• Don’t force yourself to eat when you feel sick but keep up the fluid intake
• Avoid dehydration
• It is important to keep your fluid intake up to prevent dehydration
• Clear, cold drinks may be better tolerated
• Try sipping fizzy drinks such as soda water, ginger beer or lemonade
• Sip these slowly, using a straw may help
• Solid fluids such as sorbet or jelly may be easier to manage
• Herbal, ginger or peppermint tea may soothe an upset stomach
• Eat slowly and relax afterwards, but avoid lying flat
• Nausea may become worse when the stomach is empty so try to take regular snacks
• If possible, a short walk before eating may help.
• Fresh air also helps to stimulate your appetite.
• Avoid wearing tight fitting clothes
• Try to relax and eat slowly in a well ventilated room.

Eating with a poor appetite or feeling sick:

• Start with small frequent meals and snacks
• Try to make your food and drinks as nourishing as possible.
• Highly spiced or rich or fatty foods can make nausea worse - avoid them if they do
• Your appetite may come and go, so it is important to make the most of the times when you feel like eating.
• Experiment with different foods. You may find you like things you don’t usually eat.
• If the smell of cooking makes you sick you could try eating cold food
• Don’t worry if you don’t feel like cooking, cold meals can be as nutritious as hot ones
• Don’t worry if it isn’t ‘normal’ foods at ‘normal’ times - if you fancy cereal at midnight, enjoy it!
• A small glass of wine, beer or your favourite drink may boost your appetite. Check with your doctor first.
• Avoid drinking with meals as this may fill you up and spoil your appetite.
• Convenience foods are a useful standby and can be just as nourishing.
• Accept offers from friends and relatives to help with cooking and shopping.

Drug therapy. If nausea is severe and associated with vomiting medications are given intravenously (into a vein). Alternatively, in this situation they can be injected or infused into the fat under the skin (subcutaneously) either as a single injection or   infused slowly via an infusion pump. If patients are not vomiting oral tablets are usually suitable. There are also a variety of other routes of administration ranging from suppository (inserted into the back passage) and transdermally (a plaster stuck to the skin), Buccally (a tablet left between the lip and gum - like the cowboy used to chew tobacco). Listed below are the commonly used anti-sickness medications used in patients with cancer.

• Act via the chemoreceptor trigger zone - Domperidone ( Motilium), Prochlorperazine (Stemetil, Buccastem), chlorpromazine
• Acts directly on the gastrointestinal track - Metochlopramide (Maxolon)
• Act via antihistamine or motion sickness route - Cyclizine (Valoid), Hyoscine (Scopoderm TTS)
• Sedatives - lorazepam, haloperidol
• Act by blocking the H3T receptor in the stomach Granisetron (Kytril), Ondansetron (Zofran), Tropisetron, Palonestron
• Dexamethasone - given to enhance the effect of the main drugs
• Synthetic cannabis - Nabilone
• Substance P inhibition (Emend) a new antiemetic acting on a specific receptor in the brain neurokinin 1-receptor antagonist (NK-1 antagonist)

Other therapies - Many patients obtain a great deal of benefit from supportive and complementary therapies. This may be because they genuinely have a direct benefit or they have psychological benefit (placebo). Either way, if patients have a benefit and do not experience side effect from them, then they have useful role. Listed below are the more commonly available remedies which have been used in patients with cancer.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.