A longitudinal study of the development of anticipatory nausea and vomiting in cancer chemotherapy patients: the role of absorption and autonomic perception.

We interviewed 70 cancer patients receiving chemotherapy at home before their second treatment session to obtain baseline measures of absorption, autonomic perception, depression, state-trait anxiety, and basic demographic information. Patients were then interviewed before each of their next six treatment sessions, at which time measures of depression, state anxiety, severity and duration of postchemotherapy nausea and/or vomiting (PCNV), and experience of anticipatory nausea and/or vomiting (ANV) were obtained. Previous findings suggesting that motion sickness, trait anxiety, depression, sex of subject, and age are predictors of the development of ANV were not replicated. Patients with ANV did score significantly higher on measures of absorption and autonomic perception than patients who did not develop ANV. Those variables hypothesized to mediate conditioning (i.e., toxicity of treatment drugs, severity of PCNV, levels of state anxiety) accurately predicted which patients developed ANV. Absorption and autonomic perception added significantly to the prediction.

The spontaneous regression of cancer. A review of cases from 1900 to 1987.

The literature on the spontaneous regression of cancer is reviewed from 1966 to 1987 to update reviews by Everson & Cole and by Boyd. These authors reviewed all cases of spontaneous regression from 1900 to 1965. We then report the entire series from 1900 to 1987. We also attempted to determine what attributions for spontaneous regressions have been reported. Although almost half of the authors failed to speculate or specify a possible cause for the spontaneous regression, the remainder postulated responsible factors such as immunological or endocrine, surgical, necrosis, infection, or operative trauma. The only unorthodox treatment to appear in the literature was the psychological. We conclude that the literature on the spontaneous regression of cancer is still unable to provide unambiguous accounts of the mechanisms operating to affect these regressions.

Ratings of cancer chemotherapy toxicity by oncologists, nurses, and pharmacists.

In order to examine the perceived toxicity of commonly used drug regimens for cancer chemotherapy, eight oncologists, twelve nurses, and five pharmacists rated the toxicity of 30 different drug combinations. Although the correlations revealed a high degree of agreement, the oncologists' ratings and the nurses' ratings differed systematically at the lower- and the higher-toxicity levels. This was most readily described by a "regression effect," wherein oncologists' ratings appear to regress toward the mean relative to the nurses' ratings. The perception of both toxicity and the importance of side effects such as nausea and vomiting may be substantially different between physicians and nurses, and hence, has important implications for how patients communicate these to the various health care professionals.