Fever During Stomach Cancer Treatment: Is It Common and How Is It Managed?

Fever can occur during stomach (gastric) cancer treatment, and it deserves careful attention because it may signal an infection or other complications. During chemotherapy, a fever of 38.0°C (100.4°F) or higher is treated as a medical emergency because infection can become life‑threatening when white blood cells are low. ^{[1] [2]} Fever can also occur after surgery and should prompt evaluation, especially if accompanied by pain, redness at the incision, or worsening symptoms. ^{[3] [4]}

Why Fever Happens

• Chemotherapy-related low white blood cells

  • Many chemo regimens reduce neutrophils (neutropenia), weakening your ability to fight infection; in this setting, fever may be the only early sign of infection and requires immediate action. ^{[1] [5]}

• Post‑surgical complications

  • After gastric cancer surgery, fever can be due to lung collapse (atelectasis), pneumonia, wound infection, or intra‑abdominal abscess; new or persistent fever in the first 1–2 weeks should be assessed promptly. ^{[3] [4]}

• Viral infections (e.g., flu)

  • People on cancer treatment are at higher risk of severe flu; any fever warrants contacting your care team immediately. ^[6]

When Fever Is an Emergency

• During chemotherapy

  • Any temperature of 38.0°C (100.4°F) or higher is considered a medical emergency; call your oncology team and seek urgent care. ^{[1] [2]}

• Signs of severe infection or sepsis

  • Symptoms like chills, confusion, low blood pressure, trouble breathing, or feeling very unwell require immediate emergency evaluation. ^[5]

• After surgery

  • Fever with increasing abdominal pain, inability to pass gas, wound redness or drainage, or breathing problems needs urgent review. ^{[3] [4]}

Immediate Steps if You Develop a Fever

• Check your temperature right away with a reliable thermometer any time you feel warm, flushed, chilled, or unwell. ^{[1] [2]}
• Call your oncology team immediately if it’s 38.0°C (100.4°F) or higher, and tell emergency staff that you are receiving chemotherapy if you go to the ER. ^{[1] [7]}
• Do not take fever reducers (like acetaminophen) before you’ve spoken with your team, as they can mask fever and delay diagnosis. ^{[1] [2]}

How Clinicians Manage Fever

• Rapid evaluation and antibiotics

  • With suspected neutropenic fever, clinicians treat urgently with blood tests and broad‑spectrum antibiotics, ideally within 1 hour (within 30 minutes if unstable). ^{[5] [8]}
  • Treatment is adjusted as test results return and the clinical picture becomes clearer. ^[9]

• Investigations to find the source

  • Blood cultures, urine tests, chest X‑ray, and targeted imaging (e.g., CT abdomen) may be used to identify pneumonia, urinary infection, wound infection, or intra‑abdominal abscess. ^{[10] [4]}

• Supportive care

  • IV fluids, oxygen if needed, and adjustments to chemotherapy dose or schedule may be considered to reduce future risk. ^[11]

Prevention Tips You Can Start Today

• Hand hygiene

  • Wash hands often, and ask everyone around you to do the same; clean hands prevent infections. ^[2]

• Temperature monitoring

  • Keep a working thermometer easily accessible and know how to use it; take your temperature with any chills or feeling unwell. ^{[1] [2]}

• Infection precautions

  • During periods of low white blood cells, avoid crowds and sick contacts, and follow your team’s guidance on food safety and mask use. ^[2]

• Post‑surgery care

  • Use deep‑breathing and coughing exercises to prevent atelectasis and pneumonia, and follow wound‑care instructions closely. ^[3]

Special Considerations for Stomach Cancer

• Chemotherapy for gastric cancer commonly causes side effects like nausea and fatigue, and while fever is not guaranteed, it can occur and must be evaluated urgently when it does. ^[11]
• In Korea-based expert guidance for gastric cancer care, a fever ≥38°C during chemotherapy is emphasized as a potential emergency requiring ER evaluation and prompt antibiotics if neutrophils are low. ^[12]

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Quick Reference: What to Do with a Fever

Situation	Threshold/Sign	What to Do	Why It Matters
During chemotherapy	Temp ≥38.0°C (100.4°F)	Call oncology team and seek urgent care; tell staff you’re on chemo	Fever may be the only sign of dangerous infection with low white cells. [1] [2]
Feeling unwell (warm, flushed, chills)	Any time	Check temperature promptly	Early detection speeds care. [1]
Unstable symptoms (confusion, low BP, breathing trouble)	Any time	Call emergency services/ER immediately	Sepsis needs antibiotics within 30–60 minutes. [5] [8]
After gastric surgery	Fever with abdominal pain, wound redness/drainage, or not passing gas	Contact surgeon/ER	Possible abscess, pneumonia, or wound infection. [3] [4]

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Key Takeaways

• Fever can occur during stomach cancer treatment, and during chemotherapy, a temperature of 38.0°C (100.4°F) or higher is an emergency. ^{[1] [2]}
• Rapid antibiotics and evaluation are standard for suspected neutropenic fever to prevent severe infection. ^{[5] [8]}
• After surgery, new or persistent fever should be assessed promptly to rule out postoperative complications. ^{[3] [4]}
• Good hand hygiene, timely temperature checks, and following your team’s prevention advice reduce risk. ^[2]