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Fever, Sweats, and Hot Flashes (PDQ®)

Patient Version
Last Modified: 02/24/2012

Causes of Fever in Patients with Cancer

Key Points for This Section


Fever is a rise in body temperature caused by the body's response to illness.

Normal human body temperature changes during each 24-hour period according to a definite pattern. It is lowest in the morning before dawn and highest in the afternoon. Temperature control actions in the body keep the amount of heat that is made equal to the amount lost. This keeps body temperature normal.

An abnormal rise in body temperature is caused by either a condition called hyperthermia or fever. Hyperthermia is caused by a breakdown in the body's temperature control actions. In fever, the temperature controls in the body are working as they should, but body temperature rises as the body responds to illness.

There are three phases of fever:

  • In the first phase, body temperature rises as blood vessels in the skin narrow. This prevents heat from leaving the body through the skin. The skin becomes cool, the muscles contract and cause shivering or chills, and the body makes more heat. The body continues to make and keep heat until a new, higher temperature is reached.

  • In the second phase, a new, higher temperature has been reached. The amount of heat the body makes and loses is the same. Shivering stops, and the body stays at the new, higher temperature.

  • In the third phase, body temperature falls to normal as blood vessels in the skin open and move blood from inside the body to the skin surface. This helps get rid of extra heat. Sweating occurs and helps to cool the body.

Certain problems are more likely in older people or the very young. In older people, the temperature control centers in the brain may not work the way they should and can lead to hyperthermia. This may cause irregular heartbeat, lack of blood flow to parts of the body, confusion, or heart failure. In children between 6 months and 6 years old, high fever may lead to seizures.

There are many possible causes of fever in patients with cancer.

The main causes of fever in patients with cancer are reactions to:

Other causes of fever in cancer patients include:

Patients with fever need to be checked carefully for signs of infection.

The doctor will ask questions about past medical problems, check all medicines the patient is taking, and do a physical exam to look for the cause of fever. Patients, especially those who have fever and neutropenia (a very low white blood cell count), will have a complete checkup for signs of infection. Some of the areas the doctor will check include:

Patients with neutropenia may not show the usual signs of infection. These patients need to be checked often and should see their doctor if they have a fever.



Glossary Terms

abnormal (ab-NOR-mul)
Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
antibiotic (AN-tee-by-AH-tik)
A drug used to treat infections caused by bacteria and other microorganisms.
artery (AR-tuh-ree)
A blood vessel that carries blood from the heart to tissues and organs in the body.
biological response modifier therapy (BY-oh-LAH-jih-kul reh-SPONTS MAH-dih-FY-er THAYR-uh-pee)
Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological response modifier therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological therapy, biotherapy, BRM therapy, and immunotherapy.
biopsy (BY-op-see)
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
bladder (BLA-der)
The organ that stores urine.
blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
blood clot (blud klot)
A mass of blood that forms when blood platelets, proteins, and cells stick together. When a blood clot is attached to the wall of a blood vessel, it is called a thrombus. When it moves through the bloodstream and blocks the flow of blood in another part of the body, it is called an embolus.
blood transfusion (blud tranz-FYOO-zhun)
A procedure in which a person is given an infusion of whole blood or parts of blood. The blood may be donated by another person, or it may have been taken from the patient earlier and stored until needed. Also called transfusion.
blood vessel (blud VEH-sel)
A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.
bowel (BOW-ul)
The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called intestine.
breast (brest)
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
condition (kun-DIH-shun)
In medicine, a health problem with certain characteristics or symptoms.
confusion (kun-FYOO-zhun)
A mental state in which one is not thinking clearly.
connective tissue (kuh-NEK-tiv TIH-shoo)
Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.
disorder (dis-OR-der)
In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.
donor (DOH-ner)
In medicine, a person who gives blood, cells, tissue, or an organ for use in another person, such as in a blood transfusion or an organ transplant.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
fever (FEE-ver)
An increase in body temperature above normal (98.6 degrees F), usually caused by disease.
graft-versus-host disease (... dih-ZEEZ)
A disease caused when cells from a donated stem cell graft attack the normal tissue of the transplant patient. Symptoms include jaundice, skin rash or blisters, a dry mouth, or dry eyes. Also called GVHD.
groin (groyn)
The area where the thigh meets the abdomen.
gums (gumz)
The tissue of the upper and lower jaws that surrounds the base of the teeth. Also called gingiva.
hemorrhage (HEH-muh-rij)
In medicine, loss of blood from damaged blood vessels. A hemorrhage may be internal or external, and usually involves a lot of bleeding in a short time.
hyperthermia (HY-per-THER-mee-uh)
Abnormally high body temperature. This may be caused as part of treatment, by an infection, or by exposure to heat.
infection (in-FEK-shun)
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
kidney (KID-nee)
One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.
medicine (MEH-dih-sin)
Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.
neuroleptic malignant syndrome (NOOR-oh-LEP-tik muh-LIG-nunt SIN-drome)
A life-threatening condition that may be caused by certain drugs used to treat mental illness, nausea, or vomiting. Symptoms include high fever, sweating, unstable blood pressure, confusion, and stiffness. Also called NMS.
neutropenia (noo-troh-PEE-nee-uh)
A condition in which there is a lower-than-normal number of neutrophils (a type of white blood cell).
physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun)
An exam of the body to check for general signs of disease.
rectum (REK-tum)
The last several inches of the large intestine closest to the anus.
seizure (SEE-zher)
Sudden, uncontrolled body movements and changes in behavior that occur because of abnormal electrical activity in the brain. Symptoms include loss of awareness, changes in emotion, loss of muscle control, and shaking. Seizures may be caused by drugs, high fevers, head injuries, and certain diseases, such as epilepsy.
sinus (SY-nus)
A cavity, space, or channel in the body. Examples include hollow spaces in the bones at the front of the skull, and channels for blood and lymph. Sinuses may also be found in the heart, brain, and other organs.
sputum (SPYOO-tum)
Mucus and other matter brought up from the lungs by coughing.
stomach (STUH-muk)
An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.
stroke (stroke)
In medicine, a loss of blood flow to part of the brain, which damages brain tissue. Strokes are caused by blood clots and broken blood vessels in the brain. Symptoms include dizziness, numbness, weakness on one side of the body, and problems with talking, writing, or understanding language. The risk of stroke is increased by high blood pressure, older age, smoking, diabetes, high cholesterol, heart disease, atherosclerosis (a build-up of fatty material and plaque inside the coronary arteries), and a family history of stroke.
throat (throte)
The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The throat is about 5 inches long, depending on body size. Also called pharynx.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
transplantation (tranz-plan-TAY-shun)
A surgical procedure in which tissue or an organ is transferred from one area of a person’s body to another area, or from one person (the donor) to another person (the recipient).
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
urethra (yoo-REE-thruh)
The tube through which urine leaves the body. It empties urine from the bladder.
urine (YOOR-in)
Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.
vagina (vuh-JY-nuh)
The muscular canal that goes from the uterus to the outside of the body. During birth, the baby passes through the vagina. Also called birth canal.
vancomycin (VAN-koh-MY-sin)
An antibiotic drug used to fight resistant bacterial infections.
vein (vayn)
A blood vessel that carries blood to the heart from tissues and organs in the body.
white blood cell (hwite blud sel)
A type of immune cell. Most white blood cells are made in the bone marrow and are found in the blood and lymph tissue. White blood cells help the body fight infections and other diseases. Granulocytes, monocytes, and lymphocytes are white blood cells. Also called leukocyte and WBC.