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Controlling sickness in advanced cancer

It's not always possible to cure advanced cancer. But even if your cancer can't be cured, treatment is available to control your symptoms, such as sickness.

Advanced cancer means the cancer has spread from where it started or has come back some time after you were first treated.

Between 5 and 7 out of 10 people (50 to 70%) with advanced cancer have nausea and vomiting.

Some people may have more than one cause of sickness and it may not always be linked to the cancer itself. For example, you may feel sick if you have an infection. 

Blocked bowel

Sometimes a tumour in the tummy (abdominal) area, such as ovarian or stomach cancer, can grow to completely block the bowel. This is called a bowel obstruction.

The waste from food you have digested cannot get past the blockage. Some cancers can also stop the bowel working properly by pressing on the nerves that keep the bowel working.

This causes symptoms such as:

  • feeling bloated and full
  • pain
  • feeling sick
  • vomiting large amounts
  • constipation

Doctors help to relieve sickness caused by a blocked bowel in various ways.

Surgery

You might be able to have a tube called a stent put into the bowel during an endoscopy. Or the surgeon can remove the blocked section of bowel. It might be possible to close up the bowel again during the operation.

Stoma

You might need to have a stoma. A stoma is an opening onto the abdomen. Your bowel motions come out of the opening and collect in a waterproof bag that you stick to your skin over the stoma opening.

No one can say how much you will benefit from the operation. The cancer might not come back to block the bowel again. But it is quite a big operation at a time when you are likely to be feeling low. Talk through your concerns about the operation with your doctor and cancer specialist nurse or friends and family.

You might not want to have major surgery if you are very ill and aware that this is probably the final few weeks of your life. There are other ways of relieving your symptoms.

Nasogastric tube

One way to relieve your symptoms is to put a very thin tube down your nose and into your stomach. This is called a nasogastric tube (NG tube). The tube is attached to a bag and drains off the fluid that builds up in your stomach. This stops you being sick.

Drugs

Octreotide reduces the amount of fluid that builds up in your stomach and digestive system and helps to stop you feeling and being sick. You might have this instead of an operation.

Octreotide can only control the symptoms of a blocked bowel for a few weeks. But it can help to make you a lot more comfortable during that time.

Constipation

Don't be embarrassed to ask for help with constipation. The longer you leave it the more problems it can cause.

You can ease constipation by eating lots of fibre and drinking plenty of fluids, but you might also need to take a laxative. Your doctor can prescribe one.

Ginger is a good natural remedy for sickness caused by constipation. Try eating stem ginger or crystallised ginger. Or sip ginger beer or ginger ale slowly.

Many hospital and community nurses can help with constipation. Ask them for advice about preventing or relieving it.

It is important to remember that if you have constipation with severe abdominal cramping pain and vomiting, don't take laxatives. Contact your doctor or specialist nurse as soon as possible, as your bowel may be blocked.

Dehydration

Dehydration means there is not enough fluid in your body. It can affect how your body works and cause symptoms such as:

  • feeling and being sick
  • confusion
  • tiredness.

You might not feel like eating or drinking much if you are living with advanced cancer. But try to drink every hour or two, even if it is only sips of water.

Your doctor might give you fluids through a drip if you are dehydrated and not drinking enough.

It’s possible for you to have fluids through a needle into your skin, rather than into a vein. This is called subcutaneous hydration. Your nurse can show you and your relatives how to connect the tubing to the needle and switch the fluids on and off.

You can have the infusion connected up overnight only so that it doesn't get in the way during the day. You can have fluids in this way at home with support from district nurses or symptom control nurses.

Chemical imbalances

Kidney problems

You might have kidney problems if your cancer is in your kidney or blocking the tubes that drain it. Kidney problems can also occur if you are dehydrated. Kidneys that are not working properly can make you feel sick. Anti sickness medicines are the best way to try to control this.

Liver problems

You could have liver problems if your cancer started in your liver, or more commonly, has spread into the liver. Feeling sick can be caused by your liver not working as well as it should. Anti sickness medicines are the best way to try to control this.

High calcium levels in the blood

Too much calcium in your blood is called hypercalcaemia (pronounced hyper-kal-seem-ia). This is a common cause of sickness in people with cancer that has spread into the bones. The cancer cells make the bone cells break down and release calcium into the blood.

Some types of cancer also affect the way that the body controls calcium levels. The cancer makes the body produce too much calcium, so the level in the blood gets too high.

Symptoms of high calcium levels include: 

  • extreme tiredness (fatigue) and lethargy
  • feeling weak
  • not wanting to eat much
  • constipation
  • loss of concentration and interest in doing things
  • mild confusion

Untreated hypercalcaemia can become much worse.

It is very important that you tell your doctor if you have symptoms of a high calcium level. Hypercalcaemia can make you more and more drowsy until you are sleeping nearly all the time. You might go into a coma and eventually die from this if it remains untreated.

Help for you

It can feel very overwhelming trying to cope with feeling sick from advanced cancer. Talk to your doctor if your symptoms are not improving with help.

You can talk to the Cancer Research UK Nurses on freephone 0808 800 4040. Lines are open Monday to Friday, 9am to 5pm.
Last reviewed: 
31 Jan 2015
  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Cancer: Principles and practice of oncology (10th edition)
    VT DeVita, S Hellman, SA Rosenberg, TS Lawrence
    Lipincott Williams and Wilkins, 2015

  • Improving supportive and palliative care for adults with cancer

    National Institute of Health and Care Excellence (NICE), 2004

  • Palliative care - nausea and vomiting

    National Institute of Health and Care Excellence (NICE) Clinical Knowledge Summary, Accessed 2015

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