Chemotherapy – Induced Nausea and Ginger

by | Nov 22, 2013 | 2012, Cancer, Ginger

Written by Jessica Patella, ND. Ginger significantly reduced nausea which occurs during chemotherapy treatment. This is difficult to treat with pharmaceuticals.

Up to 60% of patients receiving chemotherapy treatment experience nausea (7). Ginger root (Zingiber officinale) has been used for thousands of years for gastrointestinal upset, nausea and joint pains (6), but there is very little research on the effects of ginger on chemotherapy induced nausea, until now (1). Recent research has found that supplementing with ginger reduced nausea associated with chemotherapy treatment (1).

Most prescriptions given for nausea associated with chemotherapy are formulated to treat vomiting, not nausea (2). This is supported by the fact that 70% of patients who take these medications still report nausea and vomiting after chemotherapy (3).

There are three types of chemotherapy induced nausea: anticipatory, acute and delayed. Anticipatory nausea occurs in anticipation of chemotherapy treatment and develops in 8-20% of patients (4). Acute nausea occurs within 24 hours after chemotherapy treatment and delayed nausea occurs after 24 hours and up to 5 days after chemotherapy treatment (5). The majority of patients report the most severe nausea as acute nausea, occurring within the first day of treatment with chemotherapy (5).

The research included 662 participants from 23 different private oncology practices (1). The majority of the participants were white (91%) females (93%) with an average age of 53 years (1). The most common cancers were breast (74%), gastrointestinal (8%) and lung (6%) (1). Participants were randomly assigned to one of four groups: placebo, 0.5 grams of ginger, 1.0 grams of ginger, or 1.5 grams of ginger per day.

Supplementation began 3 days before the start of chemotherapy and continued for a total of 6 days. Nausea and vomiting were recorded four times per day (morning, afternoon, evening, night) by each participant.

Overall, all doses of ginger significantly reduced the severity of acute nausea compared to placebo on the first day of chemotherapy treatment (p=0.003), but exact measurements were not provided. The largest reduction in the intensity of nausea was with the 0.5 grams and 1.0 grams per day of ginger (p=0.017 and p=0.036, respectively) (1).

There was no significant difference for delayed nausea and there was no difference in the number of vomiting episodes between the ginger groups and the placebo group (1).

In conclusion, 0.5 grams to 1.0 grams per day of ginger significantly reduced acute nausea on the first day of chemotherapy treatment, although it did not reduce the frequency of vomiting (1). Overall, this was a strong multi-center, double-blind, placebo controlled study (1).

Source: Ryan, Julie L., et al. “Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients.” Supportive care in cancer 20.7 (2012): 1479-1489.

© Springer-Verlag 2011

Posted September 16, 2013.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health.  She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians.  Visit her website at  www.awarenesswellness.com.

References:

  1. Ryan JL, et al.  Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients.  Support Care Cancer 2012, 20:1479-89.
  2. Aapro M. 5-HT(3)receptor antagonists in the management of nausea and vomiting in cancer and cancer treatment. Oncology 2005, 69:97–109.
  3. Herrstedt J, Dombernowsky P.  Anti-emetic therapy in cancer chemotherapy: current status. Basic Clin Pharmacol Toxicol 2007, 101:143–150.
  4. Morrow GR, et al.  Anticipatory nausea and vomiting in the era of 5-HT3 antiemetics. Support Care Cancer 1998, 6:244–247.
  5. Morrow GR, et al. Time of first occurrence, severity, and persistence of nausea following initial chemotherapy in 322 patients: aURCC CCOP study. Support Care Cancer 2001, 9:290.
  6. Arfeen Z, et al. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care 2005, 23:449–452.
  7. Acute Nausea and Vomiting Incidence.  National Cancer Institute.