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Chills
Chills, shivering or
shaking normally herald an increase in the body's temperature and arrive
before a fever spike. Typically,
chills last no longer than 15 minutes.
They are a common side effect of immunotherapy drugs like
interferon, interleukin-2, and tumor necrosis factor (TNF) but should
lessen after 1 or 2 weeks of treatment.
Fever
A
fever requires medical attention. More than a third of all cancer
patients will experience fever as a result of an infection, the tumor
itself, chemotherapy treatment, a reaction to blood products, or the
development of an autoimmune disease.
Your
doctor will want to determine whether your white blood cell count is
normal or low. A low white
blood cell count is called neutropenia.
Two-thirds of neutropenic patients with a fever have an infection
and the proper diagnosis is crucial and can be life-saving. The origin
of a fever in a patient with normal white blood cell counts may never be
determined.
The
cancer itself may also cause fever. Some cancers associated with
tumor-produced and fever-inducing cytokines are kidney cancer, liver
cancer, Hodgkin’s disease, and non-Hodgkin’s lymphoma.
Many
chemotherapy agents used against cancer can bring on fever and chills.
Here is a list of some of the more widely used chemo drugs.
-
Bacillus
Calmette-Guérin (Pacis, TheraCys, TICE BCG) – Fever
and chills are a common side effect of this medication. Check with
your medical team as soon as possible.
-
Bleomycin
(brand name: Blenoxane)
- Fever and chills is a common side effect of this drug usually
appearing 3 to 6 hours after the dose is administered.
Seek immediate attention.
-
Systemic
Carboplatin
(brand name: Paraplatin) - Fever and chills is a less common
side effect. Check with your doctor as soon as possible if they
develop.
-
Systemic
Carmustine
(brand name: BiCNU) - If you develop fever and chills check with
your medical team immediately. This is a less common side effect.
-
Cisplatin
(brand name: Platinol, Platinol-AQ) - Though a less common side
effect, fever and chills can develop and warrant immediate attention
from your medical team.
-
Chlorambucil
(brand name: Leukeran) – Call your medical team immediately if
you develop a fever and chills.
These can be an indication of an overdose.
-
Dacarbazine
(brand
name: DTIC) -
Painful or difficult urination accompanied by fevers and chills is a
less common side effect of this agent.
You could also develop this condition after treatment ends.
It requires the immediate attention of your medical team.
-
Docetaxel
(brand name: Taxotere) – Painful or difficult urination
or lower back pain accompanied by fevers and chills are less common
side effects of this agent. Either
condition requires the immediate attention of your medical team.
-
Doxorubicin
- systemic (brand names: Andriamycin PFS, Andriamycin RDF, Rubex)
– Fever and chills and painful urination or lower back pain
accompanied by fever and chills are a less common side effect of
doxorubicin. Check with
your medical team as soon as possible if you develop one of these
conditions.
-
Doxorubicin
– liposome (brand name: Doxil) – Fever is a common
side effect in all treatment groups.
It’s a less common side effect for patients being treated
for Karposi’s sarcoma. A sign of overdose may be painful
urination, lower back pain or a cough and hoarseness accompanied by
fever and chills. Check with your doctor as soon as possible.
-
Systemic
Etoposide (brand name: VePesid, Etopophos, Toposar) - Call your
medical team as soon as possible if you develop fever and chills
along with back or side pain, a
cough or hoarseness or difficult or painful urination.
-
5-flourouracil
or 5-FU (Adrucil) – If during or after treatment you
develop difficult or painful urination followed by fever and chills,
call your medical team immediately.
-
Gemcitabine
(brand name: Gemzar) – Call your doctor immediately is you
develop any of the following symptoms followed by fever and chills:
hoarseness or cough; lower back pain; or difficult or painful
urination.
-
Paclitaxel
(brand name: Taxol) – If you develop fever and chills after
developing a cough or hoarseness or back pain or difficult or
painful urination, call your doctor as soon as possible. These are
common side effects of paxlitaxel.
-
Procarbazine
(brand name: Matulane) - If you start sweating and develop a
fever or cold clammy hands.. stop taking this medicine immediately
and call your medical team. If you can’t reach your doctor, go to
a hospital emergency room.
-
Vinblastine
(brand name: Velban) - Fever and chills accompanied by cough or
hoarseness or lower back or side pain or painful urination are
frequent side effects. Check
with your medical team immediately.
-
Vincristine
(brand name: Oncovin, Vincasar PFS, Vincrex) – Check with your
medical team immediately if you develop a cough or hoarseness
accompanied by a fever and chills.
This is a rare side effect.
What
Can Be Done
Chills
As
long as you don't have a chemo-related skin condition that argues
against their use, a heating pad or hot water bottle can help to
minimize chills. Extra
blankets may also help and can be removed as needed when the fever hits.
Your
medical team may prescribe an opiate such as meperidine, morphine or
dilaudid to relieve the symptoms.
Fever
Once
the cause of a fever has been determined or excluded, your doctor can
prescribe medications to deal with it.
Single or combination antibiotics are usually prescribed for
patients with neutropenia. Patients without a low white blood count may be prescribed
anti-inflammatory drugs. In
the case of tumor generated fever, corticosteroids have shown
effectiveness.
SOURCES:
-
National
Guideline Clearinghouse
-
Cancer,
Principals and Practice of Oncology,
Devito, Hellman & Rosenberg, Lippencott Williams & Wilkins,
2001.
This page was last
edited on 06/19/2003
Written
by Rachael Myers Lowe, cancerpage
Reviewed by Maureen
Wilkie, RN, CCM
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