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Chemotherapy Hiccups

Cancer and Hiccups

One of the less documented side effects of cancer and chemotherapy is hiccups. Though often not viewed as a serious affliction, hiccups can be highly distressing and, in serious cases, lead to an inability to sleep, eat, drink, or even catch one’s breath. Before going any further into this topic, it is important to note, especially with an affliction as serious as cancer, that this website is not intended to serve as medical advice, and the only person to consult before attempting any treatment or diagnosis is your doctor or specialist. The being said, there is a lot of information out there on the relationship between cancer and hiccups, and this page was made to synthesize and clarify the basics of that information.

Hiccups has been documented as an occasional side effect of various forms of cancer (and also their treatments). The hiccups themselves can range from infrequent and light to severe and continuous, often causing significant distress for those experiencing them. Severe and/or chronic hiccups are infrequent and are mostly found in patients with advanced cancer. The main forms that have been linked to this side effect are lung, pancreatic, esophageal, and colon cancer, as well as brain stem tumors and kidney failure. Other forms of cancer, as well as treatments for it, can also cause hiccups. There is little information on what specifically causes hiccups in cancer though stress and anxiety, irritation to phrenic nerves, reflux, and gastrointestinal complications have been cited. These are things that can cause hiccups in those without cancer as well.

Cancer Treatments and Hiccups

Studies have shown that severe hiccups can be caused not only by cancer, but also by its treatments. There are some that believe that hiccups actually have little or nothing to do with cancer itself, but are instead a “poorly recognized complication of chemotherapy." Chemotherapy, steroids, and various other medications have been shown to cause hiccups in patients. The difficulty in dealing with these cases is that stopping the cause of the hiccups also stops the treatment.

Chemotherapy hiccups can be caused by medications given to stop the nausea associated with it. Dexamethasone, Cisplatin, Emend, Kytril, Zofran, and Ramosteron are drugs often given to chemotherapy patients that are known to cause hiccups. For the most part, when the cycle of the medication is finished, the symptoms should abate. Stopping the medications is difficult as it can lead to other unfortunate symptoms such as nausea and vomiting. If medications appear to be the cause, speaking to your oncologist about lowering the dosage may help.

Chemotherapy can often lead to reflux, which in itself can be a cause of hiccups. If reflux is a symptom as well as hiccups, treating the former can often cure the latter. Staying away from difficult to digest foods (such as dairy) and sleeping on an incline can help stop reflux. In addition, many over the counter medications, such as Prilosec, can help. Of course, before trying any medications, consult your oncologist. If reflux is present, many home remedies for hiccups can make the situation worse.

Treating Hiccups in Cancer Patients

There are dozens of medications that have been shown to help alleviate hiccups in cancer patients. Though research is being done to establish which medications work best, there is still much to learn. The FDA has approved only one drug to date to palliate hiccups; a drug called chlorpromazine, which was developed over 50 years ago (read more). Some of the drugs that have been used to help cancer patients with hiccups are:

  • Baclofen (One of the more prescribed drugs for this issue)
  • Chlorpromazine
  • Haloperidol
  • Nifedipine
  • Metoclopramide
  • Gabapentin

Many of these drugs have adverse side effects and can be dangerous for certain patients. Gabapentin is an anticonvulsant medication that has been shown to be a useful drug for alleviating hiccups with little to no side effects or complications for cancer patients.

For serious cases, phrenic nerve blocks have been shown to be extremely useful and safe. The phrenic nerves are nerves that run from the throat down to the diaphragm. Irritation to these nerves is commonly thought to lead to hiccups. A phrenic nerve block consists of injecting Lidocaine (a numbing medication) to the phrenic nerve area in the neck. This procedure numbs the nerves and, in numerous cases, has been shown to completely stop hiccupping amongst advanced cancer patients and to have no side effects. The procedure is relatively simple and in severe cases or cases where medicinal treatment has failed, it may be a good option.

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