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Ginger Provides Significant Reduction of Chemotherapy-induced Nausea

The prestigious American Society of Clinical Oncology publishes each year a list of major cancer advances during the previous year. In their “Clinical Cancer Advances 2009”, they list this research report as a “notable research” in the subject category of “Quality of Life and Quality of Cancer Care”.

Here is a description of this notable study, the largest randomized study to date, from the ASCO website (http://www.asco.org):

A large, randomized clinical trial has shown a significant reduction of chemotherapy-related nausea for patients taking ginger supplements along with standard antiemetic drugs, offering relief during the first day after chemotherapy for the more than 73% of patients with cancer treated with chemotherapy who suffer from this side effect (Presented at the 2009 ASCO meeting as Abstract 9511).

In the phase II/III double-blind, multicenter study of 644 patients, investigators found all doses of ginger significantly (p = 0.003) reduced nausea compared with placebo. Julie L. Ryan, PhD, MPH, of the University of Rochester Medical Center, presented these results during Saturday’s Patient and Survivor Care Oral Abstract Session.

Patients with cancer who had previously experienced nausea during chemotherapy and were scheduled for at least three additional chemotherapy treatments were eligible for the study.

All patients took ginger or placebo for 6 days starting 3 days before initiating chemotherapy. Patients were randomly assigned to one of four arms: placebo, 0.5-, 1.0-, or 1.5-gram doses of a purified, dried ginger extract in 250-mg capsules. “Nausea was assessed at a baseline chemotherapy cycle and again during two cycles of chemotherapy during which patients were either given ginger or the placebo,” Dr. Ryan said.

Patients reported their level of nausea four times each day on a scale of 1 to 7, with 1 representing no nausea and 7 as an indicator of extreme nausea. In addition to the ginger supplement or placebo, all patients received a standard 5-hydroxytryptamine type 3 receptor antagonist drug (ondansetron or granisetron) on day 1 of the chemotherapy cycle.

“Most patients report the most severe nausea on the first day of chemotherapy,” Dr. Ryan said. “So we examined the change in nausea in the four study arms on day 1.” The largest reduction in nausea — approximately 40% — occurred with 0.5- and 1- doses of ginger, Dr. Ryan reported.

Additionally, investigators observed a statistically linear decease (p < 0.001) in nausea over 24 hours, and according to Dr. Ryan, this trend is more pronounced and more easily observed on day 1 in study cycle three.

Dr. Ryan reported that ginger had a relatively minimal effect on vomiting, largely because antiemetic drugs are already so effective at eliminating that chemotherapy-related side effect.

Patients enrolled in the trial had a mean age of 53; 90% were female and 92% were white. Represented cancer types included breast cancer (66%), alimentary cancer (6.6%), and lung cancer (6.1%).

“Our study is the largest to examine the use of ginger to reduce chemotherapy-related nausea,” Dr. Ryan said, adding that data were collected at 23 nationwide private oncology practices affiliated with the University of Rochester Cancer Center Community Clinical Oncology Program. “We conclude that ginger will lead to improved quality of life for many patients during chemotherapy.”

For more information about managing the nausea and vomiting associated with chemotherapy, go to our companion website and find a comprehensive description on this subject, including lists of drugs used for nausea and vomiting.

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