Taken along with standard anti-nausea medication, ginger can significantly reduce chemotherapy-related nausea, according to the results of a Phase II/III study conducted by the University of Rochester Medical Center, in Rochester, NY, at oncology practices affiliated with its Community Clinical Oncology Program. The results were presented at the 2009 annual meeting of the American Society of Clinical Oncology.
Two-thirds of study participants were women undergoing chemotherapy for breast cancer, suggesting that ginger may be an important tool for alleviating nausea in this group.
Nausea and vomiting remain significant problems for more than 70 percent of people undergoing chemotherapy, despite the widespread use of antiemetics (medicines that prevent nausea and vomiting).
For centuries providers of complementary therapy have used ginger, a spice, to control stomach upset, but few large studies have evaluated its safety or effectiveness. Clinical trials have reached different conclusions about how effective ginger is against chemotherapy-related nausea. Although two small studies (each involving about 30 to 40 participants) concluded that ginger is helpful, one larger study of 162 people found it was not.
Study Design and Goals
This Phase II/III study enrolled 644 people—most of them women with breast cancer—who had experienced nausea because of chemotherapy and were scheduled to receive at least three additional cycles of treatment. The participants were randomly assigned to one of four groups:
Group one received a placebo (a pill with no active ingredients).
Group two received 0.5 grams (g) of ginger extract.
Group three received 1.0 g ginger extract.
Group four received 1.5 g ginger extract.
For the next two cycles of chemotherapy, participants took these doses for six consecutive days, starting three days before the cycle began. On day one of chemotherapy, all participants also took a standard type of antiemetic called a 5-HT3 receptor antagonist—either ondansetron (brand name: Zofran) or granisetron (brand name: Kytril).
The study was double-blind, meaning that neither researchers nor participants knew who had been assigned to which group. All participants received their doses in 250 milligram capsules taken twice daily.
On days one through four of each cycle, study participants rated the severity of their nausea four times a day on a scale of 1 (not at all nauseated) to 7 (extremely nauseated). The goal was to determine if ginger, when given with a standard antiemetic medicine, was more effective than placebo in controlling chemotherapy-related nausea.
Researchers found that all doses of ginger significantly reduced nausea when compared with placebo on day one of chemotherapy, when nausea tends to be the most severe. The greatest reduction—40 percent—occurred for those taking 0.5 g and 1.0 g of ginger. Researchers also found that nausea decreased steadily over the 24 hours after the ginger was taken.
What Does This Study Mean for Me?
This is the largest study to examine the potential effects of ginger on chemotherapy-related nausea. Although more research is needed to determine the best dosage and timing, this study suggests that ginger may play an important role in controlling nausea.
If you are experiencing chemotherapy-related nausea despite taking anti-nausea medicine, or you are starting treatment and concerned about nausea, you may wish to discuss the results of this study with your doctor. He or she can help you decide whether taking ginger extract may be right for you.
Be aware that ginger should not be taken in combination with blood-thinning medicines such as warfarin (brand name: Coumadin). Keep your doctor informed about all of the medicines you are taking, whether prescription or over-the-counter, as well as any vitamins or supplements.
JL Ryan et al. Ginger for chemotherapy-related nausea in cancer patients: A URCC CCOP randomized, double-blind, placebo-controlled clinical trial of 644 cancer patients. Journal of Clinical Oncology 2009; 27: 15s (suppl; abstr 9511).