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Fever, immobile, have metastatic breast cancer. Can you offer anything?

I appreciate that you are here. We have a friend who has cancer, and who today has a high fever (38.8C). She is immobile, and has been for some time. It started as breast cancer , but has metastisized pretty much all over. Tho down and immobile, she had been doing well lately. I guess it s just a matter of time, but can you offer anything?
Asked On : Wed, 7 Nov 2012
Answers:  2 Views:  77
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General & Family Physician 's  Response
Hello. I'm sorry your friend is ill. Her situation represents one of those difficult decision-making processes that occasionally face physicians and patients (and their friends and families). Her fever is probably a sign of a secondary infection -- a decubitus ulcer (bedsore), a urinary tract infection, pneumonia, etc. -- that could be fatal if left untreated. In some cases, when patients are terminal and they've reached a decision about the types of care they wish to receive, they request that antibiotics be withheld in these situations and they simply be made as comfortable as possible. In other cases, patients request that all possible measures be taken to deal with infections, nutritional issues, and any other problems that crop up along the way.
Your friend's physician should be apprised of her fever, and its source should be identified, if at all possible. This may be a straightforward problem that is easily treatable. However, if her fever is a sign of a serious infection that will require aggressive therapy and hospitalization, your friend should be asked about her desire for such treatment. If she opts to forgo treatment, every effort should be made to keep her comfortable.
I hope that helps. My best to you and your friend.
Answered: Wed, 7 Nov 2012
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Oncologist, Radiation Dr. Milind Kumar's  Response
I agree with Dr Christensen and would like to add here that oral antibiotics would remain a viable option which will control infection and can be taken at home. I feel calling in palliative care physician or general physician is appropriate
Answered: Thu, 8 Nov 2012
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