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Antineoplastic Drug Side Effects

By Matthew Fox, MD ; Updated August 14, 2017

Antineoplastic drugs, also known as chemotherapy agents, are used to treat cancer—the uncontrolled, invasive growth of abnormal cells. Chemotherapy agents treat cancer by inhibiting cell growth. Unfortunately, most agents are not selective for cancer cells only. That is, they affect all cell types, most prominently those with the most prolific growth.

Blood Problems

The bone marrow is responsible for making platelets, red cells and white blood cells. Platelets help stop bleeding. Red blood cells carry oxygen in the blood. White blood cells are part of the immune system's defense against invading organisms and help to repair damaged tissues. The bone marrow is constantly producing new red and white cells to replace old cells. Chemotherapy inhibits this growth, which can cause low platelets, and low red and white cell counts. Low platelets can lead to bleeding; low red cell counts is called anemia, and fatigue is a prominent symptom. Low white cell counts leave a person vulnerable to infection.

GI Side Effects

According to CancerCare, a national nonprofit organization that provides support for those affected by cancer, common gastrointestinal problems include nausea, vomiting, mouth sores, diarrhea and constipation. Medications and changes to the diet can help.

Hair Loss

Hair loss, also known as alopecia, is a common side effect of chemotherapy. Hair loss typically begins two to three weeks after chemotherapy begins. Hair usually grows back two to three months after the end of chemotherapy. It may grow back a slightly different color, straighter or curlier.


Fatigue is very common, and can be due to the cancer itself or the chemotherapy. Other potential contributing factors include anemia, insomnia, depression and other medications, such as pain medications.

Nerve Problems

According to CancerCare, nerve damage from chemotherapy can cause numbness, pain or tingling in the hands and feet. This is known as peripheral neuropathy. In addition to symptoms in the hands and feet, peripheral neuropathy can make it difficult to pick things up and can cause hearing loss or jaw pain, and difficulty walking or balancing. The nerve damage is often temporary.

Sexual and Reproductive Side Effects

Sexual and reproductive side effects in men include difficulty achieving erections or orgasm, and low libido. Men should wear a condom even if their partner is on birth control because some chemotherapy drugs are found in the semen, according to the National Cancer Institute. In women, chemotherapy can cause hot flashes, infections of the bladder or vagina, dryness and itching in the vagina, irregular periods and decreased interest in sex. Whether a man or woman is undergoing chemotherapy, contraceptives should be used, as chemotherapy can cause birth defects.

Skin and Nail Changes

Skin problems include sensitivity to the sun, itchiness, dryness or redness. The nails can become dry, yellow and cracked. Sudden or severe itching, rashes or hives can be a sign of an allergic reaction and requires assessment by a physician or nurse.

Fluid Changes

Chemotherapy-induced fluid changes in the body can lead to swelling. This is called peripheral edema. It can also be caused by cancer and heart conditions. Symptoms associated with swelling that warrant calling a physician include an irregular heart beat, shortness of breath, sudden swelling or weight gain, and decreased urination.

Other urination changes include urinating more often, cloudy urine and color changes. A physician should be notified it these changes are accompanied by a fever, chills, pain or blood.

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