For normal people, fever is just a sign of cold, but for tumor patients, fever is not only common, but also may be a sign of disease progression or even turnaround! So what should tumor patients do if they have fever and their body temperature has increased?
Causes of fever in tumor patients.
1. Common infection. The most common causes of fever in tumor patients are infections by bacteria, viruses and mycobacteria. Tumor patients with low immunity are prone to infectious diseases, most commonly respiratory tract infections, followed by urinary tract infections (especially common in post-operative gynecological tumor patients).
2. Drug fever. Tumor patients often use some special drugs, such as bleomycin, cisplatin, interferon, interleukin, zoledronic acid, etc. These drugs have fever as a common side effect; there are also thermogenic reactions related to blood transfusion and blood products that can lead to fever, such as albumin transfusion, blood transfusion, etc.
3.Central fever after brain metastasis. When the cancer metastasizes to the thermoregulatory center of the inferior optic thalamus, this kind of fever is rare and can be confirmed by brain CT or MRI.
4.Fever after radiotherapy. It is mainly caused by radiation pneumonia. Patients with esophageal cancer, lung cancer and mediastinal tumor may undergo radiotherapy, and the dose and accumulation of radiation may cause radiation lung injury, which may lead to radiation pneumonia, and can be diagnosed based on medical history, physical examination and chest X-ray.
5. Post-chemotherapy fever. It is estimated that more than 90% of patients will experience a decrease in white blood cells after chemotherapy. About 70% of the fever in patients with decreased white blood cells is caused by infection.
6.Hormonal fever. Due to brain tumor or some special cancers need high dose and long course of corticosteroids. Adrenal crisis caused by hormone application is generally rare.
7.Tumor fever. When the above causes are excluded and no infectious cause is found, the possibility of tumor fever must be considered. Tumor fever is common in the progressive stage of tumor, patients with extensive tumor necrosis or obvious tumor cell destruction will have tumor fever, limited inflammation in malignant tumor tissue, excessive heat production by tumor cells, etc.
What are the characteristics of different causes of fever temperature?
1. Generally speaking, the fever related to blood transfusion or medication lasts for a short time, and the fever often subsides on its own within 24 hours after treatment.
2.The general characteristics of fever caused by brain metastasis: sudden high fever, body temperature can rise linearly, reaching 40-41℃, continuous high fever, although high fever but no facial flushing and other manifestations, instead, dry skin and cold extremities can be seen. The effect of antibiotics and antipyretics is not good when high fever is present.
3, infectious fever: fever temperature can be high or low, and there are many accompanying symptoms, such as coughing and coughing, urinary frequency and urgency, etc.
4, tumor fever: ① at least once a day, the body temperature > 37,5 ℃, and most of them do not exceed 38,5 ℃, ② fever more than 2 weeks; ③ various laboratory tests without evidence of infection, ④ no allergy; ⑤ fever does not subside after 7 days of treatment with empirical and appropriate antibiotics; ⑥ fever can be rapidly and completely subside after naproxen.
5. Fever after radiotherapy and chemotherapy: the significant feature is that all of them have a history of recent treatment. After radiotherapy and chemotherapy, it is easy to cause the body’s immunity to drop sharply, and it is easy to combine with infection, and radiotherapy also has radiation tissue damage and stress inflammation.
How to deal with the fever of tumor patients? Can we take antipyretic drugs by ourselves?
1. Drug fever: Generally, no special treatment is needed, and the fever will subside on its own within 24 hours after stopping the drug. The general treatment method is to drink more water and stop the suspicious drugs, and you can also take some conventional antipyretic drugs.
2, fever after radiotherapy, chemotherapy, most of the combined infection, and often the infection is more complex. It is reported that about 40% of patients with infections have bacteremia; 35% of fever is caused by bacteria but no bacteremia; and 15% is caused by mycobacterial or other fungal infections. Therefore, patients with fever in this category should seek prompt medical attention.
3.Tumor fever, almost always intermittent, can last for several months. Various antipyretic drugs such as aspirin and paracetamol have no significant antipyretic effect on tumor fever, while non-steroidal anti-inflammatory drugs such as anti-inflammatory pain and naproxen are effective for tumor fever.
4.Oncology patients have common “headache and brain fever”, which is commonly known as cold or upper respiratory tract infection, generally do not worry, rest more, drink more water, or make some anti-cold medicine can pass.
What should tumor patients be alert to when they have fever? When is it necessary to go to hospital for treatment?
1. Leukopenia infection. Those who have received radiotherapy, chemotherapy or molecular targeted drug treatment within the recent month and have declining white blood cells, such as persistent high fever, should be alert to granulocytopenic infection, which has a vicious prognosis and may die due to infectious shock if they do not receive timely and effective treatment and proper care.
2. Catheter-associated infections. Patients with various catheters (internal jugular vein, subclavian vein, PICC, urinary catheter, abdominal ascites drainage tube, thoracic chest drainage tube, bile drainage tube, gastric tube) should think of possible “tube infection” if they have persistent high fever that does not subside. Catheter-associated infections are serious and can lead to bacteremia or even sepsis if not treated properly. In this case, you should go to the hospital to remove the tube and take symptomatic treatment.
3.Tumor patients with persistent high fever, chest pain, severe diarrhea, unilateral limb edema, and impaired consciousness should be sent to hospital for treatment in time. Pulmonary infarction, pseudomembranous enterocolitis, deep vein thrombosis, intracranial metastatic tumor, etc. should be alerted to the combined pulmonary infarction, pseudomembranous enterocolitis, deep vein thrombosis, and intracranial metastatic tumor.