Chemotherapy treatment as maximum opportunity for cancer cure or control when maximum drug doses can be administered to patients. Adequate control of nausea side effects allows maximum chemotherapy drug dosages to be given. Despite improvements in antiemetic treatments, over 70% of patients continue to experience nausea during chemotherapy. Data from the current continuation show: i) substantial involvement of the parasympathetic branch of the autonomic nervous system (ANS) in nausea development and expression; ii) vagal tone measured before treatment is given shows promise in predicting the subsequent occurrence of chemotherapy induced nausea. Proposed studies will answer five specific research questions: 1) Vagal activity based on the standard deviation of differences in successive heart beats (R-R intervals) will be compared with patient self-report of nausea to answer the question """"""""Do patients who develop chemotherapy induced nausea show a decrease in parasympathetic activity before the symptom?"""""""" 2) Ambulatory measures of gastric activity through spectral analysis of electrogastric activity will be compared with a patients' self-report to answer the question """"""""what is the temporal relationship between the gastric tachyrhythmia and patient report of nausea?"""""""" 3) Comparison of vagal tone taken under paced breathing prior to the administration of chemotherapy drugs will be compared with patients' self- report to answer the question """"""""Can measures of vagal tone predict subsequent chemotherapy treatment-induced nausea?"""""""" 4) Measures of vagal tone will be compared in patients who do and do not develop anticipatory nausea and delayed nausea to answer the question """"""""Do vagal characteristics predict anticipatory nausea or delayed nausea?"""""""" 5) Repeated assessment of chemotherapy patients at treatments 1,3,6 and then 3 and 6 months after chemotherapy ends will answer the questions """"""""Are changes in vagal activity resulting from chemotherapy drugs reversible?"""""""" Current data come from 36 single gender subjects (women) with a single drug treatment (cisplatin or its analogue carboplatin) for a single diagnosis (ovarian cancer). Proposed research will expand and examine the generalizability of current findings by studying 200 patients of both genders with a variety of diagnoses given a variety of chemotherapy drugs. Anticipated results could have methodological and theoretical applications in antiemetic trials and studies of individual differences in self- reporting symptoms. Better understanding of potential nausea mechanisms could also help predict patients at risk of severe nausea and lead to improved pharmacologic and behavioral control of nausea resulting from chemotherapy or other situations such as motion sickness and pregnancy.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001905-13
Application #
2256732
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
Phillips, Janice
Project Start
1979-09-30
Project End
1999-04-30
Budget Start
1995-05-01
Budget End
1996-04-30
Support Year
13
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Rochester
Department
Internal Medicine/Medicine
Type
Schools of Dentistry
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
Morrow, Gary R; Hickok, Jane T; Andrews, Paul L R et al. (2002) Reduction in serum cortisol after platinum based chemotherapy for cancer: a role for the HPA axis in treatment-related nausea? Psychophysiology 39:491-5
Hickok, J T; Roscoe, J A; Morrow, G R (2001) The role of patients' expectations in the development of anticipatory nausea related to chemotherapy for cancer. J Pain Symptom Manage 22:843-50
Roscoe, J A; Morrow, G R; Hickok, J T et al. (2000) Nausea and vomiting remain a significant clinical problem: trends over time in controlling chemotherapy-induced nausea and vomiting in 1413 patients treated in community clinical practices. J Pain Symptom Manage 20:113-21
Nair, M G; Hickok, J T; Roscoe, J A et al. (2000) Sources of information used by patients to learn about chemotherapy side effects. J Cancer Educ 15:19-22
Roscoe, J A; Hickok, J T; Morrow, G R (2000) Patient expectations as predictor of chemotherapy-induced nausea. Ann Behav Med 22:121-6
Morrow, G R; Andrews, P L; Hickok, J T et al. (2000) Vagal changes following cancer chemotherapy: implications for the development of nausea. Psychophysiology 37:378-84
Morrow, G R; Hickok, J T; DuBeshter, B et al. (1999) Changes in clinical measures of autonomic nervous system function related to cancer chemotherapy-induced nausea. J Auton Nerv Syst 78:57-63
Hickok, J T; Roscoe, J A; Morrow, G R et al. (1999) Use of 5-HT3 receptor antagonists to prevent nausea and emesis caused by chemotherapy for patients with breast carcinoma in community practice settings. Cancer 86:64-71
Morrow, G R; Roscoe, J A; Hickok, J T et al. (1998) Initial control of chemotherapy-induced nausea and vomiting in patient quality of life. Oncology (Williston Park) 12:32-7
Morrow, G R; Hickok, J T; Burish, T G et al. (1996) Frequency and clinical implications of delayed nausea and delayed emesis. Am J Clin Oncol 19:199-203

Showing the most recent 10 out of 14 publications