Why May Fever Be a Serious Concern in Cancer Patients?
It may indicate an underlying serious condition.
Reasons why fever may be dangerous in cancer patients:
Neutropenia (critically low neutrophil count, ANC < 1,000 cells/µL):
Cancer or its treatment may drastically lower the WBC count.
White blood cells are responsible for fighting infections in the body.
A drastic fall in WBC count increases the risk of infection manifold.
Rapid progression of the infection:
Due to a weakened immune system, a small infection may turn serious.
It may rapidly progress to sepsis.
Masked symptoms –
The body may not be able to produce an inflammatory response to an infection.
Symptoms like cough, pain, and swelling may not be present.
A mild or moderate fever (≥ 100.4°F / 38.0°C) may be the only warning sign.
Other causes may include:
Neoplastic fever:
Tumor cells may release pyrogens.
These pyrogens elevate the body temperature.
Fever due to drug reactions and immune therapies:
- Immunotherapy: It may cause immune-related side effects, including fever.
- Drug fever –
Fever can be caused by an adverse reaction to certain drugs.
It can also be caused by certain drug interactions.
Drug-induced serotonin syndrome / toxicity:
Sometimes, serotonergic medicines are used together by cancer patients.
It may lead to accumulation of serotonin in the brain.
It may alter temperature regulation in the brain.
How to manage fever in cancer?
Fever in cancer can be an emergency condition in suspected febrile neutropenia patients.
It is not treated the same way as in normal people.
The blood count is evaluated to identify the WBC count.
At the onset of fever, the doctor will immediately start emergency broad-spectrum antibiotics for suspected febrile neutropenia.
Blood and urine cultures are investigated to rule out the cause.
Sometimes, in a critically low WBC count, white blood cell boosters may be given to some patients.
Can cancer patients take fever-reducing medication on their own?
Fever-lowering medicines cannot be taken without asking the doctor because:
- It may mask the symptoms of an underlying warning.
- It may lead to a delay in treatment.
Supportive therapy can be used at home only if the doctor confirms.
It can be done only in low-risk conditions.
It includes:
- Constant hydration
- Keeping the air circulating
- Performing lukewarm sponging
What are the red flag signs of fever that need emergency care?
- Uncontrolled shivering or shaking chills
- Shortness of breath
- Rapid breathing
- Unusual lethargy
- Mental confusion or dizziness
- Decreased urine output or unable to urinate for 8 to 12 hours (oliguria/anuria)
Patients at risk for febrile neutropenia must never wait for symptoms to worsen: seek emergency medical evaluation immediately at the first sign of fever (≥ 100.4°F / 38.0°C) or chills.
They must immediately seek medical help.
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