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Guide for patients and loved ones

Side-effect diary

Recording side effects helps your doctor manage them better.

Last updated: ~1 min read
A symptom diary
Figure 1.A symptom diary — Side-effect diary

01Short answer

In a side-effect diary, make a short note every day: temperature, nausea and vomiting, diarrhoea or constipation, mouth sores, pain, tiredness, sleep, appetite, skin changes, bruising and mood. Rate each symptom on a simple scale (for example mild, moderate, severe) and note when it started and what helped. Bring it to appointments. For urgent signs (fever, bleeding, breathlessness) call without waiting.

02Simple explanation

A diary carries your body’s voice to the doctor.

Short, but every day.

03Scientific explanation

In clinical practice side-effect severity is graded with standard scales such as CTCAE; patient records make this grading more accurate.

Regular recording of patient-reported outcomes improved quality of life in some studies.

04What happens in the body?

What to record

Temperature, gut symptoms, mouth, skin, pain, tiredness, sleep, appetite, mood and new medicines.

How

A few minutes at the same time each day. A simple scale: 0 none, 1 mild, 2 moderate, 3 severe. What helped?

A severity scale
Figure 2.A severity scale — Side-effect diary

When to call

Fever, chills, bleeding, breathlessness, vomiting or diarrhoea that will not stop, confusion: do not wait.

A note at night
Figure 3.A note at night — Side-effect diary

05Keeping the diary

Four steps.

Note the symptom — What you feel.1Note the symptomWhat you feel.
Rate the severity — A simple scale.2Rate the severityA simple scale.
Note the time — When and how long.3Note the timeWhen and how long.
Bring it to visits — Discuss with the doctor.4Bring it to visitsDiscuss with the doctor.
Better managementThe doctor gets precise information.
A sense of controlYou can see changes.

06Key points at a glance

TopicIn brief
What to recordTemperature, gut symptoms, mouth, skin, pain, tiredness, sleep, appetite, mood and new medicines.
HowA few minutes at the same time each day. A simple scale: 0 none, 1 mild, 2 moderate, 3 severe. What helped?
When to callFever, chills, bleeding, breathlessness, vomiting or diarrhoea that will not stop, confusion: do not wait.

07Key terms

CTCAE
A standard scale for grading side effects.
Mucositis
Inflammation of the lining of the mouth and gut.
Patient report
Symptoms recorded by the patient.

08Key points

  • Make a short note daily.
  • Rate the severity.
  • Bring it to visits.
  • Call at once for urgent signs.

09Frequently asked questions

Should I write even with no symptoms?

Yes, a “good day” note is useful too.

Paper or app?

Whatever suits you; regularity matters most.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Should I write even with no symptoms?

  2. Paper or app?

My questions

12Sources

  1. National Cancer Institute (NCI). Side Effects of Cancer Treatment
  2. National Cancer Institute (NCI). Chemotherapy to Treat Cancer
  3. NHS. Chemotherapy
  4. National Cancer Institute (NCI). Managing Your Care
  5. Cancer Research UK. Coping with cancer
  6. American Cancer Society. Neutropenia (Low White Blood Cell Counts)
  7. National Cancer Institute (NCI). Nutrition in Cancer Care (PDQ®) – Patient Version
  8. MedlinePlus (U.S. National Library of Medicine). How to Understand Your Lab Results
  9. World Health Organization (WHO). Sepsis — fact sheet
  10. National Cancer Institute (NCI). When Your Parent Has Cancer: A Guide for Teens
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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