naive women (N=56) scheduled for standard adjuvant treatment for stage I–II breast cancer (mean age=45.6 years). PTN was evaluated for acute (days 0–1) and delayed (days 2–5) responses.
Results
The results revealed a significant relationship between pretreatment distress and the severity of the patients’ subsequent delayed nausea (p<0.007) but not a relationship with acute PTN (p<0.19). No significant relationships were seen between expectations and PTN. However, there was evidence of an additive effect of nausea expectations and distress, with the highest levels of delayed PTN seen in patients with both expectations and higher distress before treatment. The results suggest a selective effect of pre-infusion psychological variables on the delayed phase of nausea after chemotherapy, consistent with an emerging view that the different phases of nausea are mediated by different neural pathways.
Conclusion
Future research should examine the possibility that delayed nausea, which the literature suggests is more resistant to antiemetic drugs than acute nausea, might be responsive to psychological interventions before initial treatments.
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References
Andrykowski MA, Gregg ME (1992) The role of psychological variables in post-chemotherapy nausea: anxiety and expectation. Psychosom Med 54:48–58
Arakawa S (1997) Relaxation to reduce nausea, vomiting, and anxiety induced by chemotherapy in Japanese patients. Cancer Nurs 20(5):342–349
Blasco T, Pallares C, Alonso C, Lopez Lopez JJ (2000) The role of anxiety and adaptation to illness in the intensity of postchemotherapy nausea in cancer patients. Span J Psychol 3(1):47–52
Cassileth BR, Lusk EJ, Bodenheimer BJ, Farber JM, Jochimsen P, Morrin-Taylor B (1985) Chemotherapeutic toxicity—the relationship between patients’ pretreatment expectations and post-treatment results. Am J Clin Oncol 8:419–425
Cull A, Cowie VJ, Farquharson DI, Livingstone JR, Smart GE, Elton RA (1993) Early stage cervical cancer: psychosocial and sexual outcomes of treatment. Br J Cancer 68(6):1216–1220
de Boer-Dennert M, de WR, Schmitz PI, Djontono J, Beurden V, Stoter G, Verweij J (1997) Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. Br J Cancer 76(8):1055–1061
Dibble SL, Isreal J, Nussey B, Casey K, Luce J (2003) Delayed chemotherapy-induced nausea in women treated for breast cancer. Oncol Nurs Forum 30(2):E40–E47
DiLorenzo TA, Bovbjerg DH, Montgomery GH, Jacobsen PB, Valdimarsdottir H (1999) The application of a shortened version of the profile of mood states in a sample of breast cancer chemotherapy patients. Br J Health Psychol 4:315–325
Foubert J, Vaessen G (2005) Nausea the neglected symptom? Eur J Oncol Nurs 9(1):21–32
Gianaros PJ, Muth ER, Mordkoff JT, Levine ME, Stern RM (2001) A questionnaire for the assessment of the multiple dimensions of motion sickness. Aviat Space Environ Med 72(2):115–119
Gift AG, Narsavage G (1998) Validity of the numeric rating scale as a measure of dyspnea. Am J Crit Care 7(3):200–204
Haut MW, Beckwith BE, Laurie JA, Klatt N (1991) Postchemotherapy nausea and vomiting in cancer patients receiving outpatient chemotherapy. J Psychosoc Oncol 9:117–130
Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de WR, Chawla SP, Carides AD, Ianus J, Elmer ME, Evans JK, Beck K, Reines S, Horgan KJ (2003) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin—the Aprepitant Protocol 052 Study Group. J Clin Oncol 21(22):4112–4119
Hesketh PJ, Van BS, Aapro M, Tattersall FD, Naylor RJ, Hargreaves R, Carides AD, Evans JK, Horgan KJ (2003) Differential involvement of neurotransmitters through the time course of cisplatin-induced emesis as revealed by therapy with specific receptor antagonists. Eur J Cancer 39(8):1074–1080
Hickok JT, Roscoe JA, Morrow GR, Bole CW, Zhao H, Hoelzer KL, Dakhil SR, Moore T, Fitch TR (2005) 5-Hydroxytryptamine-receptor antagonists versus prochlorperazine for control of delayed nausea caused by doxorubicin: a URCC CCOP randomised controlled trial. Lancet Oncol 6(10):765–772
Hickok J, Roscoe J, Morrow G, King D, Atkins J, Fitch TR (2003) Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5-hydroxytryptamine-3 antiemetics. Cancer 97(11):2880–2886
Hollen PJ, Gralla RJ, Kris MG, McCoy S, Donaldson GW, Moinpour CM (2005) A comparison of visual analogue and numerical rating scale formats for the Lung Cancer Symptom Scale (LCSS): does format affect patient ratings of symptoms and quality of life? Qual Life Res 14(3):837–847
Hornby PJ (2001) Central neurocircuitry associated with emesis. Am J Med 111(Suppl 8):A106S–A112S
Hu DS, Silberfarp PM (1991) Management of sleep problems in cancer patients. Oncology (Huntingt) 5(9):23–28
Jacobsen PB, Andrykowski MA, Redd WH, Die-Trill M, Hakes TB, Kaufman RJ, Currie VE, Holland JC (1988) Nonpharmacologic factors in the development of posttreatment nausea with adjuvant chemotherapy for breast cancer. Cancer 61:379–385
Miller M, Kearney N (2004) Chemotherapy-related nausea and vomiting—past reflections, present practice and future management. Eur J Cancer Care 13:71–81
Molassiotis A, Yam BM, Yung H, Chan FY, Mok TS (2002) Pretreatment factors predicting the development of postchemotherapy nausea and vomiting in Chinese breast cancer patients. Support Care Cancer 10(2):139–145
Montgomery GH, Bovbjerg DH (2000) Pre-infusion expectations predict post-treatment nausea during repeated adjuvant chemotherapy infusions for breast cancer. Br J Health Psychol 5105–5119
Montgomery GH, McClary KA, Bovbjerg DH (1996) Adjuvant therapy for breast cancer and psychological distress. Ann Oncol 7977–7978
Olver IN (2005) Update on anti-emetics for chemotherapy-induced emesis. Intern Med J 35(8):478–481
Osoba D, Zee B, Pater J, Warr D, Latreille J, Kaizer L (1997) Determinants of postchemotherapy nausea and vomiting in patients with cancer. Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 15(1):116–123
Rhodes VA, Watson PM, Johnson MH (1986) Association of chemotherapy related nausea and vomiting with pretreatment anxiety. Oncol Nurs Forum 13(1):41–47
Rhodes VA, Watson PM, McDaniel RW, Hanson BM, Johnson MH (1995) Expectation and occurrence of postchemotherapy side effects. Cancer Pract 3:247–253
Roscoe JA, Bushunow P, Morrow GR, Hickok JT, Kuebler PJ, Jacobs A, Banerjee TK (2004) Patient expectation is a strong predictor of severe nausea after chemotherapy: a University of Rochester Community Clinical Oncology Program study of patients with breast carcinoma. Cancer 101(11):2701–2708
Roscoe JA, Hickok JT, Morrow GR (2000) Patient expectations as predictor of chemotherapy-induced nausea. Ann Behav Med 22(2):121–126
Roscoe JA, Morrow GR, Hickok JT, Stern RM (2000) Nausea and vomiting remain a significant clinical problem: trends over time in controlling chemotherapy-induced nausea and vomiting in 1413 patients treated in community clinical practices. J Pain Symptom Manage 20(2):113–121
Shacham N (1983) A shortened version of the profile of mood states. J Pers Assess 47305–47306
Sun CC, Bodurka DC, Weaver CB, Rasu R, Wolf JK, Bevers MW, Smith JA, Wharton JT, Rubenstein EB (2005) Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer 13(4):219–227
Warr DG, Grunberg SM, Gralla RJ, Hesketh PJ, Roila F, Wit R, Carides AD, Taylor A, Evans JK, Horgan KJ (2005) The oral NK(1) antagonist aprepitant for the prevention of acute and delayed chemotherapy-induced nausea and vomiting: pooled data from 2 randomised, double-blind, placebo controlled trials. Eur J Cancer 41(9):1278–1285
Warr DG, Hesketh PJ, Gralla RJ, Muss HB, Herrstedt J, Eisenberg PD, Raftopoulos H, Grunberg SM, Gabriel M, Rodgers A, Bohidar N, Klinger G, Hustad CM, Horgan KJ, Skobieranda F (2005) Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 23(12):2822–2830
Watson M, Meyer L, Thomson A, Osofsky S (1998) Psychological factors predicting nausea and vomiting in breast cancer patients on chemotherapy. Eur J Cancer 34(6):831–837
Zook DJ, Yasko JM (1983) Psychologic factors: their effect on nausea and vomiting experienced by clients receiving chemotherapy. Oncol Nurs Forum 10(3):76–81
Acknowledgements
This work was supported by grants from the American Cancer Society (Bovbjerg, RSG-010-180-01-PBP) and the National Cancer Institute (Bovbjerg, CA81137; Montgomery, CA105222). The authors would like to acknowledge the important contributions of Mr. Brett Stoudt, Ms. Angelina Stojceska, Ms. Katie Kupfer, and Ms. Kelleigh Briden for providing assistance on data management of this study, Suzy Blumenthal, MPH, for her timely resolution of data issues, Ms. Laurin Mack for her excellent editorial assistance, and, most importantly, the study participants and their many clinical providers for their contribution of time and effort to the research.
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Higgins, S.C., Montgomery, G.H. & Bovbjerg, D.H. Distress before chemotherapy predicts delayed but not acute nausea. Support Care Cancer 15, 171–177 (2007). https://doi.org/10.1007/s00520-006-0113-y
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DOI: https://doi.org/10.1007/s00520-006-0113-y