[Anticipatory nausea and anticipatory vomiting, food aversion and anticipatory immunomodulation: classical conditioning in cytostatic drug treatment of pediatric chemotherapy patients].

Nausea and/or vomiting are adverse side-effects of cancer chemotherapeutic drugs in adult as well as pediatric cancer patients' complicating treatment and compliance. Nausea and vomiting are not only experienced as posttreatment symptoms after chemotherapy (i.e., posttreatment nausea and/or vomiting). In a subgroup of cancer patients, these symptoms also occur prior to a chemotherapeutic drug infusion, called anticipatory nausea (AN) and anticipatory vomiting (AV). The aim of this paper is to present a model derived from basic psychology to explain anticipatory symptoms as learned responses based on classical conditioning. In addition, food aversions and also immunomodulation are interpreted as conditioned responses. Some data on prevalence of ANV in a pediatric sample and on the correspondence between anticipatory symptoms and predictions from the conditioning model are presented. Finally, therapeutic techniques to prevent AN and/or AV are deduced from the conditioning model.