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Chemotherapy used to treat mesothelioma can cause side effects, which will vary from patient to patient.

Within the past few decades, researchers and specialists have developed chemotherapy into an effective treatment for mesothelioma. The main function of chemotherapy is to kill cancer cells and slow tumor growth. Unfortunately, chemotherapy can also kill normal cells and, as a result, cause side effects.

Learning more about the side effects caused by chemotherapy can help you understand what to expect as a patient.

What Causes Side Effects?

Side effects occur when chemotherapy drugs kill normal, healthy cells along with cancer cells. To understand why chemotherapy kills normal cells, you have to understand it works.

Any given chemotherapy drug has one basic function: to attack and kill cells that divide quickly and frequently. Chemotherapy drugs are designed this way to target cancer cells, which are one of the most rapidly dividing cells in the human body.

The human body has several other cells that divide on a frequent basis, including mouth, skin, bone marrow and hair cells. When these cells divide, chemotherapy drugs sometimes target and kill them as if they were cancer cells.

For example, mouths sores, a common side effect of chemotherapy, are caused when chemotherapy drugs target and kill mouth cells along with cancer cells.

It’s important to note that side effects are always temporary and begin to fade away as soon as a patient completes his or her chemotherapy treatment.

General Side Effects

Side effects associated with chemotherapy vary depending on the drug and on each patient’s individual diagnosis. Some drugs have more of an effect on hair cells and cause pronounced hair loss. Other drugs interfere with mouth cells and lead to more frequent mouth sores. Generally speaking, patients may typically experience one or more of the following side effects:

  • Nausea and vomiting
  • Hair loss
  • Fatigue
  • Mouth sores

Keep in mind that chemotherapy affects each patient differently. Some patients may experience hair loss and fatigue, while others may not experience any side effects at all. Additionally, each chemotherapy drug attacks cancer cells in a different way and causes different side effects. Read more about the most common chemotherapy drugs in our free informational guide.

Drug-Specific Side Effects

Chemotherapy drugs are classified into groups according to how they attack cancer cells. Each drug interrupts the replication of cancer cells differently and causes its own side effects.


These chemotherapy drugs interfere with the replication of DNA and RNA inside of cancer cells. Interfering with the process of cellular replication prevents the cell from multiplying and ultimately induces apoptosis (cell death).

Antimetabolites used to treat mesothelioma include gemcitabine (Gemzar) and pemetrexed (Alimta). Side effects associated with gemcitabine and pemetrexed may include:

  • Loss of appetite, nausea and vomiting
  • Skin rash
  • Constipation
  • Diarrhea
  • Mouth sores
  • Hair loss
  • Fatigue
  • Changes in taste
  • Anthracycline antibiotics

Like antimetabolites, anthracycline antibiotics interfere with the replication of cancer cells. This group of chemotherapy drugs is, however, derived from streptomyces, a bacteria found in decaying soil.

Doxorubicin is the only anthracycline antibiotic used to treat mesothelioma. Side effects caused by doxorubicin may include:

  • Diarrhea
  • Vomiting
  • Irregular heart beats
  • Fatigue
  • Swelling (especially in the feet and ankles)
  • Cardiomyopathy (congestive heart failure)
  • Plant Alkaloids

Plant alkaloids are a group of chemotherapy drugs derived from the periwinkle plant. Each plant alkaloid flights cancer in its own unique way. Vinorelbine, the only plant alkaloid used to treat mesothelioma, kills cancer cells in two ways: inhibiting angiogenesis and interfering with the formation of microtubules. By inhibiting the growth of new blood vessels, vinorelbine essentially starves cancer cells and slows their growth. Interfering with the formation of microtubules, a structure that helps cells divide, eventually leads to apoptosis (cell death). Side effects caused by vinorelbine may include:

  • Reduction in white blood cells, red blood cells and platelets
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea
  • Hair loss

Alkylating agents

Alkylating agents kill cancer cells by adding an alkyl agent to their DNA. This breaks up the DNA strands of the cancer cells, disrupts the process of replication and leads to apoptosis (cell death).

Alkylating agents commonly used to fight mesothelioma include carboplatin (Paraplatin) and cisplatin (Platinol). Some patients may not react well to cisplatin and are given carboplation as a substitute.

  • Reduction of white and red blood cells (carboplatin only)
  • Nausea
  • Vomiting
  • Constipation
  • Chest pain
  • Reduced appetite

Dealing with Side Effects

First and foremost, it is important to note that most side effects are temporary. As soon as a patient finishes chemotherapy, healthy cells will start to grow back and side effects will diminish over time.

If you are considering chemotherapy, you should discuss with your specialist how chemotherapy might specifically affect you. Generally speaking, patients can manage side effects associated with chemotherapy in a number of ways.

Write down any side effects you experience in a journal or diary. Including details like the date, time and duration of side effects can help doctors suggest specific ways you can cope.

How do I ease nausea and vomiting?

  • Try eating a light meal before treatment. Avoid overly sweet, fatty or fried foods
  • Ask your specialist about anti-nausea medication

How do I reduce tiredness after treatment?

  • Keep yourself hydrated and eat a healthy meal before you receive treatment
  • Exercise moderately by taking short walks
  • Take short naps and try not to overexert yourself throughout the day

How do I deal with hair loss?

  • Use mild shampoo and avoid heavy hair dyes
  • Wear a hat or scarf to protect yourself from the sun

How do I take care of mouth sores?

  • Use a soft toothbrush after every meal
  • Avoid acidic or spicy foods, like citrus, tomatoes or curry
  • Have a dentist give you a check up before you receive chemotherapy
  • Use prescription medicine to prevent existing mouth sores from worsening during treatment