Predicting development of anticipatory nausea in cancer patients: prospective examination of eight clinical characteristics.

An algorithm based on learning theory and previous research for predicting which cancer patients would develop nausea in anticipation of chemotherapy treatments was tested. Patients with four or more of the following eight characteristics after their first treatment were predicted to develop anticipatory nausea (AN) by their fourth chemotherapy treatment: experienced nausea and/or vomiting after first treatment; nausea after treatment described as "moderate, severe, or intolerable;" vomiting after treatment described as "moderate, severe, or intolerable;" less than 50 yr of age; a susceptibilty to motion sickness; feeling warm or hot all over after treatment; sweating following treatment; feelings of generalized weakness following treatment. The characteristics significantly predicted subsequent anticipatory nausea development (p less than .01) by their fourth treatment in 355 consecutive cancer patients. Results were independent of the type of cancer being treated. The accuracy of the prediction was less specific than prior research, 34% of patients predicted to develop AN did so, compared to 16% of the total sample. Results are consistent with a learned etiology for the development of anticipatory side effects and support the importance of predictive methodologies in investigating mechanisms of anticipatory nausea development.