Cancer Treatment Side Effects: A Home Care Guide for Patients and Families

When someone in the family is diagnosed with cancer, the first thoughts are about the diagnosis and the treatment plan. Soon, though, new questions arrive: how do we manage the nausea after chemotherapy, what do we do about a sore mouth, can she eat normally, what if there is a fever at night, and which of the medicines in the house are safe? The oncology team decides the treatment, but a great deal of day-to-day care happens at home.

This guide is a practical home care companion for people having cancer treatment and their families. It does not replace your oncologist. It explains side effect care, safety rules, how hormone tablets such as letrozole and tamoxifen are used, and the warning signs that need an urgent call to the hospital.

Rule number one: talk to your oncology team

• Keep their phone number, and the hospital’s emergency number, written down at home.
• Ask what side effects to expect, and which are emergencies.
• Tell them about every medicine, vitamin and herbal remedy. Some supplements and herbs interfere with cancer drugs.
• Do not stop, delay or skip treatment on your own, even if you feel better or worse.
• Be wary of anyone who promises a cure with herbs, special diets, injections or spiritual remedies. Delaying proven treatment can cost lives.

Fever during treatment: an emergency

Chemotherapy can lower the white blood cells that fight infection. A temperature of 38 degrees Celsius or higher, shivering, or feeling suddenly unwell during chemotherapy needs a call to the oncology team, or a trip to the hospital straight away, even at night. Do not wait until morning, and do not take paracetamol first to lower it and then wait. Keep a reliable thermometer at home, such as a Digital Thermometer Life Care or a Rossmax Thermometer. See our guide to the best digital thermometer in Pakistan.

Nausea and vomiting

These are among the most feared side effects, but they can usually be controlled with the right medicines.

• Take the anti-sickness medicines that the team prescribes, on schedule, and not only when you feel sick. These include ondansetron (Xonica 8 mg) and granisetron, and sometimes others.
• Eat small, frequent meals, and avoid very sweet, greasy, spicy or strong-smelling foods. Cold or room-temperature foods smell less.
• Sip fluids through the day. ORS helps if vomiting is frequent. See our guide to nausea and vomiting.
• Ginger tea may help some people.
• Call the team if you cannot keep fluids down for more than 24 hours, or you see signs of dehydration.

Mouth sores and dry mouth

• Brush gently with a very soft toothbrush after meals and at bedtime.
• Rinse with a bland rinse as the team advises, often lukewarm salt water. Your doctor may suggest a medicated rinse, for example Niflam Mouth Wash, which is used for sore mouth after radiotherapy and dental procedures. Avoid alcohol-based mouthwashes.
• Choose soft, moist, cool foods such as yoghurt, khichdi, dalia, custard and mashed fruit. Avoid hot, spicy, salty, acidic or crunchy foods.
• Sip water often, and use lip balm.
• Tell the team about painful sores, white patches (thrush) or trouble swallowing.

Read our guide to mouth ulcers for more on mouth care.

Eating and weight

• Eat what you can, when you can. Many people eat better early in the day.
• Choose calorie- and protein-rich foods: eggs, milk, yoghurt, paneer, chicken, fish, daal, nuts, and add ghee or oil to food.
• Drink nourishing fluids such as milkshakes, lassi, soup and fruit juice.
• Do not follow extreme diets, or avoid whole food groups, without a dietitian’s advice.
• If food tastes metallic, try plastic cutlery, lemon or mint, and cold food.
• Ask the team about a dietitian, and about nutritional supplements.

Tiredness

Fatigue is very common. Rest when needed, but try to stay lightly active with short walks. Accept help with chores. If fatigue is severe, ask the team to check for anaemia. See our guide to iron deficiency and anaemia, but do not start iron or other supplements without the oncologist’s approval.

Infection safety at home

• Wash hands often with soap and water, and ask visitors to do the same. See our guide to hand sanitiser vs soap, and keep a sanitiser such as Dettol Hand Sanitizer for outings.
• Avoid people who are unwell, and crowded places during the lowest counts. Wear a mask in public.
• Cook food thoroughly, wash fruit and vegetables, drink safe water, and avoid raw or street food.
• Take care of the skin and mouth, and clean small cuts straight away.
• Do not receive live vaccines without your oncologist’s advice.

Skin and hair

• Moisturise often with a gentle, fragrance-free product. See our winter dry skin care guide.
• Use sunscreen and cover up. Skin is more sensitive to sun during treatment. Read our sunscreen guide.
• Hair loss often starts two to three weeks after chemotherapy begins. Use a soft brush, and mild shampoo. Hair usually grows back after treatment ends.
• Follow the team’s advice on radiation skin care, and do not apply creams to the treated area unless approved.

Hormone therapy tablets for breast cancer

Many women with hormone-sensitive breast cancer take a daily tablet for years after surgery, chemotherapy or radiotherapy to lower the chance of the cancer returning.

• Tamoxifen is used before and after menopause. It can cause hot flushes, vaginal changes, and rarely blood clots and womb problems. Report unusual vaginal bleeding, leg swelling or chest pain.
• Aromatase inhibitors such as letrozole (for example Selet, Retzole and Hitase) and anastrozole are used after menopause. They can cause joint and muscle aches, hot flushes, dryness and bone thinning. Your doctor may arrange bone density tests and advise calcium and vitamin D. See our guides to calcium deficiency and vitamin D deficiency.
• Take them every day, without gaps, for the full period your oncologist recommends, often five to ten years. Missing doses can lower their benefit.
• Do not stop if you feel side effects. Ask your doctor, because there are often ways to help, or other options.

See our cancer care category. These are prescription medicines. If you have a prescription, upload it here.

Emotional health

• Fear, sadness, anger and exhaustion are normal. Talk to someone, whether family, a friend, a counsellor, a religious leader or a support group.
• If low mood or anxiety does not lift, tell your doctor. See our guide to depression and anxiety medicines.
• Sleep problems are common. Read about insomnia.
• Families need support as well. Share caring tasks, and take breaks.

Call the oncology team or go to hospital if:

• Fever of 38 degrees Celsius or more, or shivering.
• Uncontrolled vomiting or diarrhoea, or you cannot drink.
• Bleeding, unusual bruising, or black stools.
• Breathlessness, chest pain or a swollen, painful leg.
• Severe pain that medicines do not control.
• Severe mouth sores that prevent eating or drinking.
• Confusion, severe drowsiness or fainting.
• A red, hot or swollen area around a central line or port.

Frequently asked questions

Can I take herbal remedies during chemotherapy?

Only with the approval of your oncologist. Some herbs and supplements can change how cancer drugs work or harm the liver.

Is it safe to take painkillers like ibuprofen?

Not without checking. NSAIDs can raise the bleeding risk when platelets are low, and can harm the kidneys. Ask the team which pain relief is safe.

Can I exercise during treatment?

Gentle activity such as walking is generally helpful, as long as the team agrees and you listen to your body.

How can I support a family member with cancer?

Listen, help with practical tasks, go to appointments, and keep treating them as the person they are, not only as a patient.

Find thermometers, masks, hygiene and care essentials, and order prescribed medicines from Khasmart, with delivery across Pakistan.

This article is for general information and is not a substitute for advice from your oncologist or doctor. It does not include doses; your doctor decides the medicine and amount. In an emergency, call the hospital or go to the nearest emergency department.