Managing Chemotherapy Side Effects and Fever in Advanced Lung Cancer

Fever in lung cancer?

Hello Doctor, my husband is 35 years old and is currently in advanced stage lung cancer, close to stage IV.
He has undergone surgery and has just started chemotherapy with "Taineng." However, he began experiencing side effects on the fourth day of the initial chemotherapy.
I would like to ask if we can request a change to a different chemotherapy drug if he is feeling this uncomfortable so early on.
Would that be better? Additionally, due to the side effects causing fever, can he still undergo the second round of chemotherapy while experiencing a fever? Thank you.

Tianxin Ma, 30~39 year old female. Ask Date: 2015/06/23

Dr. Lai Yicheng reply Oncology

Dear Sweetheart Mom,
Hello! Accepting chemotherapy may lead to various side effects; some individuals may experience partial side effects, while others may have none at all.
This largely depends on the type and dosage of chemotherapy your husband is receiving, as well as his body's response.
It is advisable to discuss with the physician or nurse about the potential side effects and how to manage them.
Throughout the chemotherapy process, the doctor will regularly check your husband's white blood cell count through blood tests.
If the white blood cell count drops too low, it may delay treatment, require adjustments to the medication dosage, or even lead to a temporary halt in chemotherapy.

In the event of neutropenia, please be vigilant for signs of infection and try to avoid crowded places.
It is important to check his temperature at least once a day to monitor for fever.
If his temperature exceeds 38°C (100.4°F), please seek medical attention from the attending physician.

Best regards,
Director Lai, Radiation Oncology Department, Changhua Hospital

Reply Date: 2015/06/23

More Info

Managing chemotherapy side effects, especially in advanced lung cancer, is a critical aspect of treatment that requires careful consideration and communication with the healthcare team. Your husband's situation, being relatively young at 35 and facing stage IV lung cancer, understandably raises concerns about the side effects of chemotherapy and how they might impact his treatment plan.

Firstly, it is not uncommon for patients undergoing chemotherapy to experience side effects, which can vary significantly depending on the specific drugs used, the dosage, and the individual's overall health. Common side effects include nausea, vomiting, fatigue, hair loss, and, as you've mentioned, fever. The onset of side effects can occur within days of starting treatment, and it is essential to report these to the treating physician as soon as they arise.

Regarding your question about switching chemotherapy drugs, yes, it is possible to request a change in medication if the side effects are intolerable. Oncologists are generally open to discussing the patient's experience with side effects and may consider alternative regimens that might be better tolerated. However, the decision to change drugs should be based on a thorough evaluation of the patient's condition, the effectiveness of the current treatment, and the potential benefits and risks of the new regimen. It is crucial to have an open dialogue with the oncologist about these concerns, as they can provide insights into the expected side effects of different drugs and help tailor the treatment plan accordingly.

As for the fever, it is essential to determine the cause of the fever before proceeding with further chemotherapy. Fever can be a sign of infection, which is a significant risk during chemotherapy due to potential neutropenia (low white blood cell count). If your husband is experiencing a fever, especially if it exceeds 38°C (100.4°F), it is vital to contact his healthcare provider immediately. They may recommend blood tests or other evaluations to rule out infection or other complications. If an infection is present, it may need to be treated before continuing with chemotherapy. In some cases, if the fever is mild and there are no signs of infection, the oncologist may still proceed with the next cycle of chemotherapy, but this decision should be made on a case-by-case basis.

In summary, managing chemotherapy side effects is a collaborative process between the patient and the healthcare team. If your husband is experiencing significant discomfort, it is essential to communicate this to his oncologist, who can assess the situation and consider alternative treatment options. Additionally, any fever or signs of infection should be promptly addressed to ensure safe and effective treatment. Regular follow-ups and open communication are key to navigating the challenges of chemotherapy in advanced lung cancer.

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