Is fever a common side effect of Liver Cancer treatment? How can it be managed?

Fever can occur during liver cancer treatment, and in some situations it is expected, while in others it signals a medical emergency especially during chemotherapy. ^[1] Fever is specifically listed as a possible symptom with certain immunotherapy regimens used for advanced liver cancer, and you should tell your care team if it appears. ^{[2] [3]} During chemotherapy, any fever of 100.4°F (38°C) or higher requires urgent medical evaluation because it may be the only sign of a serious infection. ^{[1] [4]}

How common is fever across treatments?

• Immunotherapy (checkpoint inhibitors such as durvalumab plus tremelimumab): Patient materials note fever as a potential side effect, and reporting it to the team is advised. ^{[2] [3]}
• Targeted therapies: Some targeted regimens can cause non‑infectious fevers (example from other cancers), showing that drug‑related fever syndromes can occur; your team will guide you based on the specific agent. ^[5]
• Chemotherapy: Fever is common in the context of infection risk, and when combined with low white blood cells (neutropenia), it is treated as an emergency. ^{[1] [6]}
• Disease‑related symptoms: In liver cancer, fever can also relate to complications like bile duct blockage, which warrants notifying your team. ^[7]

Why fever matters during chemotherapy

Fever may be the first and only sign of infection, and infections during chemotherapy can be life‑threatening due to weakened immune defenses. ^[1] You should check your temperature any time you feel warm, flushed, chilled, or unwell, and call your doctor right away at 100.4°F (38°C) or higher. ^{[1] [4]}

When to seek urgent care

• Temperature ≥100.4°F (38°C): Call your doctor immediately; this is treated as a medical emergency during chemotherapy. ^{[1] [4]}
• Shaking chills or feeling suddenly ill: These can be infection signs that need prompt assessment. ^[8]
• New cough, sore throat, burning with urination, redness/swelling at a catheter or surgical site: These suggest infection and need urgent attention. ^[8]
• Signs of blockage (itching skin, nausea, jaundice) in liver cancer: Report these promptly, as procedures may be needed to relieve bile duct obstruction. ^[7]

Immediate management steps

• Do not delay: All fevers after anticancer therapy are initially managed as neutropenic until proven otherwise, with empiric antibiotics started quickly. ^[6] Patients with any systemic compromise (low blood pressure, low oxygen, confusion, organ dysfunction) should receive antibiotics within 30 minutes. ^[6]
• Evaluation: Your team will check blood counts (to assess neutropenia), culture for infection sources, and examine potential sites like mouth, skin, urinary tract, anus, IV or biopsy sites, and central lines. ^{[9] [10]}
• Treatment: Management may include IV antibiotics, growth factor support for white blood cells, and supportive care based on test results. ^{[9] [6]}

Managing fever with immunotherapy and targeted agents

Fever listed with durvalumab plus tremelimumab should be reported; your team may pause therapy, evaluate for infection, and manage immune‑related side effects if present. ^{[2] [3]} Some targeted therapies are associated with non‑infectious fever syndromes, and early recognition with treatment holds and supportive care reduces complications. ^[5]

Practical home steps

• Monitor temperature: Keep a thermometer and check when feeling unwell; 100.4°F (38°C) or higher requires an immediate call. ^{[1] [4]}
• Avoid self‑treating fever with common pain/fever reducers before speaking with your provider during active treatment, as they can mask symptoms. ^[11]
• Prevent infections: Frequent handwashing and minimizing exposure to sick contacts reduce risk. ^[4]

Summary

Fever can be a side effect with certain liver cancer treatments, especially immunotherapy, and should be reported. ^{[2] [3]} During chemotherapy, fever is treated as a medical emergency because it may signal a dangerous infection and needs prompt evaluation and antibiotics. ^{[1] [6]} Notifying your team about any fever or infection signs, and following prevention measures, helps keep you safe throughout treatment. ^{[8] [4]}