Written By: Devin Golden

Chemotherapy Side Effects

Chemotherapy side effects are common for mesothelioma patients. The side effects of mesothelioma chemotherapy are similar to those of other cancers. Knowing what to expect can help patients prepare for and withstand discomfort.

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse


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Important Facts About Mesothelioma Chemotherapy Side Effects

  • Chemotherapy side effects occur due to chemotherapy attacking healthy cells in your body.
  • The most frequent chemotherapy side effects for mesothelioma patients are nausea, fatigue and loss of appetite.
  • Pemetrexed and cisplatin, the top two chemotherapy drugs for mesothelioma, are less likely than other chemotherapy drugs to cause hair loss.

What Are the Side Effects of Mesothelioma Chemotherapy?

Not all mesothelioma chemotherapy medications cause the same side effects. Cisplatin, the generic chemotherapy medication for Platinol, is a platinum-based chemotherapy. Platinum chemotherapy drugs are less likely than others to cause hair loss.

There are approximately 40 different side effects from mesothelioma chemotherapy. Some of the most common are:

  • Changes to taste
  • Fatigue and weakness
  • Body aches
  • Nausea
  • Vomiting
  • Loss of appetite
  • Decreased weight
  • Diarrhea
  • Pale complexion
  • Low white blood cell count

More serious side effects from mesothelioma chemotherapy include:

  • Allergic reactions
  • Itching or rashes
  • Inflammation of membranes lining the digestive tract (mucositis)
  • Damage to the heart muscle (cardiotoxicity)
  • Fertility loss
  • Increased risk of infection
  • Bruising
  • Nosebleeds
  • Sore mouth
  • Heartburn
  • Liver damage (hepatotoxicity)

What Is ‘Chemo Brain’?

Chemo brain is one of the few potential long-lasting side effects of mesothelioma chemotherapy where you may experience symptoms up to one year after stopping treatment. This phenomenon involves cognitive impairments. Many patients experience memory loss and/or brain fogginess before, during and after treatment.

For some, chemo brain persists only for a short time after ending chemotherapy. For others, this side effect lasts much longer. According to the Dana-Farber Cancer Institute website, chemo brain usually goes away 9-12 months after chemotherapy treatment ends. Between 10% and 20% of patients experience chemo brain for longer than one year.

Effects of chemo brain include:

  • Slower cognition
  • Concentration problems
  • Communication issues
  • Difficulty learning new skills
  • Inability to multitask
  • Short attention span
  • Needing more time to finish tasks
  • Forgetfulness about events, actions or conversations

What Causes Chemo Brain?

There is no one specific cause of chemo brain. The reasons range from stress of a cancer diagnosis to the effects of chemotherapy on the brain. Chemotherapy causes short- and long-term memory loss and mental fogginess. While other types of treatment can cause this side effect, chemotherapy is most associated with it.

Chemo brain is often associated with chemotherapy crossing the “blood-brain barrier.” This is a selective border of endothelial cells that prevents solutes in the body’s blood from crossing into the central nervous system. If chemotherapy crosses this border, it can affect the neurons in the brain.

According to the American Cancer Society and Dana-Farber Cancer Institute websites, there are ways to combat chemo brain. Regular physical and mental exercises are highly suggested, as are:

  • Getting enough rest/sleep
  • Eating vegetables and other healthy foods
  • Avoid alcohol
  • Receive treatment for anxiety, depression or sleep apnea

How to Handle Chemotherapy Side Effects

Patients can reduce the negative effects of mesothelioma chemotherapy. While some side effects will occur, living a healthy lifestyle can reduce the severity of symptoms. Other effects, like chemo brain, may never materialize.

The top suggestion from experts to help lessen unwanted side effects involves how often patients eat each day. Since chemotherapy can cause anorexia and make food less appealing, doctors recommend eating 5-6 meals a day. These meals involve smaller portions, which is less intimidating for patients.

Eating high-protein foods provides the body nutrients in a small amount consistently throughout the day. Patients can eat smaller portions of high-protein foods (like fish, chicken or tofu) and keep their bones and muscles healthy against chemotherapy agents circulating in the blood.

Other suggestions regarding eating habits include:

  • Drink water or other substances an hour before meals
  • Eat slowly
  • Avoid strong-smelling, fried and fatty foods
  • Prioritize leafy green vegetables
  • Add sauces to make healthy foods more desirable

Some additional suggestions to handle chemotherapy side effects include:

  • Getting enough sleep
  • Take naps during the day
  • Exercising regularly
  • Reading
  • Doing word puzzles and other mental exercises
  • Ask your doctor about medications to prevent nausea

Substituting Carboplatin for Cisplatin

Some patients don’t respond well to cisplatin, so their doctor may recommend substituting carboplatin. This is especially true if the patient has kidney problems or another medical condition.

While carboplatin is a platinum-based chemotherapy drug like cisplatin, it is far less potent. This means it’s safer for kidneys and other organs.

The combination of carboplatin and pemetrexed has similar survival rates as cisplatin and pemetrexed.

Sources & Author

  1. Pemetrexed and cisplatin. Cancer Research UK. Retrieved from: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/pemetrexed-cisplatin.  Accessed: 11/30/2022.
  2. Cisplatin + Pemetrexed (Alimta). ChemoExperts. Retrieved from: https://www.chemoexperts.com/cisplatin-pemetrexed-alimta.html. Accessed: 05/03/2021.
  3. Alimta. RxList. Retrieved from: https://www.rxlist.com/alimta-side-effects-drug-center.htm. Accessed: 05/03/2021.
  4. The Chemotherapy Drugs That Cause Hair Loss. VeryWellHealth. Retrieved from: https://www.verywellhealth.com/the-chemotherapy-drugs-that-cause-hair-loss-430147. Accessed: 05/03/2021.
  5. The side effects of platinum-based chemotherapy drugs: a review for chemists. National Library of Medicine. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/29632935/. Accessed: 05/03/2021.
  6. Chemo brain. Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/chemo-brain/symptoms-causes/syc-20351060. Accessed: 05/03/2021.
  7. Chemo Brain. American Cancer Society. Retrieved from: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/changes-in-mood-or-thinking/chemo-brain.html. Accessed: 05/21/2021.
  8. Tips for Managing Chemobrain. Dana-Farber Cancer Institute. Retrieved from: https://www.dana-farber.org/health-library/articles/tips-for-managing-chemobrain/. Accessed: 05/21/2021.
  9. Tips for Managing Chemotherapy Side Effects. WebMD. Retrieved from: https://www.webmd.com/cancer/tips-for-managing-chemotherapy-side-effects. Accessed: 05/04/2021.
Devin Golden

About the Writer, Devin Golden

Devin Golden is a content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.