title: Nausea as a sentinel symptom for cytotoxic chemotherapy effects on the gut-brain axis among women receiving treatment for recurrent ovarian cancer: an exploratory analysis.
abstract: Nausea is a common and potentially serious effect of cytotoxic chemotherapy for recurrent ovarian cancer and may function as a sentinel symptom reflecting adverse effects on the gut-brain axis (GBA) more generally, but research is scant. As a first exploratory test of this GBA hypothesis, we compared women reporting nausea to women not reporting nausea with regard to the severity of other commonly reported symptoms in this patient population.
  
  
  
  A secondary analysis of data systematically collected from women in active chemotherapy treatment for recurrent ovarian cancer (n = 158) was conducted. The Symptom Representation Questionnaire (SRQ) provided severity ratings for 22 common symptoms related to cancer and chemotherapy. Independent sample t tests and regression analyses were used to compare women with and without nausea with regard to their experience of other symptoms.
  
  
  
  Nausea was reported by 89 (56.2 %) women. Symptoms that were significantly associated with nausea in bivariate and regression analyses included abdominal bloating, bowel disturbances, dizziness, depression, drowsiness, fatigue, headache, lack of appetite, memory problems, mood swings, shortness of breath, pain, sleep disturbance, urinary problems, vomiting, and weight loss. Symptoms that were not associated with nausea included hair loss, numbness and tingling, sexuality concerns, and weight gain.
  
  
  
  Nausea experienced during chemotherapy for recurrent ovarian cancer may be an indicator of broader effects on the gut-brain axis. A better understanding of the mechanisms underlying these effects could lead to the development of novel supportive therapies to increase the tolerability and effectiveness of cancer treatment.
authors.affiliation: School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA. donovanh@pitt.edu.|University of Pittsburgh Cancer Institute, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA. donovanh@pitt.edu.|Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, 15213, USA. donovanh@pitt.edu.
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Donovan
authors.affiliation: School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Hagan
authors.affiliation: School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
authors.forename: Grace B
authors.initials: GB
authors.lastname: Campbell
authors.affiliation: University of Pittsburgh Cancer Institute, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA.|Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, 15213, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Boisen
authors.affiliation: School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Rosenblum
authors.affiliation: University of Pittsburgh Cancer Institute, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA.|Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, 15213, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
authors.affiliation: University of Pittsburgh Cancer Institute, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA.|Department of Psychiatry, University of Pittsburgh, 5115 Centre Avenue, Suite 140, Pittsburgh, PA, 15232, USA.|Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.|Department of Behavioral & Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA.|Clinical & Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.affiliation: University of Pittsburgh Cancer Institute, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA.|Department of Medicine, University of Pittsburgh, Hillman Cancer Center - Research Pavilion G17b, 5117 Centre Avenue, Pittsburgh, PA, 15213, USA.|Department of Anesthesiology, University of Pittsburgh, Hillman Cancer Center - Research Pavilion G17b, Pittsburgh, PA, USA.|Center for Neuroscience, University of Pittsburgh, Hillman Cancer Center - Research Pavilion G17b, Pittsburgh, PA, USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Horn
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects*; D017615:Enteric Nervous System / Q000187:drug effects*; D005260:Female; D041981:Gastrointestinal Tract / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced* / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy-induced nausea and vomiting; Gut-brain axis; Ovarian cancer; Symptom assessment