- fever is commonly defined as an elevation in body temperature
above 98.6 degrees
- there are many causes of fever in the cancer patient,
- medications and some treatments (Bleomycin, biologic response
- for those cancer patients undergoing active treatment,
especially chemotherapy, a fever greater than 100.5 degrees is
considered a medical emergency, requiring prompt initiation of
- fever is not usually dangerous in those patients not on active
treatment, however, some will require treatment for infection
- for patients in active treatment, temperature should be checked
when the patient feels warm, feverish, has rigors or "just feels bad"
- all patients on active treatment should have a thermometer in
the home and be able to interpret it
- it is not necessary to check the temperature daily, only if
- elderly patients may not register an increased temperature with
infection, other signs and symptoms of infection in these patients
may include change in mental status, lethargy, malaise, subnormal
- seizure activity rarely occurs in adults due to high
- if the patient is in active treatment, determine the most
recent treatment date to assess if he/she is at risk for neutropenia
- usually occurs 7 to 10 days after chemotherapy has been given
- encourage the patient and care giver to keep records of
treatment dates and labs for the home care nurses
For patients in active treatment:
- call MD for any temperature over 100.5 degrees, may need
immediate antibiotic treatment if neutropenic
- considered a medical emergency
- hold antipyretics until cultures are obtained
- once cultures are obtained, acetaminophen or NSAIDs may be
administered as needed for comfort
- steroids, NSAIDs, some analgesics may mask fever in infection
- call MD for change in mental status in elderly patients who may
not develop a fever in response to an infection
For patients not in active treatment:
- comfort measures are the focus of fever management
- antipyretics (acetaminophen, NSAIDs) for discomfort
- tepid baths or sponge baths may help bring fever down
- meperidine can be given for severe rigors
- increase fluids if not contraindicated
- not considered a medical emergency but MD may choose to treat
uncomplicated infections with antibiotics
- NSAIDs (e.g.. Naprosyn) may be helpful in tumor fevers
Haeuber, D. and Spross, J (1994). "Protective Mechanisms: Bone
Marrow" in Gross, J. and Johnson, BL (eds) Handbook of Oncology
Nursing, 2nd ed., Boston: Jones and Bartlett, p. 373-399.
Ellerhorst-Ryan, JM (1997). "Infection" in Groenwald, SL, Frogge,
MH, Goodman, M, Yarbro, CH, Cancer Nursing: Principles and Practice,
4th ed Boston: Jones and Bartlett, p. 585-603.
Early Palliative Care in Lung CA Focuses on Coping, Symptoms
Jan 31, 2013 - Early palliative care clinic visits, integrated with standard oncologic care for patients with metastatic lung cancer, emphasize symptom management, coping, and psychosocial aspects of illness, according to research published online Jan. 28 in JAMA Internal Medicine.
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