Any experience with fever please?

[Cdel]

Hi all - thanks in advance for your insights. I’m caring for my 67 yr old brother with stage 4 mCRPC diagnosed in 14 (4+3). Treatments have been RPT in 15, 1st line ADT, RT to prostatic bed in 19, enzalutamide, 6 cycles Docetaxel ending Jan 23, Olaparib until April, currently on Aberaterone. PSA jumped from 2.8 July 22 to 729 March 23. It seems Chemo and Olaparib weren’t effective. Since taking Aberaterone it is down to 324. Cancer is in multiple lymph nodes and bones (D5.D6, left hip joint, pelvis).

Side effects of meds have been severe, especially Olaparib. He’s on a 10 mg pain patch (Buprenorphine) and takes a tramadol pill (Ultracet) to manage pain. Over the past 5 days he’s run a fever that just makes him feel terrible and accentuates pain he can otherwise manage. We try to control the fever with regular doses of Tylenol. He doesn’t appear to have an infection based on standard blood and urine test but his MO says we’ll have to admit him to hospital to investigate further. Has started him in anti bios. Urine did show trace protein and I noticed slight swelling in his ankles and feet over past 24 hrs.

Has anyone had experience with fever that goes up to 101.5 - 102.0 (when untreated). It’s going on 5 days now. What could be causing this if it’s not an infection? Thanks much for your feedback.

[ArabianNights]

I'm so sorry about your brother and everything he is going through.

My dad also suffered from extreme fevers. He had fevers for almost 3 weeks straight until we could get them under control. His fevers came with intense pain episodes. It was absolutely horrible so I can relate to what you are going through.

They never found a source of infection for my dad. To get the fevers under control, he took naproxen and dexamethasone. The fevers seemed to be related to intense inflammation flare-ups. Nothing else seemed to work - Tylenol didn't help much but he sometimes took it along with the naproxen since this is allowed.

My dad has since passed but after so long it was a relief to get the fevers under control. Everything else was very manageable and he lived well after the fevers were under control.

I hope this information is helpful for you. Wishing the best for your brother and your family.

[Cdel in reply to ArabianNights]

So sorry for your loss. May he rest in peace. Thanks much for this insight. Very helpful. Like your dad, when the fever is under control he does so much better. We see his MO in a couple of days and I’ll raise the idea of inflammation being the source of his fever. Thanks again.

[Marit85 in reply to ArabianNights]

Hi! I am also caring for my dad. May I ask if you remember the doses of dexa that he was prescribed? My father also have high inflammation markers.

[ArabianNights in reply to Marit85]

So sorry about your dad ❤️. I would start with 1- 2mg and see if that helps. There are other side effects of steroids so it’s better to keep it low if you can. It is also great for increasing appetite.

[Marit85 in reply to ArabianNights]

Thank you so much!