Which measure helps prevent chemotherapy-induced nausea in patients with ovarian cancer?

• A. Encourage high-fat meals only after therapy
• B. Administer antiemetic prior to therapy
• C. Withhold fluids before therapy
• D. Avoid all medications

Answer: (B)

Preventing chemotherapy-induced nausea and vomiting is most effectively done by giving antiemetic therapy before the chemotherapy starts. This pre-treatment, or prophylactic, approach blocks the body’s emetic pathways in advance, so the nausea and vomiting pathways aren’t activated as the drugs reach the system. In ovarian cancer, where chemotherapy regimens are often strongly emetogenic, using a combination antiemetic strategy before the infusion—such as agents that block serotonin receptors, support with a neurokinin-1 receptor antagonist, and include a corticosteroid—significantly lowers both the chance and the severity of nausea and vomiting. This pre-emptive plan helps patients keep up with treatment, maintain hydration and nutrition, and reduces the need to stop or modify therapy.

Options that suggest delaying antiemetics until after therapy or restricting fluids or medications don’t provide the same protective effect and can contribute to dehydration and worse symptoms. High-fat meals after therapy don’t address the underlying emetogenic trigger, and withholding fluids before therapy only risks dehydration without preventing CINV.