Psychosocial Issues (Part 18)

In: Pulmonary function

9 Mar 2013

Conditioned responses to chemotherapy treatment are prevalent in cancer patients and can occur before treatment, generally labeled as “anticipatory nausea and vomiting” (eg, vomiting approaching the hospital), as well as during or after treatment. The prevalence of conditioned nausea and vomiting ranges from 18 to 57 percent in more than 20 studies. The presence and severity of conditioned as well as treatment-induced nausea and vomiting can vary widely among patients, and the factors underlying individual differences are not yet clear. In their review, Burish and Carey conclude that anticipatory nausea, vomiting, and related symptoms are due largely to maladaptive learning; this learning generally follows a respondent conditioning paradigm. Individual variables, especially anxiety, are associated with the development of the conditioned responses. buy birth control online
Sophisticated measures of the frequency and intensity of nausea and vomiting have been developed for the evaluation of antiemetic regimens; however, these measures do not routinely evaluate the affective consequences of nausea and vomiting. In addition, many of the antiemetic medications have side effects of their own (eg, extrapyramidal symptoms, excessive sedation). Behavioral interventions, especially relaxation techniques (hypnosis, progressive muscle relaxation, and systematic desensitization) have been developed and studied in different cancer sites. Symptom relief has been reported in controlled trials, mainly focused on anticipatory reactions due to chemotherapy. There is increasing evidence that nonspecific interventions, such as distraction by video games or relaxing by listening to music can effectively control the side effects of chemotherapy. However, this land of intervention has not been tested extensively in controlled lung cancer trials.


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