Is fever a common side effect of pancreatic cancer treatment?

Fever is not among the most common routine side effects of chemotherapy or radiation for pancreatic cancer, but it can occur and often signals an infection or low white blood cell counts (neutropenia), which is an emergency during treatment. Chemotherapy commonly causes fatigue, nausea, diarrhea, neuropathy, hair thinning, and low blood counts, rather than fever itself. ^{[1] [2]} Radiation therapy more often causes fatigue, nausea, and localized skin or digestive effects, rather than fever. ^{[3] [4]}

Why fever matters during treatment

• Chemotherapy can lower your white blood cell count, which weakens the immune system and raises the risk for serious infections; in this setting, fever may be the first and only sign of infection and requires urgent evaluation. ^{[5] [6]}
• Public health guidance classifies a temperature of 100.4°F (38.0°C) or higher during chemotherapy as a medical emergency that warrants immediate contact with your care team. ^{[7] [8] [9]}

Common causes of fever in this setting

• Infection during periods of low white blood cells (neutropenia) after chemotherapy. ^{[5] [6]}
• Device or wound infections (for example, at a catheter or port site). ^[6]
• Less commonly, tumor-related fever or drug reactions; however, infection must be ruled out first given the risk profile during active cancer therapy. ^[10]

What to do if you develop a fever

• Take your temperature if you feel warm, flushed, chilled, or unwell; call your oncology team right away for 100.4°F (38.0°C) or higher. ^{[7] [6] [8]}
• If you need emergency care, inform triage that you are receiving chemotherapy so you can be seen quickly. ^[11]

How clinicians manage fever during chemotherapy

• Until proven otherwise, any fever after anticancer therapy is treated as neutropenic fever: you will typically receive prompt evaluation and rapid, broad‑spectrum intravenous antibiotics, ideally within 30–60 minutes if there are signs of instability. ^[10]
• Standard first‑line hospital antibiotics may include a single anti‑pseudomonal beta‑lactam (for example, piperacillin‑tazobactam, cefepime, or ceftazidime), with modifications for allergies and clinical findings. ^{[12] [13]}
• Ongoing management is adjusted based on your vital signs, lab results (including absolute neutrophil count), cultures, and imaging. ^[13]

Preventing fever and infections during treatment

• Practice frequent hand hygiene and ask those around you to do the same. ^[9]
• Monitor your temperature during times you feel unwell and keep a working thermometer and your care team’s contact information accessible. ^[8]
• Discuss with your oncology team whether preventive strategies (such as growth factor support to reduce neutropenia risk in certain regimens) are appropriate for you based on your treatment plan and blood counts. ^{[14] [15]}

Does radiation therapy itself cause fever?

Radiation for pancreatic cancer more commonly causes fatigue, nausea, skin/hair reactions, and occasional digestive bleeding rather than fever; fever during or after radiation should prompt evaluation for intercurrent infection or another cause. ^{[3] [4]}

Key takeaways

• Fever is not a routine, expected side effect of pancreatic chemo or radiation, but during treatment it is a red‑flag sign that may indicate infection and must be treated urgently. ^{[5] [7]}
• A temperature of 100.4°F (38.0°C) or higher during chemotherapy warrants immediate contact with your care team or urgent evaluation. ^{[8] [6]}
• Hospitals manage suspected neutropenic fever with rapid assessment and empiric IV antibiotics while tests are pending. ^{[10] [12]}

When to seek urgent care

Call your oncology team now or seek emergency care if you:

• Have a fever of 100.4°F (38.0°C) or higher. ^{[8] [9]}
• Have shaking chills or feel acutely unwell. ^[6]
• Notice signs of infection such as redness, swelling, warmth, or pus at a catheter/port site; a new cough; sore throat; or burning with urination. ^[6]

Staying alert to fever and acting quickly helps prevent serious complications and keeps your treatment on track. ^{[7] [8]}