CINV: How to Control Chemotherapy‑Induced Nausea & Vomiting

Chemo can feel like a roller‑coaster, and the nausea and vomiting part—known as CINV—often steals the spotlight. It’s not just uncomfortable; it can affect nutrition, treatment schedules, and overall wellbeing. The good news is that you don’t have to endure it helplessly. By understanding why it happens and employing a few proven tactics, you can stay on track with your cancer care.

Why CINV Happens

When chemo drugs hit cancer cells, they also release chemicals that trigger the brain’s vomiting center. Serotonin, substance P and dopamine are the main culprits, and they send rapid signals from the gut to the brain. That’s why nausea can start before the infusion and linger for days after. Different chemo regimens have different “risk levels”—some cause only mild nausea, while others are notorious for intense vomiting.

Top Strategies to Reduce CINV

1. Follow the anti‑emetic schedule. Most oncologists prescribe a cocktail of medicines—usually a 5‑HT3 blocker, a dexamethasone steroid, and sometimes an NK1 antagonist. Take them exactly as prescribed, even on days you feel fine. Skipping a dose can give nausea a free run.

2. Eat the right foods. Small, bland meals work best. Think crackers, toast, plain rice, or bananas. Avoid greasy, spicy or heavily scented foods that can trigger the gut‑brain reflex. Eating a light snack 30 minutes before chemo often stops nausea before it starts.

3. Hydration matters. Sip clear fluids—water, herbal tea, or electrolyte drinks—throughout the day. Warm liquids are easier on the stomach than cold ones. Aim for at least 8 ounces every couple of hours, but stop if you feel dizzy.

4. Timing is key. Some patients find that taking anti‑emetics an hour before chemo works, while others need a dose right after the infusion. Keep a simple log of what you try and how you feel; share it with your nurse to fine‑tune the timing.

5. Try non‑drug tricks. Acupressure wrist bands (pressed on the P6 point) have helped many people reduce mild nausea. Deep breathing, guided imagery, or listening to calming music during treatment can lower stress, which in turn eases the vomiting reflex.

6. Stay active, but gentle. Light walks or simple stretches after chemo keep digestion moving and can lessen the urge to vomit. Avoid vigorous exercise right after treatment, as it may stir up the stomach.

7. Talk to your team. If nausea persists despite medication, your doctor may adjust the dose, add a new drug, or switch to a lower‑risk chemo regimen. Never hide symptoms; the right tweak can make a huge difference.

Remember, CINV isn’t a one‑size‑fits‑all problem. What works for a friend might not work for you, and that’s why keeping a short daily note on food, meds, and feelings is worth the few minutes. Over time you’ll spot patterns, and your care team can use that data to personalize your anti‑emetic plan.

Bottom line: CINV can be tamed with a mix of proper meds, smart eating, hydration, and a few simple habits. Stay proactive, keep communication open, and you’ll give yourself the best chance to handle chemo with confidence.