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Personalized treatments for nausea and vomiting
Alex Molassiotis, RN, MSc, PhD of The Hong Kong Polytechnic University, Hong Kong, discusses personalized treatments for nausea and vomiting. Nausea and vomiting is a multifactorial problem and it is not always clear which factors are involved, therefore patients need to be evaluated in order to identify the risk. A following prescription of antiemetics based on that risk is then required, beyond just the antiemetics that are directly linked to managing chemotherapy related problems. Dr. Molassiotis provides a hypothetical example of a personalized treatment for nausea. He mentions that if the patient is young, very anxious and with a past experience of strong vomiting during pregnancy, those factors place her under a much higher risk. Therefore, in this example, the patient would need to be supported beyond the standard guidelines of three drug combination: 5-HT3 receptor antagonist, dexamethasone, and NK1 receptor antagonist. Lorazepam would be a necessary anti-anxiety drug to aid the existing treatment, or olanzapine if the patient experiences a lot of nausea. Dr Molassiotis’ example explains why these different risk factors need to be taken into consideration, adding some additional treatments to the standard combination. His overall message expresses how significant advances have been made in this area of supportive care, however, more progress is needed for the management of nausea, which is where the focus belongs presently and in the future. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016 Annual Meeting on Supportive Care in Cancer held in Adelaide, Australia.