Flu-like Syndrome

What Is Flu-Like Syndrome?

Other terms: flu, fever and chills

Flu-like syndrome is a side effect of many treatments used in cancer care. The exact process of how flu-like syndrome is caused is not fully understood. However, when the body is exposed to certain medications it is believed that these medications trigger normal inflammatory mechanisms of the immune system. This process is similar to the body's response when it is dealing with a "flu" virus.

Symptoms of Flu-Like Syndrome:

• Fever (sudden onset, timing associated with the therapy causing the flu-like syndrome).
• Chills (often come before the fever, usually involve upper body first).
• Muscle/joint aches (myalgias/arthralgias), (generalized aches and pains, accompanied by sensation of weakness, may or may not be relieved by rest).
• Headache (usually across forehead, accompanied by sensitivity to light, may include visual disturbances for example, blurring).
• Poor appetite.
• Nausea, vomiting
• Diarrhea
• Nasal stuffiness (runny nose usually clear, watery and persistent).
• Cough (dry, hacking, and persistent, rarely productive).
• Bone pain.
• Fatigue (malaise) (accompanied by sense of apathy, lack of energy or motivation).

Cancer Therapies Associated with Flue-Like Syndrome:

• Biologic therapies such as:
• Interleukin-2, Interferons
• Colony-stimulating factors (GM-CSF)
• Monoclonal antibodies
• Chemotherapy medications associated with flu-like syndrome:
• bleomycin, cladribine, cytarabine, dacarbazine, fluorouracil, l-asparaginase, procarbazine, and trimetrexate.

With some of the medications the flu-like syndrome is dose related and not all of the symptoms of flu are present with each of the medications mentioned. The time frame for the flu-like syndrome also varies, as well as the severity of the flu-like symptoms. Another aspect to these symptoms of flu is they may be more severe at first but as the body "gets used" to the medication the experience of fever and chills, for example, will be less severe with subsequent doses. Symptoms may reappear or worsen if treatment is interrupted and then resumed or if the dose is increased. Flu-like symptoms resolve once treatment is stopped completely.

Management of Flu-Like Syndrome:

Things you can do for symptoms of flu:

General:

Ask your health care professional to explain the medications you will be taking to treat your cancer. Specifically, ask what type of side effects you can expect and what will be done to prevent or control the side effects.

Chills:

Things you can do for chills:

• In contrast, if flu-like syndrome causes the chills, you should put on some warm clothes, blankets or take a warm bath. If you like to use hot packs or heating pads, use caution to avoid burning your skin.

Drugs that may be prescribed by your doctor for chills:

• A narcotic may be prescribed such as meperidine or hydromorphone, to stop severe chills that may occur with some drugs.