Anticipatory Nausea and Chemotherapy | Heal and Be Radiant

Some people having chemotherapy notice something odd around the third or fourth cycle. The nausea starts before the treatment does.

It might begin on the drive in. It might be the waiting room, or the smell of the hand gel by the door, or the sight of one particular nurse who has never been anything but kind. Nothing has been given yet. The body is simply getting ready for what it has learned comes next.

What Is Anticipatory Nausea?

This has a name: anticipatory nausea. The first thing to say about it is that it is not imagination. It is not weakness, and it is not "all in your head" in the dismissive sense people mean by that. It is the nervous system doing what it does extremely well: noticing what tends to happen after certain sights, smells, and places, and preparing for it in advance.

The trouble is that the preparation is the problem.

The Good News First

The anti-nausea medicines used alongside chemotherapy today are far better than they were a generation ago, so fewer people are made badly sick in the first place, and fewer go on to develop the anticipatory kind. But it still happens. And because anticipatory nausea is a learned response rather than a direct effect of the drugs, the medicines aimed at the drugs do not always reach it.

Learned responses, on the other hand, are exactly what hypnosis is best placed to work with.

What the Research Shows

The research here is older than would be ideal. A review of the trials, published in 2007, found that hypnosis could be a genuinely valuable help with both anticipatory nausea and the nausea that follows treatment, with a large effect compared with usual care. The trials were small, most of them were conducted in children, and many were done before today's medicines existed. The fair summary is this: promising, most convincing for the anticipatory kind, and not yet as well tested in adults as it deserves to be.

Children, as it happens, tend to respond very well. They slip into absorbed, imaginative states with an ease most adults have forgotten, which is part of why so much of the early work was done with them.

What It Looks Like in Practice

The aim is to give the body a different thing to learn.

The parking lot, the hand gel, and the chair are all powerful cues -- and they can be paired with something other than dread. Sessions focus on building a calm, settled response that becomes linked to those same cues, alongside a way of reaching that response that belongs to you. Most people leave with a recording to use in the car, in the waiting room, or in the chair itself.

Timing Matters

A response that has only just begun is usually easier to shift than one that has been rehearsed through six cycles. If you notice the first signs of anticipatory nausea, that is a good moment to act rather than a reason to grit your teeth and hope it passes.

A Note for Carers

If you are the person who drives someone to treatment, you may have noticed your own stomach tightening in that parking lot too. That is the same learning at work, and it is worth taking seriously for you as well.

One Important Reminder

Whatever else you do, tell your oncology team about any nausea at all -- anticipatory or otherwise. There is a great deal they can adjust, and they can only adjust what they know about. Hypnosis sits alongside that care, never in place of it.

Would you like to talk through what support could look like for you?

The call is complimentary and there is no obligation.

Schedule a Call by Phone or Zoom