Nutritional Fundamentals for Health

 
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The Effect of Ginger Extract on Nausea due to Chemotherapy

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Nausea can be a significant side effect of numerous chemotherapy medications and preventing and treating chemotherapy induced nausea and vomiting (CINV) is a priority in oncology patients. There are indeed some important and often effective conventional medications but even then, the symptoms can occur in 25% (vomiting) and 61% (nausea) of cancer patients. Nausea and vomiting are at best, unpleasant symptoms but can significantly affect quality of life and cause insufficient nutrition and can even result in chemotherapy treatment delays or reduction in desired dosing.

Nausea has been studied for nausea due to other causes such as pregnancy and post-operative nausea and vomiting. There is also a literature review published in 2013 on ginger and chemotherapy induced nausea and vomiting. However, there are some research methodology problems in the previous studies, which might be preventing common use of ginger in these patients in the oncology setting.

The primary objective of this double-blind, randomized placebo-controlled trial was to address those methodology issues and assess ginger compared to placebo in patients receiving chemotherapy agents that is moderate to highly associated with causing nausea and vomiting.  

Patients were randomly assigned to receive 300 mg capsules four times daily of standardized ginger extract or placebo in conjunction with the standard medications for nausea/vomiting for the first three cycles of chemotherapy. Ginger or placebo was given with meals, starting on the day of the chemotherapy and for a total of 5 days, for each cycle. Over three consecutive chemotherapy cycles, nausea was more prevalent than vomiting. In cycle one, those who received ginger reported significantly better quality of life in terms of chemotherapy induced nausea, nausea/vomiting, quality of life, as well as less fatigue than placebo. There were no significant results in cycle 2. In cycle 3, quality of life and fatigue were significantly better in the ginger group compared to placebo.

Commentary: The overall summary would be that ginger, in addition to the conventional antiemetics, was associated with better chemotherapy induced nausea related quality of life and less cancer related fatigue compared to those who received placebo along with their antiemetic prescription. This is good news, but it is not a trial comparing ginger to the conventional antiemetics used during chemotherapy regimens. These results confirm several previous studies. A larger study would be needed to confirm results, and hopefully a study comparing ginger to prescription antiemetics. 

Reference: 
Marx W., et al. Nutrients 2017; 9:867