Up to 70% of pts with advanced cancer have nausea. Nausea may result from uremia, liver failure, hypercalcemia, bowel obstruction, severe constipation, infection, gastroesophageal reflux disease, vestibular disease, brain metastases, medications (cancer chemotherapy, antibiotics, nonsteroidal anti-inflammatory drugs, opioids, proton pump inhibitors), and radiation therapy.

Interventions Treatment should be tailored to the cause. Offending medications should be stopped. Underlying conditions should be alleviated, if possible. If decreased bowel motility is suspected, metoclopramide may help. Nausea from cancer chemotherapy agents can generally be prevented with glucocorticoids and serotonin receptor blockers like ondansetron or dolasetron. Aprepitant is useful in controlling nausea from highly emetogenic agents like cisplatin. Vestibular nausea may respond to antihistamines (meclizine) or anticholinergics (scopolamine). Anticipatory nausea may be prevented with a benzodiazepine such as lorazepam. Haloperidol is sometimes useful when the nausea does not have a single specific cause.