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What Causes Persistent Chronic Vomiting Post Radiotherapy For Multiple Metastasis In Cerebrum?
Hello, i would like to ask a question regarding severe vomiting for 6 mounts after radiotherapy of the madulla at the level of 4th vertebra. First i would like to gie you some data regarding case history of the patient - woman, 55 years old, with diagnosed and operated breast cancer in 2007. In 2014 was diagnosed with multiple metastasis in the cerebrum, cerebellum due to problem with the vestibular system. She had a brain syrgery at the level of cerebellum and 7 metastasis where removed. After that the problem with the vestibular system stoped and radiotherapy was ordered in order to affect the rest of the metastasis. From the nuclear magnetic resonance six mouths after the surgery where visible that there is growth in the metastasis in the medulla. Again radiotherapy was ordered and there is contonious vomiting( for 6 mounts already) after the radiotherapy.For the moment she is taking domperidone 10mg 1x1 but with no effect. Would like to ask what can be done in this case??
Wed, 9 Mar 2016
Thank you for your query.
Am sorry that is going through a rough time for so long.
Vomiting occurs either due to stomach problems, medications or hyperstimulation of the centre of the brain that controls vomiting (CTZ- chemoreceptor trigger zone).
The CTZ in located in the medulla. Any compression or damage caused to this area by metastatic tumors, edema or after radiotherapy or stroke can stimulate this centre and provoke protracted vomiting.
There are antiemetic preparations (ondasetron, for instance) that work to calm this centre down and ease up the vomiting. In addition to this, anti edema measures ( if edema is resent) may help with relieving the vomiting.
Domperidone enhances transit of food from stomach to intestine and prevent vomiting. This will not be of much use in her situation.
Hope this helps.
Please feel free to contact should you need further clarification.
Wish you both good health
Am sorry that is going through a rough time for so long.
Vomiting occurs either due to stomach problems, medications or hyperstimulation of the centre of the brain that controls vomiting (CTZ- chemoreceptor trigger zone).
The CTZ in located in the medulla. Any compression or damage caused to this area by metastatic tumors, edema or after radiotherapy or stroke can stimulate this centre and provoke protracted vomiting.
There are antiemetic preparations (ondasetron, for instance) that work to calm this centre down and ease up the vomiting. In addition to this, anti edema measures ( if edema is resent) may help with relieving the vomiting.
Domperidone enhances transit of food from stomach to intestine and prevent vomiting. This will not be of much use in her situation.
Hope this helps.
Please feel free to contact should you need further clarification.
Wish you both good health
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