Ovarian Cancer: PARP Inhibitors and Nausea

When you think about cancer chemotherapy side effects, nausea and stomach upset are usually top of mind. A new class of medications called PARP inhibitors is given as a pill rather than an IV infusion, but these drugs, too, can cause some of the same gastrointestinal side effects. But just as doctors have learned how how to help patients manage nausea with traditional chemotherapy, they are devising ways to help patients taking PARP inhibitors to do the same.

For one thing, rather than assume that a PARP inhibitor is responsible for the nausea, doctors look at all possible causes. “It’s important to think about all potential contributors,” says Dr. Ramez Eskander, gynecologic oncologist at the University of California, San Diego. “There may be other causes, independent of the PARP inhibitor.”

Whether a PARP inhibitor, chemotherapy, or the disease itself is to blame, the best defense is largely the same: a good offense. In other words, patients and their doctors should anticipate likely side effects so they can pre-treat and prevent or minimize the discomfort.

Being Proactive About Nausea

It’s no secret that cancer treatment can wreak havoc on your gastrointestinal tract. Fortunately, today’s doctors can mitigate the hit with a variety of prescription medications.

“For nausea and gastrointestinal side effects, we can prescribe anti-nausea medications so patients have them at home,” Dr. Eskander says. So, if you run into nausea while taking a PARP inhibitor, you have medication on hand to help you sidestep treatment-induced nausea.

Common anti-nausea medications include:

• Prochlorperazine (Compazine)
• Promethazine (Phenergan)
• Ondansetron (Zofran)
• Granisetron (Kytril)
• Olanzapine

Most of these anti-nausea medications last for more than eight hours. So if you have a single day dosing with a PARP inhibitor, taking anti-nausea medication the evening before treatment can help reduce or even eliminate nausea.

Strategies to Minimize Nausea

You don’t have to rely on prescription medications alone to treat nausea. In fact, there are a number of lifestyle and complementary approaches that can help calm a troubled tummy. A few standouts:

• Eat small, frequent meals: Eating small meals throughout the day, rather than a large meal at one time can help minimize nausea.
• Chew on ginger: Studies consistently show that ginger helps alleviate nausea. The powerful herb appears to have an anti-spasmodic effect in the gut. Not a fan of raw ginger? Suck on ginger candy, sip ginger ale, or make a steaming cup of ginger tea.
• Wear a pressure bracelet: You can find these bracelets at your local pharmacy. They work by providing consistent pressure on a particular acupressure point on the wrist that helps reduce nausea.
• Breathe deep: Moving air in and out of your lungs with a few deep breaths can help relieve nausea, particularly if you pair deep breathing exercises with meditation. It can also help you relax and release stress and anxiety.

Nausea isn’t normal, and you shouldn’t have to suffer through it, whether you’re on a PARP inhibitor or not. What’s more common with cancer treatment, however, are changes in appetite, taste, and food preferences. You might no longer find enjoyment in your favorite foods, or you’ll discover that things don’t taste the same while on treatment.

Of course, the degree of nausea and taste changes you experience are unique to you and your particular treatment protocol. But in almost every case, your hunger level is likely to change and you may feel queasy come meal time.

If you do experience severe nausea or vomiting while taking a PARP inhibitor, it’s important to contact your doctor. Nausea is easily treated and doctors can modify your treatment protocol so you’re no longer suffering.

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