Liver Cancer Stage 4: Understanding the Causes of Chills and Fever

There are several reasons why patients with late-stage liver cancer may experience chills and fever. Understanding these factors can help both patients and caregivers manage symptoms more effectively.

Tumor-Related Complications and Immune System Suppression
One of the primary causes of fever in advanced liver cancer is the development of tumor-related complications. Additionally, treatments such as chemotherapy and interventional procedures can significantly weaken the immune system, making the body more susceptible to various inflammatory responses. This immune suppression often contributes to episodes of fever and chills.

Tumor Necrosis and Inflammatory Responses
As cancer cells grow rapidly, they can outpace their blood supply, leading to areas of necrosis (cell death) within the tumor. These dead tissues can trigger an inflammatory reaction in the body, which may result in fever and chills. In such cases, doctors may evaluate biomarkers like white blood cell count, neutrophils, procalcitonin, and C-reactive protein to rule out bacterial infections. If these markers are within normal ranges, the fever is likely of neoplastic origin, commonly referred to as "cancer fever." Typically, this type of fever does not involve severe chills and can be managed with nonsteroidal anti-inflammatory drugs such as indomethacin.

Infections Due to Weakened Immunity
In some cases, chills and fever may be signs of an actual infection, especially if symptoms like cough are present. Patients with advanced liver cancer often have compromised immune systems, making them more vulnerable to common infections such as colds or bacterial illnesses. In these situations, appropriate antimicrobial therapy or symptomatic treatment for colds may be recommended.

While fever is relatively common in end-stage liver cancer, it's important to distinguish between infection-related fever and cancer-induced fever to ensure proper treatment. Supportive care measures such as physical cooling methods and medications like indomethacin can help alleviate discomfort and improve quality of life.