More than Half of Nurses Have Stopped or Delayed Patients' Chemotherapy Treatment

A new survey shows that a significant and alarming percentage of oncology nurses – 56 percent, or 325 nurses – report having had to stop or delay their patients’ treatment because of chemotherapy-induced nausea or vomiting – CINV – and they cite it as one of the most important factors, after fatigue, that affect cancer patients’ quality of life.

“Oncology nurses are on the front lines, providing necessary education and support to help patients manage cancer diagnoses and treatment,” said Barbara Rogers, CRNP, MN, AOCN, Adult Hematology-Oncology Nurse Practitioner, Fox Chase Cancer Center. “These survey data highlight the need for improved strategies, including a zero tolerance policy, to manage the nausea and vomiting that affect our patients’ lives as they undergo chemotherapy.”

More than 1 million cancer patients in the United States undergo chemotherapy every year, and nearly 70 percent will experience nausea and vomiting due to chemotherapy.

The survey was conducted and analyzed on-site at the Oncology Nursing Society’s (ONS) 33rd Annual Congress, where nearly 5,000 oncology nurses gathered with the goal of improving cancer care.

Studies have shown that both doctors and nurses tend to underestimate the incidence of both acute CINV, which occurs within 24 hours of treatment, as well as delayed or refractory CINV, which occurs after the first 24 hours. The survey suggests that one reason may be that one-third of nurses feel their patients never, or only sometimes, communicate with them openly about their experiences with nausea and vomiting because they do not want to complain (35 percent), they expect to suffer (28 percent), and they do not think that anything can be done about these side effects (18 percent). While almost all oncology nurses discuss CINV treatment options proactively with their patients, 71 percent of patients still suffer from CINV for two or more days.

“Current research has told us that while vomiting may be better controlled, nausea remains a problem in practice. The overwhelming message here is that with treatments available today, we should be treating all CINV as aggressively as possible,” said Rogers, an ONS member. “Based on these survey findings, ONS members must go back to their individual practices with the goal of opening the lines of communication about CINV between healthcare providers and patients, to achieve greater control of this debilitating side effect.”

About CINV

CINV is one of the most feared side effects for cancer patients, and it can have a major impact on a patient’s quality of life. CINV is generally classified as acute, delayed or anticipatory, with delayed nausea and vomiting prevalent in nearly 60 percent of patients receiving highly nausea-inducing chemotherapy. Patients most at risk for developing CINV include those under the age of 50, female patients, and those who receive higher doses or multiple types of chemotherapy regimens. Additionally, CINV may affect patients who have experienced nausea and vomiting during previous chemotherapy treatments, and those who experienced sweating, dizziness or warmth following previous chemotherapy treatment. If left untreated, CINV can lead to dehydration, malnutrition, treatment delay or even discontinuation of chemotherapy treatment.