When you begin chemotherapy, the hospital usually offers education on hygiene and infection prevention. The information makes sense in the moment, but once you are back home it can be hard to know exactly what to disinfect and how careful to be. This article offers general information on why infection control matters during this period and how to put it into practice in everyday life without overwhelming yourself.
Many chemotherapy drugs attack rapidly dividing cancer cells, but they also affect the normal fast-growing cells in the body — including the white blood cells made in the bone marrow, especially the neutrophils that fight bacteria. The point at which the neutrophil count drops to its lowest after a treatment is often called the "nadir," and it typically occurs somewhere between day 7 and day 14 after the infusion, depending on the regimen. This is when the body's defenses are thinnest and ordinary germs can more easily cause infection.
The goal of infection control is not to create a perfectly sterile environment, but to gradually reduce the most common routes of infection. The simplest and most effective habit is hand washing — with soap for about 30 seconds after going out, after using the bathroom, before meals, and before touching your face or mouth. When soap and water are not available, an alcohol-based hand sanitizer can be used.
It helps to avoid crowded indoor spaces and close contact with anyone who has cold or flu symptoms. If you must be in a busy place, a mask can offer some protection. At home, wipe frequently touched surfaces such as doorknobs, faucets, and phones, and keep your own towel and toothbrush separate from the rest of the household. If you live with a pet, let someone else handle waste cleanup, and always wash your hands afterward.
For food, a good default is to eat cooked meals while they are freshly prepared and still warm. Undercooked meat, fish, and eggs; unwashed raw vegetables or fruit eaten with the skin; and unpasteurized dairy are worth avoiding during this time. Do not leave leftovers at room temperature for long, and use separate cutting boards for raw and cooked items. That said, how strict to be varies by hospital and by each person's condition, so follow the guidance of your own care team or nutrition staff first.
The mouth and skin can also be doorways for bacteria. Brush gently with a soft toothbrush, and if your mouth is sore, follow the method your team recommends rather than using harsh rinses. Keep skin moisturized so it does not crack, and care for any wounds cleanly. Most importantly, remember that infection can still happen no matter how careful you are — and that fever is the key warning sign. If you feel chills or your temperature rises to around 38°C (100.4°F), especially around the nadir, it is safer to contact the hospital for guidance than to simply ride it out with fever reducers.
This article is intended as general information, and the standards you should follow may differ depending on your individual treatment plan and health. Nothing here replaces medical care, so please discuss specific decisions and practices with your own healthcare team.