Possible side effects of chemotherapy

Chemotherapy for mesothelioma can cause side effects. The most common of these are caused by:

  • Effects on your blood cells, which can cause an increased risk of infection, bruising and bleeding or anaemia (low red blood cells).
  • Effects on your gut, which can make you feel sick, have a sore mouth or diarrhoea.
  • Effects on your nerves, which can cause numbness or tingling in your hands or feet and changes in hearing.

Most people also feel tired during treatment. Other possible side effects include hair thinning and sore eyes.

Tell your doctor or nurse if you notice any side effects. There are treatments they can give you, which will help.

It’s especially important to contact the hospital straight away if you feel unwell, have a high temperature or have any symptoms of infection. This is because an infection can make you seriously unwell very quickly when you are having chemotherapy.

Although side effects can be unpleasant at the time, most are temporary and go away when treatment ends.

Side effects of chemotherapy

Chemotherapy drugs can affect some of the healthy cells in your body and this can cause side effects. Most side effects will go away when treatment is over.

Each person’s reaction to chemotherapy is different. Some people have very few side effects, while others may experience more.

The chemotherapy drugs must often used to treat mesothelioma are pemetrexed and cisplatin. The most common side effects of these drugs are:

Risk of infection

Pemetrexed and cisplatin can reduce the number of white cells in your blood. This will make you more likely to get an infection. Your white blood cells start to reduce seven days after treatment and are usually at their lowest 10–14 days after. When the number of white blood cells is low it’s called neutropenia.

Contact the hospital straight away on the contact number you’ve been given if:

  • your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.

Your white cells usually increase steadily and return to normal before your next treatment. You will have a blood test before having more chemotherapy. If your blood cells are still low, your doctor may delay your treatment for a short time.

Bruising and bleeding

Pemetrexed and cisplatin can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.

Anaemia (low red cells)

Pemetrexed and cisplatin can reduce the number of red cells in your blood. These cells carry oxygen around the body. If they are low you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red cells (blood transfusion).

Feeling sick

This may happen in the first few days after chemotherapy. Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It’s easier to prevent sickness than to treat it after it has started.

If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti sickness drug to one that works better for you.

Sore mouth

Your mouth may become sore or dry, or you may notice small ulcers during treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections.

Diarrhoea

Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.

Numbness or tingling in hands or feet

These symptoms are caused by the effect of cisplatin on nerves. It’s called peripheral neuropathy. You may also find it hard to fasten buttons or do other fiddly tasks. Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug. The symptoms usually improve slowly after treatment finishes but in some people they may never go away. Talk to your doctor if you are worried about this.

Tiredness (fatigue)

Feeling very tired is a common side effect. It’s often worse towards the end of treatment and for some weeks after it’s finished. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.

Eye problems

Pemetrexed may make your eyes feel sore, red and itchy (conjunctivitis). Your doctor will prescribe eye drops to prevent this. It’s important to use these as instructed.

Hearing changes

Cisplatin can affect your hearing. You may have a hearing test before you start treatment. During treatment you may get ringing in your ears (tinnitus) and lose the ability to hear some high pitched sounds. Tinnitus usually gets better after treatment ends. Some hearing changes can be permanent. Tell your doctor if you notice any changes in your hearing.

Hair loss

Your hair will thin. Very rarely people lose all the hair from their head. Hair loss usually starts after your first or second cycle of chemotherapy. It is almost always temporary and your hair will grow back after chemotherapy ends. It is important to cover your head to protect your scalp when you are out in the sun. Your nurse can give you advice about coping with hair loss.

Although they may seem hard to bear at the time, most of the side effects are temporary and will disappear once your treatment is over.

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Possible effects on fertility

Chemotherapy can affect your fertility. If this is a concern for you, it’s very important to discuss it with your doctor before treatment.