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Tumor fever

Ram2014
Posts: 8
Joined: Jul 2014

hello, my brother was just recently diagnosed about 6 weeks ago with DLBCL NHL.  He was a healthy individual before the diagnosis but since past 6 weeks nothing is going right with him in terms of his health.  He was intially admitted as he had fever which was accompanied by a seizure and since has been diagnosed with NHL.  His fever and heart rate running high since he was admitted but the doctors said it was tumor fever which in turn was increasing his heart rate.  After he diagnosis he received his 1st chemo of R-Chop 4 weeks ago but couple days later his fever and heart rate was still elevated so the oncologist told us to wait few days and we did wait about a week and half but his fever and heart rate was not getting better so we shifted him to another reputed hospital for cancer treatment.  At the other hospital all possibilities that can cause a high fever was ruled out and we were told the fever was likely due to his lymphoma so a week ago it was decided that he should receive a 2nd round of chemo with R-EPOCH regimen to hit the tumoR a little bit more harder than the first time hoping this would bring his fever down.  But it's been 9 days since he received his 2nd chemo and his temperatrue and heart rate initially kept fluctuating so we thought it was a good sign but since past 3 days the temperature is again elevated. 

 

so to wrap up everything I am wondering if anyone else has experienced tumor fever even after chemo treatment (where all possiblites of having an infection was ruled out).  As from what I am hearing from his oncologist is that he is a unique case but I wanted to make sure I reach out to others to see if anyone has experienced the high fever that my brother is experiencing.  

 

I would really appreciate any help I can get in terms of his condition.

Rocquie's picture
Rocquie
Posts: 838
Joined: Mar 2013

Welcome to the group, Ram. I am sorry to hear that your brother is having so much trouble.

Fever is what had me going to the Family Doctor, several times, for about 2 months, until I was finally diagnosed with Lymphoma. I too, was very healthy before. 

No one ever mentioned the term "Tumor Fever" to me but I did have fevers and increased heart rate throughout my treatment. I had chemo with R-CHOP 8 times. I have been in remission for over a year and I am on Rituxan Maintenance.  Lymphoma, indeed all cancers, are very individualistic--symptoms vary from person to person. 

I hope you will trust your brother's doctor to make the right medical decisions for him. Even though it can be frightening, Lymphoma is very treatable. 

I wish the best for you, your brother, and all your family. Keep us posted, OK?

Blessings,

Rocquie

 

Ram2014
Posts: 8
Joined: Jul 2014

Hi Rocquie thank you for your response and your Blessings. We do have faith in his doctors but I guess we need to be a little patient.  I did read a lot of blogs in regards to lymphoma in which patients have won their fight against cancer.  But at the same time it's very heartbreaking to see him suffer as so far none of my immediate family members had any serious health problems.  Will keep you posted about his situation.

 

and also am very happy to hear that you are in remission:))

 

Jeff148's picture
Jeff148
Posts: 184
Joined: Apr 2014

That's interesting as I hadn't had any sign of a fever for months. The last four nights, after dinner, I've been having a low grade fever. The highest has been 100. I take two advil and put a cold wash cloth on my head and it drops after about 2 hours. In the morning, no fever. Then after dinner, it starts all over again. I think keeping your Dr. posted is the best thing you can do. I have never heard of tumor fever either. This all started after my 5th treatment with R-ABVD for NLPHL.

Ram2014
Posts: 8
Joined: Jul 2014

Hi Jeff his oncologist are aware about his fevers and high heart rate and he has been getting tylenol around the clock but the fevers are very stubborn for him which is making him weaker in addition to the chemo drugs.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3473
Joined: May 2012

RAM2014,

Is your brother's WBC count normal ?  I was hospitalized for 3 days after my first infusion for fever, but it was due to low WBC (a very common reaction to chemo drugs).  I too have never heard the term "Tumor Fever" before, and never had a fever before diagnosis. (And fever never returned after that one episode.)

By this point, undoubtedly his WBC has been checked repeatedly, but I would at least ask the question.  If the center is even half competent, he has also been checked for every bacterial infection known to medical science.   If he has no identifiable infections, ask the doctors if they have ruled out neurological involvement of some kind.

When I was admitted to the hospital I kept saying to the nurses and the Hospitaler, "The fever is probably low WBC." After three days and at least ten infection forms being ruled out, they told me "Your fever was caused by low WBC. Your cancer center is giving you a neulasta shot today, and you should be fine."

This is mostly a new one for me...it must undoubtedly be either WBC or an infection. Extremely aggressive forms of lymphoma cause night sweats, but I do not know if the are fever-related, since I did not have them. My next-door neighbor is very late stage DBL NHL and had extreme night sweats, but never fever.  It may be time to get obnoxious and demand answers, rather than requesting them.

I am interested in what you and your brother find out. Bless him and you both,

max

 

Ram2014
Posts: 8
Joined: Jul 2014

Hi Max intially when he had the first episode of fever his WBC was normal.  Since his hospitalization he has been extensively examined by an infectious disease doctor and neurologist both.  he so far has received 1st round of R-CHOP and 2nd round was done with R-EPOCH without the O since he has neuropathy in his legs.  After the 1st chemo his temperature and heart rate were still elevated so we shifted him to another well known hospital where the doctors were right on his case and decided to give him more aggressive chemo (I.e. r-epoch).  After the 2nd chemo his fever and HR came down for good 2 days and since has been fluctuating.  So couple days ago it was decided that his tumors are very aggressive and so for the 3rd chemo he would be given more aggressive treatment possibly RICE but that would be done once his WBC returns to normal.  But since his temperature is still elevated he still would need to be in the hospital (it would be 7 weeks this Tuesday since he has been hospitalized).  My main concern is every time he is exposed to a new stronger  chemo drug he would experience more side effect which would make him more weaker.   And so that's the reason I wanted to know if anyone had experienced fevers thought out the treatment which was there till their tumor completely disappeared.

 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3473
Joined: May 2012

Ram,

Sorry that things are so bad for him at the moment. There is a quite common situation known simply enough as "Flu-like Symptoms" which can cause severe muscle aches and fever (I had this for nearly my whole six months on chemo, and had to constantly eat Loritab to face the pain, it was so bad). You might mention it to his doc, but one would want to believe they ruled this out long ago.  Like many other problems, I only KNOW about it because I HAD it .

http://chemocare.com/chemotherapy/side-effects/flulike-syndrome.aspx#.U7muAOkg-70

It sounds like his medical  team is working whatever the issue is as hard as they can.  When the docs start throwing a lot of different therapies at once it can also be a sign that they are becoming frantic, but there are a lot of long-term writers here who have come back from the brink, to remain well for years or decades.  I pray they get a handle on his issues quickly.

max

Ram2014
Posts: 8
Joined: Jul 2014

Hi Max thanks for the information I think I will still mention it to the docs to see what they tell me.  A quick question though how high did your fever stay and if you were getting the treatment as outpatient.  

 

thanks a lot

 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3473
Joined: May 2012

Ram,

All of my treatment was outpatient . R-ABVD (a Hodgkin's treatment) almost never requires admittance, but a contributor here, Matthew Butts, was hospitalized for a lengthy amount of time while receiving it, due to medical problems.  

My neighbor six years ago had some strain of extremely aggressive NHL, and all of his infusions were as an inpatient.  (He told me his biopsy was the size of a softball, and that it was so large he had to hold his arm up, away from his body.)  I believe he was on r-epoch, but am not certain. As I recall, he did about four days in the hospital each three weeks or so. The remainder of the time he was in bed at home.  He could barely make it to the bathroom.  He began at about 300 pounds, and at the end was about 160.  My wife and I thought that he had moved or died, until we saw him at the end. (It was only later that we realized he had been in the house in bed the whole time, getting up only to be hauled to the hospital by his room-mate.)  His appearance was stunning, unbelievable really.  But he has been cancer-free since, and is about the size he was before any of the problems began.  I know that is a greusome story, but I share it because it reminds us that ANYONE can recover from lymphoma.  When I went back to work after treatment, several coworkers did not recognize me at first, and were visibly stunned at my appearance . I learned around that time that my boss had told the office manager to close my responsibilities, because after speaking with me he had told her, "There is no way he will live or be back." He had even forced my security clearance to lapse from refusing to renew it. I estimate that my appearance aged about 15 years.  When I met my kid's middle school coach long after treatment he said "You color is so good now! You were an odd gray color during treatment."

I do not recall what my temp averaged during treatment, which was in 2009. My Loritab had Tylenol in it, which is a fever reducer anyway. Loritab is available with or without the Tylenol in it, and I asked my oncologist about getting it without the Tylenol to safeguard my liver, but he said I should stay on the version he perscribed.  I do recall that most of the time the main issue was severe muscle aches, moreso than the fever.   I am not at all an addictive sort of personality, and after chemo, I walked away from the Loritab and never had any side-effects or withdrawl at all.  It was a total non-issue.  Twenty years earlier I was in ICU 25 days, smacked out of my brain on IV morphine and Darvon (I had one of those electronic buttons, that allows the patient to give himself a dose when needed).  The docs told my mom near the end of my ICU time that I would likely be addicted, but I walked away from that also, and never had any issues coming off of it .  I guess I am lucky at least in that one manner.  In all things give thanks,

max

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Ram2014
Posts: 8
Joined: Jul 2014

Thanks Max for the insight.

Anonymous user (not verified)

I was on Rituxan for 26 infusions. I had flu-like symptoms the whole time. My joints ached, my muscles were sore, nose stuffy etc. I did not have a high fever but my temp stayed around 100 a few times for several days at a time. I had my last infusion in April, followed by a CT scan and chest X-ray. All my organs had returned to normal size (previosly enlarged spleen and liver) and "numerous" lymph nodes in the mesentery were still visible at .5 cm and showed "no sighnificant change" from a scan 6 months earlier. The radiologist said I should be checked for mesenteric panniculitis, a rare inflammation of the mesentery, which can cause fever and flu-like symptoms. My Onc says no so I am having an internal medicine Dr. look at it, but cannot get the required procedures till the fever and and cold symptoms are gone. So I am now on a watch and wait with my next apppointment in early November.

I have noticed drastic changes since going off the Rituxan. My knees and shoulders are much better. Stamina is a bit better. Nasal stuffiness is gone. However the reason I am replying is to say that I have had a terrible cold for the last month, complete with high fever and all the usual symptoms including fever which just doesn't seem to go away. i am also experiencing sharp pains in my left side near where my spleen is located. Plan to tough it out till November unless things get worse.

Bottom line is I think your brother's fever could well be from side effects of cancer drugs. But make sure not to depend on one doctor's opinion. Get several involved.

Ram2014
Posts: 8
Joined: Jul 2014

Hi GKH,

his fever has stayed well over 102 from his initial hospitalization.  I also questioned about high temperature due to chemo drugs but as per them it doesn't look like it's related to the drugs as his history was there from day 1 since he was admitted.

vinslymphoma
Posts: 24
Joined: Feb 2014

Sorry Ram to hear about your bro..but it looks like all Bsymptoms though i am sure the docs might have told you about this..i have not heard of treatment while the patient is having fever..its better to get a second opinion and further diagnosis on the condition first..apart from this, i would suggest you to help your brother to calm down his mind and settle down with this idea that NHL is very curable and treatable very much and he is going to recover with the drugs that we have now in place..there are treatments like stem cell transplant that can be used..

prayers for ur bro to get the strength to sustain this and recover soon!!

Vinoth

Ram2014
Posts: 8
Joined: Jul 2014

Hi Vinoth,  

the hospital that he is admitted is where we came to get a second opinion.  And i have called at other institutions to get a third opinion but every one needs to see him personally which his hard to do as he is still inpatient.

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