Medical Oncologist
Infection prevention
Hand hygiene: the single most important thing
Because hands are how most infections actually travel — a hand touching something and then touching food, a face, or a patient. It is the cheapest thing you can do and the one with the largest effect, and it applies to the whole household rather than only the person being treated. Whoever cooks and whoever helps with personal care matter most of all.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
Why does handwashing matter more than anything else?
Because hands are how most infections actually travel. Not through the air, not from surfaces in general, but from a hand touching something and then touching food, a face, or a patient. It is the cheapest thing you can do and the one with the largest effect.
It also applies to the whole household rather than only to the person being treated. The patient's own hands matter, but so do the hands of whoever cooks, whoever helps them wash, and whoever has just come in from outside.
Soap and water, most of the time
Plain soap and running water for a decent length of time is the standard. Hand sanitiser is a good substitute when you are out or cannot reach a basin, but it does not replace soap when hands are visibly dirty or after using the toilet.
Keep soap and a clean towel by every basin and by the front door. Access changes behaviour far more than instruction does.When
The moments that actually matter
- Before preparing or serving any food, every time
- Before eating, including snacks eaten standing in the kitchen
- After using the toilet, and after helping someone else use one
- On coming into the house from outside, before anything else
- Before touching the patient's mouth, port, line or any wound
- After handling urine, vomit, motions or soiled laundry
- After touching pets, litter trays or anything from the garden
- After coughing, sneezing or blowing your nose
- After handling rubbish, shoes, money or shopping bags
Not sure whether this applies to you?
Ask an oncologistHow
Washing hands properly, which most people do not
The technique matters more than people assume. A rushed rinse leaves exactly the places that carry most.
Wet first, then soap
Running water, warm or cold — the temperature makes little difference. Soap onto wet hands lathers properly; soap onto dry hands mostly gets rinsed away.
Rub for long enough
Long enough to sing something short through twice in your head. The time is what lets the soap work, and almost everybody stops too soon.
Cover the places that get missed
Between the fingers, the backs of the hands, the thumbs, the fingertips and under the nails. Fingertips and thumbs are the parts that touch most and the parts most often skipped.
Rinse thoroughly
Under running water rather than in a filled basin. If the tap is a handle type, turn it off with your wrist or with the towel rather than the hand you have just washed.
Dry properly
On a clean towel, and dry rather than damp. Wet hands pick things up far more readily than dry ones, and a shared damp towel undoes much of the work.
!
Handwashing does not replace this
A fever during chemotherapy is an emergency, however careful the household has been. Go to the nearest emergency department the same day and say clearly that the person is on chemotherapy. Do not give paracetamol first. The same applies to shivering uncontrollably, breathlessness, confusion, or redness, pain or discharge around a port or line. Infections get through despite good hygiene, and that is not anyone's failure.
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Making it stick
Getting a whole household to actually do it
Knowing the rule is not the problem. Doing it forty times a day, for months, is.
Put soap everywhere
Every basin, the kitchen sink, and by the front door with a small towel. People wash when it is easy and skip it when it means walking to another room.
Also worth having
- Sanitiser in every bag and by the bed
- A separate towel for the patient
Individual towels, changed often
One shared damp towel is a route rather than a precaution. Give the patient their own, change towels frequently, and let them dry properly between uses.
Paper towels or tissue for the patient are a reasonable alternative during the low-count days.Tell visitors at the door
"Come in, wash your hands first" said cheerfully as they arrive works. Asking later does not. Soap and a towel visible at the entrance makes the request obvious rather than pointed.
Look after the skin
Frequent washing cracks hands, and cracked skin is itself a route for infection. Use a plain moisturiser, particularly on the patient's hands, and mention any broken or sore skin to the team.
Keep nails short and clean
For the patient and for whoever helps them. Long nails hold considerably more, and during treatment nails can become brittle or lift — report any nail that is separating or sore.
Sanitiser for outside
Carry it to appointments, on transport and to any crowded place. Use it after touching handles, rails and money, and wash properly with soap when you get home.
Being straight with you
What this page cannot tell you
It cannot tell you how strict your household needs to be overall. How low the counts go, which treatment is being given and whether there is a port or line all change the picture, and your team can tell you whether they want extra measures during particular windows.
It also cannot promise that good hand hygiene prevents infection. Many infections during chemotherapy come from bacteria already living in the person's own mouth or gut rather than from anything anyone touched. Hands are the biggest lever available to you, not a shield.
What it should not be used for
Do not let careful hygiene become a reason to delay acting on a fever, and do not let it become a source of blame when an infection happens anyway. Households sometimes turn hygiene into an argument about who brought something in, and that helps nobody.
What to do next
Put soap and a clean towel at every basin and by the front door today. Give the patient their own towel. Ask every visitor to wash on arrival. Keep sanitiser in the bag for appointments. And make sure the fever plan is on the fridge, because that matters more than any of this.
Questions we are asked
Common questions about hand hygiene
Is sanitiser as good as soap and water?
It is a good substitute when you are out or cannot reach a basin, and worth carrying. It is not as good when hands are visibly dirty, after the toilet, or after handling body fluids — soap and running water are better in all of those. Use whichever is available rather than neither.
Do we need antibacterial soap?
No. Plain soap used properly for long enough works perfectly well, and it is gentler on skin that is already dry from treatment. Technique and frequency matter far more than which soap is on the basin.
How long should washing take?
Long enough to sing something short through twice in your head, rubbing throughout. Almost everyone stops well before that. Cover between the fingers, the thumbs, the fingertips and under the nails — those are the parts most often missed and the parts that touch most.
My hands are cracking from washing so often. What do I do?
Use a plain moisturiser regularly, dry hands properly rather than leaving them damp, and use lukewarm rather than hot water. Do not stop washing. Cracked skin is itself a route for infection, so tell the team if it is getting sore or breaking open.
Does the patient need to wash more than everyone else?
They should wash at the usual moments, but the bigger gain is everyone else doing it. The household brings things in from outside; the patient mostly does not. Whoever cooks and whoever helps with personal care matter most of all.
Should we use gloves at home?
For handling urine, vomit, motions and soiled laundry during the precaution period after each cycle, yes. For ordinary contact, no — gloves worn all day give false reassurance and get touched everywhere. Handwashing is the more reliable habit.
What about shared towels?
Give the patient their own, change towels frequently, and let them dry fully between uses. A shared damp towel undoes much of the washing that preceded it, and it is one of the easier household fixes to make.
We were careful and an infection happened anyway. Why?
Because many infections during chemotherapy come from bacteria already living in the person's own mouth, gut or skin, not from anything anyone touched. Hand hygiene lowers the risk substantially; it cannot remove it. It is not a failure, and blame helps nobody.
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Dr. C. Raghavendra Reddy
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Sources
- World Health Organization — Hand hygiene
- Cancer Research UK — Infections and cancer treatment
- Macmillan Cancer Support — Infection and cancer treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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