Anticipatory nausea and vomiting associated with chemotherapy occurs:
A. Within the first 24 hours after chemotherapy.
B. 1-5 days after chemotherapy.
C. Before chemotherapy administration.
D. While chemotherapy is being administered.
Correct Answer: C. Before chemotherapy administration.
Nausea and vomiting (N&V) are common side effects of chemotherapy. Some patients are able to trigger these events prior to actually receiving chemotherapy by anticipating, or expecting, to have these effects. Anticipatory nausea and vomiting (ANV) is a common complaint among cancer patients and is often predicated on the development of chemotherapy-induced nausea or vomiting. Acute or delayed nausea following chemotherapy infusion, known as chemotherapy-induced nausea (CINV) is a common side effect of treatment.
Option A: Anticipatory nausea and vomiting (ANV), also referred to as conditioned, learned or psychological nausea and vomiting, is widely believed to be a learned response to chemotherapy that 25% of patients develop by the fourth treatment cycle. It appears to link psychological, neurological and physiological systems. The risk of ANV tends to increase with the number of cycles received and the symptoms may persist long after the completion of chemotherapy
Option B: N&V occurring post-chemotherapeutic administration is not an anticipatory event but rather an effect of the drug. From a clinical standpoint, younger patients who have experienced severe and frequent nausea/vomiting after their prior treatments are at particularly high risk for the development of ANV. While the conditioning model is well accepted, cognitive factors, such as anxiety, self-absorption, and response expectancies, can be involved in ANV development
Option D: N&V occurring during the administration of chemotherapy is an effect of the drug. Behavioral interventions are especially appropriate to address ANV because it is a conditioned response, and they are best implemented prior to the complete/full development of the undesired conditioned response. Evidence suggests that behavioral intervention can reduce ANV, decrease levels of anxiety and distress, and to a lesser extent decrease cancer-related pain and nausea.