Ginger-Mechanism of Action in Chemotherapy-induced Nausea and Vomiting: A Review (original) (raw)
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Benefits of ginger in the control of chemotherapy-induced nausea and vomiting
Revista Brasileira de Enfermagem
Objectives: To identify and discuss scientific evidence of the effects of ginger use on the management of chemotherapy-induced nausea and vomiting. Methods: This is an integrative reviewperformed by Ganong’s reference. Results: We included 24 studies, highlighting three thematic categories, namely 1) antiemetic action of ginger - nausea (13 articles; of these, nine significant) and emesis (10 studies; of these, six significant); 2) action in the control of nausea (11 articles; of these, six significant) and vomiting (8 articles; of these, three significant) in the acute phase; 3) action in the control of nausea (6 articles; of these, three significant) and vomiting (6 articles; of these, three significant) in the delayed phase. There were divergences of the methods used. Final considerations: This complementary therapy has low cost and easy access, but no statistical confirmation of its effectiveness in the management of nausea and vomiting in cancer patients was found.
Efficacy of The Ginger on Chemotherapy-Induced Nausea andVomiting (CINV): A Systematic Review
2018
Background: Chemotherapy Induced Nausea-Vomiting (CINV) is a frequent side effect experienced by sufferers of malignant tumor undergoing chemotherapy. Ginger is one herb that has been used since many years and is naturally especially as antiemetic. This study aims to find out the effectiveness of ginger against nausea vomiting due to chemotherapy by systematic review and followed the PRISMA statement guidelines. Methods: Scopus, Science Direct, PubMed, and Springerlink database from January 2012 – December 2017. Articles identified by using search terms or keywords ('CINV' OR 'nausea' OR 'vomiting' OR 'emesis') AND (‘chemotherapy’) AND ('ginger' OR 'Zingiber officinale' OR 'rhizoma'). All included studies were access base on randomized controlled trial. Results: 14 out of 209 papers were including. Articles that have been reviewed results that ginger give benefits to reduce nausea vomiting due to chemotherapy showed a significa...
BMC Complementary and Alternative Medicine, 2014
Background: Preliminary research shows ginger may be an effective adjuvant treatment for chemotherapy-induced nausea and vomiting but significant limitations need to be addressed before recommendations for clinical practice can be made. Methods/Design: In a double-blinded randomised-controlled trial, chemotherapy-naïve patients will be randomly allocated to receive either 1.2 g of a standardised ginger extract or placebo per day. The study medication will be administrated as an adjuvant treatment to standard anti-emetic therapy and will be divided into four capsules per day, to be consumed approximately every 4 hours (300 mg per capsule administered q.i.d) for five days during the first three cycles of chemotherapy. Acute, delayed, and anticipatory symptoms of nausea and vomiting will be assessed over this time frame using a valid and reliable questionnaire, with nausea symptoms being the primary outcome. Quality of life, nutritional status, adverse effects, patient adherence, cancer-related fatigue, and CINV-specific prognostic factors will also be assessed. Discussion: Previous trials in this area have noted limitations. These include the inconsistent use of standardized ginger formulations and valid questionnaires, lack of control for anticipatory nausea and prognostic factors that may influence individual CINV response, and the use of suboptimal dosing regimens. This trial is the first to address these issues by incorporating multiple unique additions to the study design including controlling for CINV-specific prognostic factors by recruiting only chemotherapy-naïve patients, implementing a dosing schedule consistent with the pharmacokinetics of oral ginger supplements, and independently analysing ginger supplements before and after recruitment to ensure potency. Our trial will also be the first to assess the effect of ginger supplementation on cancer-related fatigue and nutritional status. Chemotherapy-induced nausea and vomiting are distressing symptoms experienced by oncology patients; this trial will address the significant limitations within the current literature and in doing so, will investigate the effect of ginger supplementation as an adjuvant treatment in modulating nausea and vomiting symptoms.
Supportive Care in Cancer, 2011
Purpose-Despite the widespread use of antiemetics, nausea continues to be reported by over 70% of patients receiving chemotherapy. Methods-In this double blind, multicenter trial, we randomly assigned 744 cancer patients to four arms: 1) placebo, 2) 0.5g ginger, 3) 1.0g ginger, or 4) 1.5g ginger. Nausea occurrence and severity were assessed at a baseline cycle and the two following cycles during which patients were taking their assigned study medication. All patients received a 5-HT 3 receptor antagonist antiemetic on Day 1 of all cycles. Patients took three capsules of ginger (250mg) or placebo twice daily for six days starting three days before the first day of chemotherapy. Patients reported the severity of nausea on a 7-point rating scale ("1" = "Not at all Nauseated" and "7" = "Extremely Nauseated") for Days 1-4 of each cycle. The primary outcomes were to determine the dose and efficacy of ginger at reducing the severity of chemotherapy-induced nausea on Day 1 of chemotherapy. Results-A total of 576 patients were included in final analysis (91% female, mean age = 53). Mixed model analyses demonstrated that all doses of ginger significantly reduced acute nausea severity compared to placebo on Day 1 of chemotherapy (p=0.003). The largest reduction in nausea intensity occurred with 0.5g and 1.0g of ginger (p=0.017 and p=0.036, respectively). Anticipatory nausea was a key factor in acute chemotherapy-induced nausea (p<0.0001). Conclusions-Ginger supplementation at daily dose of 0.5g-1.0g significantly aids in reduction of the severity of acute chemotherapy-induced nausea in adult cancer patients.
Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomiting
2009
Goals of work Ginger has been used to treat numerous types of nausea and vomiting. Ginger has also been studied for its efficacy for acute chemotherapy-induced nausea and vomiting (CINV). However, its efficacy for delayed CINV in a diverse oncology population is unknown. Materials and methods We performed a randomized, double-blind, placebo-controlled trial in 162 patients with cancer who were receiving chemotherapy and had experienced CINV during at least one previous round of chemotherapy. All participants were receiving a 5-HT 3 receptor antagonists and/or aprepitant. Participants were randomized to receive either 1.0 g ginger, 2.0 g ginger daily, or matching placebo for 3 days. The primary outcome was change in the prevalence of delayed CINV. Secondary outcomes included acute prevalence of CINV, acute and delayed severity of CINV, and assessment of blinding.
Nutrients
Ginger supplementation could be an effective adjuvant treatment for chemotherapy-induced nausea (CIN). The aim of this clinical trial was to address significant methodological limitations in previous trials. Patients (N = 51) were randomly allocated to receive either 1.2 g of standardised ginger extract or placebo per day, in addition to standard anti-emetic therapy, during the first three cycles of chemotherapy. The primary outcome was CIN-related quality of life (QoL) measured with the Functional Living Index-Emesis (FLIE) questionnaire. Secondary outcomes included acute and delayed nausea, vomiting, and retching as well as cancer-related fatigue, nutritional status, and CIN and vomiting-specific prognostic factors. Over three consecutive chemotherapy cycles, nausea was more prevalent than vomiting (47% vs. 12%). In chemotherapy Cycle 1, intervention participants reported significantly better QoL related to CIN (p = 0.029), chemotherapy-induced nausea and vomiting (CINV)-related QoL (p = 0.043), global QoL (p = 0.015) and less fatigue (p = 0.006) than placebo participants. There were no significant results in Cycle 2. In Cycle 3, global QoL (p = 0.040) and fatigue (p = 0.013) were significantly better in the intervention group compared to placebo. This trial suggests adjuvant ginger supplementation is associated with better chemotherapy-induced nausea-related quality of life and less cancer-related fatigue, with no difference in adverse effects compared to placebo.
Canadian Oncology Nursing Journal
Chemotherapy has serious side effects that may be detrimental to the patient, namely complaints of nausea and vomiting. To reduce the side effects of chemotherapy, many patients in our country choose herbal therapy. One such therapy is the intake of ginger. The aim of this article is to explore the effectiveness of ginger to overcome nausea and vomiting caused by chemotherapy in breast cancer patients. The method used is a systematic review. Results of the study suggest that ginger is only effective to reduce nausea, but does not lower the frequency of vomiting caused by chemotherapy in breast cancer patients.
Effect of Herbal Therapy to Intensity Chemotherapy-Induced Nausea and Vomiting in Cancer Patients
Iranian Red Crescent Medical Journal, 2013
Background: Chemotherapy-induced nausea and vomiting are the most important complications for cancer patients as its prevalence has been reported to be about 54-96 percent. ginger has been used for medicinal purposes including nausea and vomiting in traditional Persian, Chinese and Indian pharmacopoeia. Objectives: The objective of this study was to evaluate the efficacy of complimentary ginger among cancer patients experiencing nausea and vomiting. Material and Methods: A randomized cross-over clinical trial was carried out on patients under chemotherapy treatment for at least 2 episodes of chemotherapy and at least 2 episodes of previous experience of nausea and vomiting. Subjects of this study received 2 different complementary regimes with 250mg ginger capsule in regime A and placebo capsule in regime B. subjects of the study were crossed over to receive the other regime during the two cycles of chemotherapy. Results: Findings of the study indicated that subjects receiving ginger showed significant reduction in frequency and intensity of nausea and vomiting compared to placebo receiving subjects. Conclusions: According to finding of this study, in accordance to most of other researches, ginger is an effective agent to reduce chemotherapyinduced nausea and vomiting. However, there are some researches supporting ginger as a moderate antiemetic agent among cancerous patients under chemotherapy.
Asian Pacific journal of cancer prevention : APJCP, 2016
Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the frst 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (±1.31) and 1.46 (±1.28) with no statistically significant difference. After the 2nd chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After 3rd chemotherapy, mean nausea severity in cont...
Mansoura Nursing Journal
Aim: to explore the utilization of ginger and its effect on relieving the chemotherapy related nausea and vomiting among patients with gynecological cancer. Methods: An quasi-experimental research design was utilized to conduct this study on 132 patients attended the oncology center of Mansoura University Hospital between January 2013 to December 2013 for chemotherapy for a gynecologic tumor. The study sample served as a one arm intervention group. Data were collected using three tools; the 1st tool was an interview questionnaire to assess the general characteristics of the patients, the 2nd tool was the Rhodes Inventory of Nausea, Vomiting and Retching (INVR) to assess the level and severity of nausea and vomiting experienced before and after the chemotherapy and the 3rd tool was the woman's follow up card to assess the patient's compliance with the ginger tablets. Results: The baseline total Rhodes Index score was significantly decreased after receiving the assigned dose of Ginger tablets (63.8±5.3 at base line and 60.6±4.9 at end of the study P<0.0001). Conclusion: Ginger tablets are effective in reducing the chemotherapy induced nausea and vomiting. Key word: Ginger tablets, chemotherapy induced nausea and vomiting, gynecologic tumor, Rhodes Inventory of nausea and vomiting. Research hypothesis Women on chemotherapy for gynecologic tumors who consume Ginger tablets exhibits lower score of Rhodes for nausea and vomiting after receiving the treatment. Subjects and Method Research design: An quasiexperimental research design was utilized.