Nausea in Cancer & Serious Illness: Causes and Physiology (Palliative Care Doctor Explains)

Nausea is one of the most common and distressing symptoms for patients living with cancer or advanced organ illness. In this video, Dr. Jonathan Wong, a Palliative Care physician, breaks down the medical physiology behind why nausea happens and the six main pathways that trigger the brain's vomiting centre. Understanding the source of nausea—whether it is from the GI tract, medication side effects, or anxiety—is the first step toward finding the right treatment. In this video, you will learn: The medical definition of nausea and why it's hard to describe. How the "Vomiting Center" (Nucleus Tractus Solitarius) works. The 6 main sources of nausea: Vestibular, GI Tract, Organ Stretching, Chemoreceptor Trigger Zone, Brain Pressure, and Emotional Centers. What "Anticipatory Nausea" is and why memories can trigger physical symptoms. Nausea can arise from multiple different systems in the body, which is why identifying the underlying cause is essential for choosing the most effective treatment. In Parts 2 and 3, we will break down the non-pharmacological and pharmacological treatments used to manage nausea in palliative care, and how each treatment targets specific neurotransmitters and pathways. Chapters 00:00 Introduction 01:24 What is nausea? Definition and descriptions 02:52 Why nausea exists (evolutionary perspective) 03:34 The vomiting centre explained 04:27 Vestibular causes of nausea 05:41 Gastrointestinal causes 08:44 Intra-abdominal organ stretching 09:59 Chemoreceptor trigger zone 11:05 Brain tissue causes of nausea 12:20 Emotional and cortical triggers 13:40 Anticipatory nausea 14:19 Summary #Nausea #PalliativeCare #SymptomManagement #MedicalEducation #CancerCare Link to the introductory video:    • Welcome to Palliative Care Explained! Decl...   About this channel: Welcome to Palliative Care Explained - a channel aimed at answering your questions about palliative care and end of life care. My name is Dr. Jonathan Wong (MD, FRCPC) and I am a palliative care doctor based out of Winnipeg, Canada. Brought online March 28, 2025, Palliative Care Explained is a channel aimed at answering your questions about palliative care. My formal medical training is in internal medicine and palliative care and I have been working in the field of palliative care since 2011. It is my hope that this channel will better inform viewers about palliative care, end of life care and living with a serious illness. Intro music written & recorded by: Jonathan Wong Committee advisors: Dr. P. Daeninck MD, MSc, FRCPC Dr. E. Giannouli MD, FRCPC Dr. J. Strutinsky-Mason MD, MSc, MRCP (UK) Disclaimer and medical-legal statements: *As a medical professional speaking to you, I hereby declare that I do not have any conflicts of interest that would compromise the integrity of the presented information. *I do not have any financial sponsors nor am I receiving any funding from the pharmaceutical industry. *This channel and its production, is my own undertaking, with support from other palliative care experts. *This video series is for educational purposes only and is intended for audiences in Canada. *The presented information may not be applicable to all viewers. *I am not providing any direct medical treatment or advice to the viewer. *These videos are not meant to imply or establish a therapeutic relationship with the viewer. *These videos are not to replace or subvert the advice from the viewer’s own doctor or health care provider team. *Any further questions should be directed to the medical team most familiar with the viewer’s unique situation. References and further reading: Nausea and vomiting in palliative care. Leach, C. Clinical Medicine (2019) 19-4, 299-301 Palliative Medicine – A Cased Based Manual Fourth Edition MacDonald S, Herx L, Boyle A Copyright Oxford University Press 2022. Published by Oxford University Press. Oxford Textbook of Palliative Medicine Sixth Edition Cherny N, Fallon M, Kaasa S, Portenoy R, Currow D. Copyright Oxford University Press 2021. Published by Oxford University Press. JAMA Evidence Care at the close of life – Evidence and Experience McPhee S, Winker M, Rabow M, Pantilat S, Markowitz A Copyright American Medical Association 2011. Published by McGraw-Hill.