How to control nausea?

How to control nausea?
Nausea is one of the most feared side effects of chemotherapy. There is no doubt that it is one of the most uncomfortable sensations that people experience. However, we have come a long way since the days when chemotherapy initially made its way into common usage. We are better able to predict which drugs are the worse culprits, and are better able to control it. There are many components to the causes of nausea:
Anticipatory nausea is critical to control, as it can make future control more difficult. Anti anxiety drugs, e.g. Lorazepam, are commonly used. These can be used both before, and during the entire chemotherapy cycle.
 Direct stimulation of the trigger zone in the brain is suppressed by newer agents e.g ondansetron and ganisetron. This is mainly effective in the first three post chemotherapy days. Control of stomach acidity with acid reducers, e.g. Protonix, etc. These are often take throughout the chemotherapy cycle.
Improvement of bowel motility: metoclopramide (Reglan) improves the forward propulsion of stomach and intestinal contents. This is particularly useful when patients are on tube feeding support, and the tube feelings are accumulating in the stomach.
Constipation can worsen nausea, and some of the anti nausea medicines (Zofran) can worsen constipation. This needs to be proactively managed with stool softeners, diet ( fiber, prune juice), and laxatives. We use enemas only when safe to do so. 
There are other sensations which mimic nausea. Patients undergoing radiation to the head and neck region develop thick secretions in their mouth. They cannot clear these easily, and this causes a gagging sensation. Good oral care with salt or baking soda mouth rinsing, and good hydration, along with a cough suppressant ( guaifenesin/ Robitussin) will help decrease these secretions.
Every person responds differently to chemotherapy, and the anti nausea medicines. The  first cycle may be a learning curve, but we are reasonably confident of controlling the symptoms. It need not be a barrier to undergoing chemotherapy.