title: Physiologic mechanisms of nausea and vomiting in patients with cancer.
abstract: OBJECTIVE
  To review the current literature describing the multiple etiologies of nausea and vomiting in patients with cancer.
  
  
  METHODS
  Reports of pertinent research, clinical articles, and book chapters.
  
  
  RESULTS
  As a result of knowledge gained about the important role of serotonin in mediating the initial emetic response to antineoplastic drug administration, nurses have made tremendous strides in controlling acute chemotherapy-induced nausea and vomiting. The role of neurotransmitters other than serotonin in mediating the response of delayed or persistent nausea and vomiting remains unclear. Efforts continue to further describe the mechanisms and management of nausea and vomiting that occur as a result of other cancer-related conditions or treatments.
  
  
  CONCLUSIONS
  A rational, often combinational approach to antiemetic therapy is derived from a working knowledge of the physiologic mechanisms associated with nausea and vomiting in patients with cancer. Assessment of the individual's precancer history and current physiologic and psychosocial status is the corner-stone of designing and providing effective therapies.
  
  
  CONCLUSIONS
  Understanding the physiologic mechanisms responsible for the cause and control of nausea and vomiting in patients with cancer facilitates creative use of drugs and nonpharmacologic strategies that are more likely to result in control of these distressing symptoms.
authors.affiliation: Community Medical Alliance in Boston, MA, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Hogan
authors.forename: M
authors.initials: M
authors.lastname: Grant
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D006801:Humans; D009325:Nausea / Q000209:etiology / Q000451:nursing / Q000503:physiopathology*; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D009434:Neural Pathways; D011878:Radiotherapy / Q000009:adverse effects; D014839:Vomiting / Q000209:etiology / Q000451:nursing / Q000503:physiopathology*
chemical_list: D000970:Antineoplastic Agents