Hunter Cancer Centre
Part of Ramsay Health Care

Monitoring your side effects at home using the grading tool

The table is a colour coded grading tool. It is designed to you monitor your side effects and alert you if there is a need to contact your doctor.

Green Zone: Keep up the management of your care.
Yellow Zone: redo the check later in the day. if you are still yellow you are okay. Keep up the management of your care. let your doctor know how you felt at your next appointment.
Orange Zone: call your doctor for advice. Keep up the management of your care and undertake any additional precautions that your doctor indicates. you may need to visit the clinic or come into the emergency centre*.
Red Zone: call your doctor immediately. if your doctor is unreachable, come to the emergency centre*. in most circumstances your doctor will tell you to come to emergency if you are in the red zone.


  grade 0 grade 1 grade 2 grade 3 grade 4
Fever Temperature is 36 to 37.5   Temperature of 37.5 to 37.9
and/or Shivering or Shaking or feeling unwell
Temperature of 38 degrees or
greater. Shivering and shaking and feeling unwell
Continuous fever
Bleeding None Explained bruise
E.g. Aware of how you got the bruise
Unexplained bruises, bleeding from gums, urine, faeces, spontaneous nosebleeds Bleeding that continues for more than 10
Continuous bleeding
Vomiting None Once in 24 hours 2–5 episodes in 24 hours More than 5 episodes in 24
Nausea None Loss of appetite, but able to eat Eating less, but no weight loss or dehydration Nibbling at food, small sips of
Unable to eat or drink
Breathlessness None Slightly breathless on exertion, can walk a flight of stairs Slightly breathless on exertion, cannot walk a flight of stairs Breathless during showering and
Breathless when at rest
Cough None Dry cough A cough that produces sputum
A persistant dry cough
A persistent cough that produces sputum that is green.
Interfere with sleep and daily living
Urine None Change in colour Double the usual
amount you
would normally urinate
Blood noted in urine. Stinging, burning and a another increase in urinating
Smelly urine, changes in urine colour. Difficulty in urinating
Urinating every hour
Unable to urinate
Diarrhoea None More than normal, but less than 4 stools a day 4–6 stools a day, but able to continue daily activities Over 6 stools a day, interfering
with daily activities
Constipation None Occasional, though controlled with laxatives Continued despite laxative / enema use Interfering with daily activities.
No bowel motion
for >2 days
Stomach distended, nausea &/or vomiting, feeling unwell
Diet Normal Mild loss of appetite Eating 50% less not hungry Losing Weight, eating much Unable/not not wanting to eat
Skin None Dry slight itch to skin Very dry with notable rash
or peeling
Itchy Pain or swelling
to any wounds or
drip sites
Skin red and Ulcerated or
painful with bleeding skin, some broken any pus wounds
Swelling pain and area is reddened and raised
Mouth None Mouth sore and tender. Able to eat and drink Difficulty eating and drinking. Mouth is painful Mouths painful, ulcers present and impacting on your daily activities Ulcers and unable to swallow
Headaches None Mild pain, not interfering with daily activities Moderate pain Not Interfering with daily activities Severe pain, not relieved and interfering with daily living Bedridden
Feeling in hands or feet Normal sensation Slightly odd tingling or numbness sensation Numbness and tingling that is continual and affecting normal living activities Severe cramping, pain tingling and loss of feeling Crippling
Pain, cramping or numbness
Mobility Normal Able to perform usual housework or work Difficulty moving while performing housework Difficulty moving while performing basic tasks
Fatigue Normal Able to complete task but needs a rest or nap Able to complete a small task but is exhausted after completion Constant Exhausted Unable to
complete any
Confusion None Some confused episodes, occasional disorientation, occasional difficulties concentrating Occasional confusion,
disorientation, occasional difficulties concentrating. Interferes at the time, but not with attending to self cares
Confused or delirious continually Harmful to self or others reliant upon self
Memory None Slightly absent minded. Does not interfere with functioning Interfering with functioning but not with self caring Forgetting to eat or self care (e.g. showering) Unable to recall most events
Mood Normal Mild changes to mood but not interefering with housework or work Moderate changes starting to infere with housework or work and general hygiene Severe changes to mood that affect all areas including general hygiene and cares Danger to self or others
Behaviour Normal Changed but not adversely affecting patient or family Change adversely affecting patient and family Severe changes Danger to self or others
Eyes None Dry eyes Watery eyes Dry or watery eyes that interfere with function Eye sight Deteriorating eye sight that interferes with daily living Unable to eat or drink
Hearing None Ringing in the ears, but not affecting hearing Hearing loss not requiring hearing aid, not interfering with activities Hearing loss requiring hearing aid, interfering with activities Profound hearing loss