Ask for the night number before you need it. Write the temperature they care about on the same card.
Cancer treatment can irritate skin, tire you, and upset a stomach, and those problems are often managed at the next visit or with a phone call in office hours. A few problems are different. The Centers for Disease Control and Prevention tells people in treatment to call if they think they have a side effect, and to call right away for signs of infection, especially a fever, because chemotherapy can lower the white cells that fight germs. The National Cancer Institute’s pages on infection say the same thing in more detail. This piece is the card you put by the phone. Your clinic’s number outranks it.
Ask for their number, not ours
Before the first treatment, ask: what temperature do you want me to call about, including at night? Many oncology clinics use 100.4 degrees Fahrenheit, which is 38 degrees Celsius, as the line during chemotherapy. Yours may use a different line. Write the one they say. Ask whether you should go to the emergency room if no one answers, and what sentence to say at the door: your name, the cancer, the drug, and the word fever or bleeding. Do not drive yourself if you are dizzy, short of breath, or confused. Call emergency services.
Call the same day
- A fever, chills, or shaking, especially during chemotherapy or in the weeks after.
- Bleeding that will not stop, blood in the stool or urine, or many new bruises.
- Chest pain, trouble breathing, or a sudden weak arm or slurred words. Those are emergency calls, cancer or not.
- Confusion that is new, a faint, or a fall with a hit to the head.
- Vomiting or diarrhea you cannot keep water down through, or no urine for most of a day.
- Pain that is new, severe, and not the pain they already told you to expect.
- A mouth so sore you cannot drink, or a rash that is spreading fast.
The Centers for Disease Control and Prevention notes that nausea can be treated, and that the team needs to hear about it to find the medicine that fits. Tell them. Do not decide that suffering quietly is part of the job. Fatigue that pins you to the chair for days is also worth a call, not because this page can name the cause, but because anemia, infection, pain, and depression can all wear that coat.
What can usually wait until morning
Mild heartburn, a food that tasted wrong, hair in the brush, and a question about next week’s appointment can wait for office hours if you are otherwise yourself. If you are unsure which list a symptom is on, use the night number. A nurse would rather hear a false alarm than meet you late. This paper is not awake at 2 a.m. The clinic’s line is.
Do not take a leftover antibiotic
A fever during cancer treatment is not a reason to finish an old bottle from the cabinet. It is a reason to reach a person who knows today’s blood counts. The wrong antibiotic, or a dose you guessed, can hide the problem they need to see.
Sources to read yourself
- Centers for Disease Control and Prevention, Side effects of cancer treatment
- National Cancer Institute, Infection and neutropenia
- National Cancer Institute, Chemotherapy and You
A note from the desk
This is general reading, not a diagnosis and not a plan written for you. Before you change how you move, eat, or what you keep in the cabinet, ask your own clinician. Do not stop a prescribed medicine because of something you read.