People living with a terminal illness can experience excessive sweating and a high temperature (fever). Fever and sweating are often related but one can happen without the other. These symptoms can be uncomfortable and cause distress, tiredness and confusion. There are simple steps you can take to ease these symptoms, and medicines that can help, once serious underlying causes have been ruled out.
Why do we sweat
Sweating is a healthy way for your body to cool down when you are hot. The amount that you sweat depends on how active you are, the temperature of your environment and your emotional state. People living with a terminal illness may experience changes in body temperature and excessive sweating.
This can cause problems that may affect your quality of life, including:
- discomfort
- dehydration
- disrupted sleep
- soaking through clothes and bed sheets
- embarrassment.
It may also take more effort, for you and the people supporting you, to change soaked clothes and bed sheets.
What causes sweating and temperature changes?
There are many causes of sweating and fever in people living with a terminal illness. Causes can include infection, the illness itself and certain treatments. There may be more than one cause contributing to your symptoms.
If sweating or temperature change is new or has got worse, speak to your GP or the healthcare professionals supporting you. They will be able to help find the underlying cause.
We’ve outlined some possible causes to be aware of when living with a terminal illness that may need more immediate action first.
Infection
Sweating can be caused by infection, particularly if you also have a fever. It’s important to check if any change to temperature or sweating is being caused by infection.
Having a high temperature or a fever can be a symptom of sepsis. Sepsis is a life-threatening reaction to an infection which can affect the whole body.
If you’ve had chemotherapy or other treatments that affect the immune system, you could be at risk of neutropenia. Neutropenia means you have a low number of white blood cells. This can weaken your immune system. If you have neutropenia, then sweating could be a sign of neutropenic sepsis which is a medical emergency.
If you think you might have sepsis or neutropenic sepsis, this could be life-threatening. Call 999 or go to your nearest Accident and Emergency (A&E) department. They will be able to support you to get the right treatment quickly.
Cancer and cancer treatments
Neoplastic fever (also known as tumor fever) is caused by the cancer itself. This can cause a change in temperature and sweating. It can be caused by almost any cancer but is most associated with people living with:
- Hodgkin’s disease
- non-Hodgkin’s lymphoma
- acute leukemia
- renal cancer
- liver metastases.
Treatments for some cancers can change the levels of sex hormones and cause sweating. This includes some breast cancer and prostate cancer treatments.
Other causes of sweating
There are many other possible causes of sweating, which include:
- selective serotonin reuptake inhibitor (SSRI) antidepressants such as citalopram
- hormone therapies - such as tamoxifen, aromatase inhibitors, gonadorelin analogues
- opioids
- reactions to blood products (transfusion reaction)
- pain
- fear and anxiety
- low oxygen levels (hypoxia)
- low blood sugar (hypoglycemia)
- high level of the thyroid hormone thyroxine (hyperthyroidism)
- low levels of oestrogen, due to a natural or treatment-related menopause
- low levels of androgen sex hormones, due to surgery or hormone therapy
- alcohol withdrawal
- warm environment.
What can I do to help with sweating?
If the sweating or temperature change is new or has got worse, speak to your GP, district nurse or specialist nurse. They can check whether there are any underlying causes and look at things that may help.
Practical tips to help with sweating and temperature change
These are some tips that may help keep you comfortable:
- Think about the temperature of your environment. Keep rooms cool and ventilated. Adjust to what feels comfortable for you.
- Try using fans, cooling sprays, or regular sponging and washing.
- Keep good personal hygiene to make sure that your skin is kept clean and dry. If you need help with this, ask the people supporting you if they can help.
- Layer clothing and bed clothes so that they can be adjusted easily.
- Drink water and suck on ice, to prevent dehydration.
- Try to reduce your tea and coffee intake because caffeine may make sweating worse. Avoiding alcohol and spicy food may also help.
- Think about your clothing. Some people may feel more comfortable wearing cotton or silk next to the skin. These materials will feel cooler and absorb sweat more than synthetic fabrics. Other people prefer wicking fabrics used for exercise clothes.
- Sit on or lie on a towel to absorb sweat.
- Try relaxation techniques such as yoga and acupuncture.
- Do what feels right for you – the aim is for you to be as comfortable as possible.
What medicines can help with sweating?
If you’re struggling to manage your symptoms, speak to your GP, district nurse or specialist nurse. They can review your medicines and consider changing any that contribute to sweating. They may prescribe some of the following medicines:
- Paracetamol and NSAIDs (non-steroid anti-inflammatory drugs), such as ibuprofen, diclofenac or naproxen can help to treat sweating with a high temperature.
- NSAIDs and steroids can help with neoplastic fever.
- Hormone replacement therapy (HRT) may help symptoms related to hormone levels.
- Antidepressants venlafaxine or amitriptyline, cimetidine, beta-blockers and calcium channel blockers can help with other symptoms.
End of life temperature change
In the final moments of life, a person’s temperature may change a lot as their body is less able to control it. This can cause episodes of both high and low temperature, although overall body temperature will drop as someone begins to die. This is usually associated with clamminess and a change in skin colour.
Who can help?
If you’re worried about sweating and temperature change, speak to your doctor or the healthcare professionals looking after you. They should be able to support you to find the underlying cause and manage your symptoms.
If you’d like to speak to someone about how you’re feeling, contact the Marie Curie Support Line by phone, email or webchat. Call us on 0800 090 2309 or email support@mariecurie.org.uk. If you’d like some practical information, ask to speak to one of our Information and Support Nurses and they can arrange a call back for you.
You might like to chat online with people in a similar situation about symptoms and how they manage them. Our Online Community is a safe space where you can get and give support.
