Nausea and vomiting
This is an overview of CAM treatments that have been evaluated by CAM Cancer for cancer-related nausea and vomiting. Please click on a CAM treatment below to view an assessment of its safety and efficacy for nausea and vomiting based on the current research status. Please note that this is not a list of recommended treatments and does not suggest that the treatments are safe and effective.
- Safety: Mild adverse effects, such as pain or bleeding at the site of acupuncture can be expected in about 10% of all cases; serious complications seem to be very rare.
- Stimulation of acupoints: Two systematic reviews and one overview reported that stimulation of acupoints (mainly P6) reduced some aspects of CINV when administered in conjunction with standard antiemetic treatments. Subsequent reviews (n=3) have reported similar findings but methodological limitations of these reviews and the original trials prevents firm conclusions. RCTs (n=11) published following the most recent review have reported mixed findings, particularly when testing is against a sham or placebo treatment.
- Other forms of acupuncture: Three systematic reviews assessed pharmacopuncture, self-acupressure and auricular therapy (ear acupuncture). None of these reviews provides rigorous evidence of an effect of acupuncture/acupressure. Further RCTs (n=8) using points other than P6 have produced mixed results.
- Moxibustion: Two systematic reviews have reported mixed results.
- Acupuncture/acupressure in children: Few studies have been carried out in children and these are either of insufficient size or reported findings are conflicting.
- Read full version of Acupuncture summary.
- Safety: Although essential oils have generally shown minimal adverse effects, when used in appropriate dilutions, allergic reactions can occur with all oils.
- Aromatherapy massage: Two RCTs (n=66, n=87) reported positive effects of aromatherapy massage using ginger/coconut and chamomile respectively on nausea along with various other outcomes.
- Aromatherapy inhalation (5 RCTs): Two trials of ginger and one of bergamot reported no effect. One trial (n=66) reported positive effects of cardamom on nausea and a trial (n=100) of peppermint oil reported significant but small effects.
- Read full version of Aromatherapy summary.
- Safety: Biofeedback is considered to have few adverse effects.
- One RCT (n=81) reported improvements in nausea in groups receiving different biofeedback interventions in combination with relaxation therapy but not for biofeedback alone.
- Summary of key findings (coming) with link to the full version of Biofeedback summary.
- Safety: Effects on the central nervous system are common with medical cannabis and cannabinoids. Effects are dose dependent and include changes in mood (euphoria and dysphoria), memory disorders, blurred vision and dizziness as well as dry mouth. The risk of drug interactions with the various medical cannabis and cannabinoid preparations is low.
- Chemotherapy-induced nausea and vomiting: slight enhancement of the effects of standard antiemetic therapeutic agents have been reported in 2 RCTs.
- Radiation-induced nausea and vomiting: no enhancement of effects of standard antiemetic therapeutic agents reported in 2 RCTs.
- Read full version of Cannabis and cannabinoids summary.
- Safety: There are no serious direct risks associated with homeopathy but there are indirect risks, if homeopathic preparations are used in place of conventional cancer treatment.
- There is currently no evidence of an effect of homeopathic remedies on CINV (n=1 RCT).
- Read full version of Homeopathy summary.
- Safety: Hypnotherapy is considered a safe treatment modality when administered by trained professionals. Acute psychoses, severe personality disorders and an inability to be hypnotized are considered contraindications.
- Several small RCTs in children suggest that hypnosis might be helpful in anticipatory nausea and vomiting but studies suffered from methodological limitations.
- Read full version of Hypnotherapy summary.
- Safety: Classical/Swedish massage is generally considered safe. Contraindications include strong forceful massage in patients suffering from haemorrhagic disorders, low platelet counts, and blood thinning medication.
- Few RCTs of massage for nausea and vomiting have been carried out (n=4) and the overall results do not confirm any benefit of massage for CINV.
- Read full version of Massage (Classical/ Swedish) summary.
- Safety: No safety issues are on record although caution is advised in patients in distress and emotionally fragile patients.
- Evidence for music interventions for CINV is limited and contradictory. Overall SRs found no differences while a subsequent large, good-quality RCT (n=474) found significantly reduced anticipatory nausea for music listening compared to standard care but no difference in vomiting.
- Read full version of Music therapy summary.
- Safety: PMR is considered to have few adverse effects, although some concern has been raised about the use of relaxation therapy interventions among individuals who have a history of psychiatric disorders.
- Results from two RCTs suggest that PMR may reduce the duration of nausea and vomiting but not the frequency or intensity.
- Read full version of Progressive Muscle Relaxation summary.
- Safety: Reflexology has a good safety record.
- Two controlled clinical trials report favourable effects for nausea and vomiting but the findings are limited by methodological shortcomings.
- Read full version of Reflexology summary.
- Safety: Therapeutic Touch has not been associated with any safety concerns.
- One single-blind RCT (n=108) suggests non-specific effects (i.e. better than no treatment but not better than placebo therapeutic touch) on nausea and vomiting.
- Read full version of Therapeutic touch summary.
- Safety: Therapeutic Touch has not been associated with any safety concerns.
- One single-blind RCT (n=108) suggests non-specific effects (i.e. better than no treatment but not better than placebo therapeutic touch) on nausea and vomiting.
- Read full version of Yoga summary.