Straight Talk about Mesothelioma, a blog series created by Michael T. Milano, M.D., Ph.D., a radiation oncology specialist, as a resource for mesothelioma patients and their loved ones.

Chemotherapy is a common treatment for mesothelioma, and it is an unfortunate reality that it often creates side effects.  Chemotherapy drugs work by targeting cells that divide quickly,
as cancer cells do. But other cells in the body — such as those in the lining of the mouth and in the intestines — also divide quickly, and these healthy cells are also adversely affected by the chemotherapy. This is what can lead to side effects.

The side effects can vary and they depend upon many factors, including the type of drugs given, the dosage, and the duration of the treatment. Some of the most common side effects are:

  1. Diarrhea
  2. Fatigue (from too few red blood cells)
  3. Hair loss
  4. Mouth sores
  5. Muddled thinking and difficulty remembering
  6. Nausea and vomiting
  7. Shortness of breath

Not all patients will have all these side effects, and fortunately it is possible to ease the symptoms. Here are a few tips for staying ahead of some of the most common problems.


Many drugs can cause diarrhea, including those drugs used in chemotherapy. Diarrhea can quickly lead to dehydration. To avoid it, take these precautions:

  • Increase your fluid intake.
  • Avoid milk and milk products.
  • Avoid dried fruit, fiber cereals, seeds, popcorn, nuts, corn, beans.
  • Eat low-fiber foods, such as bananas, rice, applesauce, and toast.


Red blood cells carry oxygen throughout your body. Blood loss, chemotherapy, radiation, and stem cell transplants, and even the cancer itself can result in a lowered red blood cell count, which in turn will make you feel tired. Anemia is the medical term for a low red blood cell count. To counteract the effects of anemia, first try the following tips. If they are not effective, your doctor may suggest medication to boost your red blood cell count, or red-blood-cell transfusions.

  • Rest whenever you are tired, though try to avoid long naps during the day so as not to interfere with your sleep at night.
  • Add gentle exercise to your daily routine.
  • Drink plenty of water. If you allow yourself to become dehydrated, it will add to
    your fatigue.
  • Eat well, as poor nutrition can cause fatigue.

Hair Loss (alopecia)

Chemotherapy can cause hair loss, but it is rarely permanent. Your hair will likely grow back after treatment. Until it does, get fitted for a wig that matches your hair color, or purchase hats and scarves. If you choose not to use a head covering, be sure to protect your scalp with sunscreen whenever you’re outdoors.

Mouth Sores

Chemotherapy can cause mouth sores, which in turn can make eating an unpleasant experience. To prevent getting sores in your mouth:

  • Brush your teeth after every meal and floss daily.
  • Use lip balm to keep your mouth and lips moist.
  • Suck on sugar-free candies or chew gum to keep your mouth moist.

If you do get sores, avoid these products that are likely to cause further irritation:

  • Alcohol and mouthwashes
  • Hot or spicy foods
  • Tobacco products

Should the pain continue, your doctor can suggest topical mouth medications.

Muddled thinking and difficulty remembering

Problems with concentration and memory are not uncommon. Patients refer to this as “chemo brain.” If you find yourself having trouble remembering simple things, such as names or directions, let your medical team know. In the meantime, you may want to rely more heavily on writing down important information, and using organizational tools such as making lists and setting alarms.

Nausea or Vomiting

There are different types of nausea related to chemotherapy or radiation treatment. Some patients have severe nausea while others experience little to none. There are medications to ease the nausea and vomiting, and additional steps you can take to control it, specifically:

  • Try eating foods and drinking beverages that eased symptoms when you had the flu. These types of food include bland foods, sour candy, pickles, dry crackers, ginger ale or other type of soda, served flat.
  • Avoid fatty, fried, spicy, or very sweet foods.
  • Eat foods that are cold or at room temperature. The smells from hot foods may increase your nausea.
  • Acupressure wristbands are effective with some patients.

Shortness of Breath

Fluid buildup in your chest or abdomen may cause feelings of not being able to catch your breath. Your doctor may recommend oxygen therapy, or a procedure to drain the fluid and relieve the pressure.

Next article in this series: “What are the Options if Traditional Treatment is Not Effective?”