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Lung Cancer Symptoms and Treatment Tracking Journal

Daily Monitoring Sheet for Patients

Oncology

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Last updated: Mar 24, 2025

Patient Information

Name: ___________________ Date: ___________________ Medical Record #: ___________________

Daily Symptom Tracker

Pain Level (0-10)

  • Morning: ____
  • Afternoon: ____
  • Evening: ____
  • Location of pain: ________________

Breathing

  • Shortness of breath (None/Mild/Moderate/Severe): ____
  • Number of pillows needed for sleep: ____
  • Oxygen use today (L/min): ____
  • Hours using oxygen: ____

General Symptoms

  • Fatigue level (0-10): ____
  • Appetite (Poor/Fair/Good): ____
  • Nausea (Yes/No): ____
  • Coughing (None/Mild/Moderate/Severe): ____
  • Coughing up blood (Yes/No): ____

Medication Log

Medication Name Dose Time Taken Side Effects

Treatment Sessions

  • Type of treatment: ________________
  • Session number: ____
  • Side effects experienced: ________________

Questions for Healthcare Team

Notes

Emergency Contact Information

Oncologist: _________________ Phone: _________________ Nurse Navigator: _____________ Phone: _________________

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