Treatments to Relieve Fever in Patients with Cancer
Key Points for This Section
- Treatment for fever depends on the cause, stage of the disease, and goals of care.
- Fever caused by infection may be treated with antibiotics.
- Fever caused by tumors may be treated with antitumor therapy or drug therapy.
- Fever related to drugs may be treated in different ways.
- Fever related to a transfusion may be prevented.
- Supportive care measures help relieve the discomfort of fever.
- NSAIDs or acetaminophen may be used to relieve fever in some patients.
The symptoms of fever in very weak cancer patients include fatigue, muscle pain, sweating, and chills. Fever may be controlled by treating the cause of the fever. Intravenous (IV) fluids and nutrition support or other measures can also help make the patient more comfortable. The specific treatments depend on the stage of cancer and the kind of care the patient wants. For example, some patients who are near the end of life may decide not to be treated for the cause of the fever, such as pneumonia or other infections. Instead, they may want to receive general comfort care.
Antibiotics may be used to treat fever caused by bacterial infection. Antibiotic therapy may be given by IV in the hospital or at home, or may be given by mouth. Drugs to treat fungal infections or viral infections may be added if needed.
Fever caused by tumors is called paraneoplastic fever. This fever may occur when substances released by cancer cells affect the way nearby cells and tissue work. Fever caused by tumors may come in a pattern at certain times of day, or on and off for days or weeks. This fever is usually treated with standard treatment for the specific type of cancer. If the treatment doesn't work, takes time to work, or is not available, nonsteroidal anti-inflammatory drugs (NSAIDs) may be used.
Sometimes fever may be caused by a reaction to drugs given to treat the cancer or prevent infection. Drugs that are known to cause fever include some types of chemotherapy, biological response modifiers, and antibiotics. There may be a period of time between when drug therapy starts and when fever begins. This can make it hard to find out what is causing the fever.
The doctor may control the fever by changing how and when the drug causing it is given. Acetaminophen, NSAIDs, and steroids may also be given before the patient receives the drug that causes the fever.
Cancer patients may have a fever caused by a reaction to blood products (for example, receiving a blood transfusion). Acetaminophen or antihistamines are sometimes given before a transfusion, to help prevent fever.
Along with treatment of the cause of fever, comfort measures may also help relieve the discomfort that goes along with fever, chills, and sweats.
The following may help relieve fever:
- Give plenty of liquids.
- Remove extra clothing and covers.
- Bathe or sponge the patient with lukewarm water.
The following may help relieve chills and sweats related to fever:
- Replace wet blankets with warm, dry blankets.
- Keep the patient away from drafts.
- Keep the patient's room warm.
Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen may also be prescribed to relieve symptoms. Aspirin may help lower fever, but should be used with caution in patients with Hodgkin lymphoma and cancer patients who have an increased risk of thrombocytopenia (low blood platelets). Aspirin is not recommended in children with fever because of the risk of Reye syndrome.