Is Fever a Common Symptom of Liver Cancer? Causes and Management

Fever can occur with liver cancer, but it is not always present and tends to appear more often in advanced disease or when cancer has spread to the liver from another organ. ^[1] Fever is also frequently reported when cancers from other sites metastasize to the liver. ^[2] Many people with liver metastases have few or no symptoms, but fever can be one of the noticeable signs. ^[3]

How Often Does Fever Happen?

• Primary liver cancer (hepatocellular carcinoma) may cause fever among other symptoms such as weight loss, appetite loss, abdominal pain, jaundice, and pale stools; however, early-stage disease often lacks clear symptoms. ^[1]
• When cancer spreads to the liver (liver metastases), some people notice fever along with fatigue, weight loss, or abdominal discomfort, although others may have no symptoms. ^{[2] [3]}
• Health organizations and major centers list fever among the recognized symptoms for liver cancer and liver metastases. ^[4]

In short, fever is a recognized symptom, but not universal; its presence can vary depending on stage, spread, and individual factors. ^{[1] [2] [3]}

Why Can Liver Cancer Cause Fever?

• Tumor-related (paraneoplastic) fever: Cancer cells can release inflammatory substances that raise body temperature even without infection. ^[5]
• Extensive liver involvement and inflammation: When the liver is heavily affected, inflammatory responses can lead to fever. ^[4]
• Treatment-related effects: Some cancer treatments can provoke fever through immune activation or side effects. ^[6]

Importantly, infection is a very common cause of fever in people with cancer and can be serious. ^[5] Infection risk is higher if the immune system is weakened, especially during chemotherapy or targeted/immune therapies. ^[7]

Infection vs. Tumor-Related Fever: Why It Matters

• Infection-related fever may be the only warning sign of a serious problem during therapy and needs urgent attention. ^[7]
• People receiving chemotherapy are advised to treat any fever of 38.0°C (100.4°F) or higher as a medical emergency and call their doctor immediately. ^[7]
• When fever occurs after anticancer therapy, clinicians initially manage it as possible “neutropenic fever” (dangerously low white cells) with prompt antibiotics until tests clarify the cause. ^[8]

Because infection can be life‑threatening, medical teams prioritize ruling it out before concluding the fever is tumor-related. ^{[7] [8]}

Red Flags That Need Urgent Care

• Temperature ≥38.0°C (100.4°F), especially during or soon after chemotherapy or immunotherapy. ^[7]
• Chills, rigors (shaking), sweats, sore throat or cough, shortness of breath, fast heartbeat, uncontrolled diarrhea, or feeling suddenly very unwell. ^[6]
• Any fever with signs of confusion, low blood pressure, low oxygen, or organ dysfunction. ^[8]

Seek immediate medical advice if these occur, as early treatment improves outcomes. ^{[7] [6] [8]}

How Fever Is Managed

Step 1: Check and Call

• Take your temperature if you feel warm, flushed, chilled, or unwell; call your care team at 38.0°C (100.4°F) or higher. ^[7]
• Have a plan in place with your oncology team for what to do if you develop flu-like illness or fever. ^{[9] [10]}

Step 2: Rule Out Infection

• Clinicians perform blood counts, cultures, and exams of common infection sites (mouth, skin, urinary tract, catheter areas) to find the source. ^[5]
• If infection is suspected or cannot be excluded, prompt empiric antibiotics are started, especially if neutropenia is possible. ^[8]

Step 3: Treat Symptoms Safely

• Antipyretics (fever reducers) can be used under guidance to ease discomfort while the cause is investigated. ^{[11] [12]}
• Hydration and rest support recovery; targeted therapy for any identified infection or treatment side effect is added as needed. ^{[8] [9]}

The priority is to exclude and treat infection quickly; symptom relief is added alongside cause‑directed care. ^{[8] [7]}

Practical Prevention Tips

• Wash hands frequently and ask those around you to do the same to reduce infection risk. ^[13]
• Monitor for fever during treatment and act promptly if it occurs. ^[13]
• Discuss vaccination and seasonal flu precautions with your care team and plan ahead for illness management. ^{[9] [10]}

Simple hygiene and early reporting of fever can lower complications during cancer therapy. ^{[13] [7]}

Key Takeaways

• Fever can be a symptom of liver cancer or liver metastases, but it’s not always present. ^{[1] [2] [3]}
• Infection is a common and potentially serious cause of fever during cancer care; treat fever ≥38.0°C as urgent. ^[7]
• Medical teams prioritize ruling out infection and may start antibiotics quickly, especially if neutropenia is possible. ^[8]
• Comfort measures like antipyretics can help, but they should accompany prompt medical evaluation. ^{[11] [12]}

If you’re currently in treatment and develop a fever, it’s safest to contact your oncology team right away for guidance and evaluation. ^[7]