Acupressure: An Evolving Treatment for Chemotherapy-Induced Nausea and Vomiting

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By Laura Bourdeanu, NP, PhD

Chemotherapy-induced nausea/vomiting (CINV) continues to be one of the most feared side effects of cancer treatment. Progress has been made in the management of chemotherapy-induced nausea and vomiting, with new drugs and alternative therapies greatly reducing and, in some cases, eliminating this side effect. However, for patients who are faced with it, chemotherapy-induced nausea and vomiting can be overwhelming. It disrupts their lives.

Generally, the incidence of nausea is higher than that of vomiting, and it may be due to the fact that anti-nausea medications tend to be less effective in controlling nausea. The severity of the nausea and vomiting will depend on the type and dose of chemotherapy, the length of the treatment, and patient-related factors, such as age (less than 55 years), gender (female), race/ethnicity (Asian patients), no or low alcohol consumption (<4 drinks per week), and history of pregnancy-related sickness or motion sickness. The choice of anti-nausea medication regimens is largely based on the risk of developing chemotherapy-induced nausea and vomiting determined from the factors mentioned above.

Untreated nausea and vomiting can have serious effects, as they can leave the patient exhausted, anxious, and undernourished. In some cases physicians might have to lower the dose of chemotherapy drugs or the patients give up on the treatment, reducing the overall survival benefit of the treatment. Therefore, management of chemotherapy-induced nausea and vomiting is crucial, as it ensures patient’s successful completion of their treatment.

ChemotherapyA�

When determining the type of anti-nausea regiment, the physician takes into account what type of chemotherapy the patient is receiving. Most chemotherapy agents cause some degree of nausea and vomiting, with some chemotherapy agents causing worse degree of nausea and vomiting than others.

Chemotherapy is categorized into different groups, with the two considered when determining the anti-nausea regimen being:

  1. Moderately emetogenic a�� 30-90% of patients experience nausea and vomiting without anti-nausea medications
  2. Highly emetogenic a�� more than 90% of patients experience nausea and vomiting without anti-nausea medications

Types of Nausea and Vomiting

Chemotherapy can cause different types of nausea and vomiting. The regiment for prevention and treatment of nausea and vomiting depends on the which type of nausea and vomiting the patient is experiencing. These types include:

  • Anticipatory vomiting happens before treatment
  • Acute nausea and vomiting develops within a few hours of chemotherapy
  • Delayed nausea and vomiting starts more than 24 hours after treatment and can last up to 7 days
  • Breakthrough vomiting occurs when you vomit despite being on an anti-nausea drug

Old but New Treatment

Anti-nausea medications are very effective, however despite great progress in this area people are still at risk for developing chemotherapy-induced nausea and vomiting. One new, but old, option I came across was the acupressure wristband. The acupressure wristband is a non-invasive and inexpensive option that patients may use alongside standard anti-nausea treatment interventions.

There is conflicting evidence that the acupressure wristband is effective in reducing the severity of chemotherapy-induced nausea and vomiting. Most small studies and reviews showed that cancer patients gained relief from wearing the wristband; this was especially true in the prevention of anticipatory nausea/vomiting and acute nausea/vomiting. Larger studies have not been able to replicate these earlier findings and one study found that for cancer patients who expected acupressure wrist bands to ease the nausea they have from chemotherapy were much more likely to gain relief than the patients who were not given the bands.

Despite no conclusive evidence that the band works, it is FDA cleared and safe to use in combination with anti-nausea treatment. It is not invasive and you can have autonomy over when to use it. Although some believe the effects of the wristband may be related to the placebo effect, what you believe will happen if you wear the band is very important, as patients who focus on positive things have and easier time of managing or enduring the chemotherapy side effects than those who do not.

How does it work

Acupressure is a type of simulation to one of the body’s acupressure points (P6 or Neiguaun) by applying pressure using the wristband. The P6 is located on the anterior surface of the forearm, approximately three fingers widths from the first wrist crease. Acupressure works by reducing muscle tension and improving circulation, which can calm an upset stomach.

Brands and costA�

There are numerous wristbands available such as SeaBand, ReliefBand, Bioband, CVS, and Psi Bands, and they all bring about the same effect. They range in price from $6.00 to $90.00 depending on how technologically advanced you want it to be.