Clinical safety
Use your own team’s instructions first
Use the contact number and urgent-care advice your team gave you for new or worsening symptoms. If you are having systemic anti-cancer treatment, use the 24-hour number on your treatment alert card. Call 999 for a life-threatening emergency.
Create a call-now plan that does not depend on one symptom
A serious infection can develop during treatment even without a high temperature. Use the individual threshold and symptom instructions from your treatment unit.
Keep this beside the thermometer
Fill in the blanks from your own hospital information.
- 24-hour treatment number and a second route if the call does not connect.
- The temperature threshold and measurement method your unit told you to use.
- Other call-now signs such as shaking, feeling suddenly very unwell, confusion, breathlessness or symptoms of infection named by your team.
- Treatment names, last dose or infusion date and any implanted line or device.
- Current medicines, allergies and whether antibiotics or steroids have already been taken.
- Address, transport plan and someone who can call or accompany you if needed.
Before treatment starts
Ask the unit to be explicit about nights and weekends.
- Which number do I use first and how quickly should it answer?
- What temperature or symptoms mean call immediately for this treatment?
- Should I call if I feel acutely unwell but the temperature is normal?
- What should I do if I cannot check a temperature?
- Where will I be assessed out of hours?
An urgent treatment-line call
Give treatment and timing before the symptom list.
“I am on cancer treatment and my last dose was Friday. My temperature is the threshold my unit told me to report and I have shaking chills. I am calling the 24-hour line as instructed.”
Treat sudden illness during treatment as time-sensitive
Some cancer treatments reduce infection-fighting neutrophils, but serious infection can occur at any point and may not produce a high temperature. The safest rule is to use your unit's 24-hour instructions immediately when you meet its threshold or feel suddenly unwell.
Neutrophil counts often follow a pattern after treatment, but the lowest point varies by drug, dose and person. Do not use a predicted nadir to decide that another day is safe. Steroids and some other medicines can also change how infection appears. Shivering, confusion, breathlessness, severe weakness, reduced urine, mottled skin or a rapid deterioration can matter even when a thermometer reading seems reassuring.
Before each treatment cycle, check that the emergency number and destination remain current. Tell the call handler that you are receiving cancer treatment and may be neutropenic. Give the treatment date, symptoms, temperature measured with the recommended method, allergies and any central line. If assessment is requested, take the alert card and medicines. Do not drive yourself when very unwell.
Prevention is sensible but cannot remove all risk. Use good hand hygiene, food-safety advice from the team, dental care and line care, and avoid close contact with people who are acutely infectious where practical. Do not hide at home, adopt a highly restrictive diet or use preventive antibiotics unless the clinical team recommends them. Vaccinations and exposure to infections need individual advice because live vaccines can be unsuitable during some treatment.
A practical way through it
Use the parts that fit your situation and leave the rest.
- Use the unit's exact ruleWrite down its temperature threshold, symptoms that trigger a call, thermometer method, 24-hour number and assessment location. Do not substitute a threshold from another hospital.
- Measure without delayingTake your temperature if advised, but make the call promptly when you feel suddenly or seriously unwell even if you cannot measure it.
- Lead with cancer treatmentSay when treatment was given, that neutropenia is possible, and whether a line, transplant or immunotherapy is involved.
- Prepare for assessmentTake the alert card, medicine list, allergy details and an overnight bag if directed, while another person handles transport when possible.
- Reduce ordinary exposureWash hands, care for mouth and skin, prepare food safely and ask infectious visitors to postpone, without using unproven extreme restrictions.
- Check vaccines and medicinesAsk the oncology team before vaccines, antibiotics, antipyretics or new non-prescription products that could be unsuitable or mask symptoms.
What this can look like
When the temperature is normal
Four days after chemotherapy, Rowan is shaking, weak and unusually confused. The thermometer shows a value below the unit's written fever threshold.
A useful response
Call the 24-hour oncology number immediately and describe the whole clinical change, not only the temperature.
Follow the urgent assessment instructions and do not wait for another reading.
Call 999 if consciousness, breathing or circulation appears severely affected or help cannot be reached safely.
Understanding the risk
- Keep the 24-hour oncology number and treatment alert information accessible.
- Use good hand and food hygiene without adopting extreme restrictions unless advised.
Acting quickly
- Follow your unit’s own upper and lower temperature thresholds.
- Call immediately for fever, chills, flu-like illness, cough, urinary symptoms, diarrhoea or sudden deterioration.
Emergency signs
- Call 999 for severe breathlessness, collapse, confusion or another life-threatening symptom.
- Do not wait for a routine appointment or try to treat suspected infection alone.
A manageable next step
What you could do now
- Save the 24-hour oncology number in every carer’s phone.
- Keep a working thermometer and know your unit’s thresholds.
- Call the unit for sudden illness even when temperature is normal.
Checked sources
Read the original guidance
We summarise carefully and link to the source so you can check the full, most current information. Sources were checked 9 September 2026.