My husband had a large tumour ( and his large bowel) removed and was resected in April. Secondary multiple liver mets. He started chemo in June. ( oxy + xeloda ) we've not been told much except " sorry " Problem now - apparently liver tests doubled but considered normal when chemo starts, until cycle 4-5 . Then told they usually come down. He is now having very bad nights. He said. Pain is waking him which is in the liver area. His temperature is up and down like a yo-yo ranging from 36-38.2 on a regular basis. He's sweating a fair bit, but isn't s itchy skinned as he was before he was diagnosed. ( I was quite shocked that itchiness was a symptom of a liver problem). I've asked to speak to his oncologist but have been refused. And my husband isn't asking questions, he's doing his usual thing of " if I ignore it, it'll go away" but expects me to have answers when he asks me questions.. I'm stumped! I really am. I've read lots online, in books, etc, but still I don't seem able to find answers. My questions are :- Is aching/pain in liver area that keeps him from having a decent nights sleep a symptom of chemo, or that his condition is worsening? He also seems very confused/distant. Forgetful. Is that normal on chemo? Or something else to be worried about? Yucky bit now, his bowels have been fairly loose since his op, but we're of normal colour, I've noticed recently they're grey/ very pale.. Finally, what questions would it be prudent to ask? When I am with him at appointments? He starts his third cycle this coming Wednesday , during the last two he's needed transfusions because of low blood count/breathlessness . We've been told they don't like doing regular transfusions as it can stop the bone marrow working ( this bit I understand) but, what happens if the bone marrow does stop? It's all getting scary, and I'm trying NOT to dwell on it and give him as much love and attention as I can Any thoughts, or replies appreciated.

There's quite a range of questions here.

First, a swinging temperature in someone on chemotherapy should be treated as a medical emergency. You should have been advised who to contact if this happens. If not, then consider going to A&E, telling them that it's a chemotherapy issue. Unless they have a good reason otherwise, current 'Acute Oncology' protocols would require intravenous antibiotics for presumed infection.

Itchyness and jaundice sort of go together, but jaundice requires a major/total blockage of bile drainage, whereas itchyness can come from only a partial blockage with the bile getting out by unblocked routes.

The aching pain may be due to liver swelling, with the pain coming from the capsule around the liver. There are several possibilities. One is infection. Another is that the tumours are swelling because they are being killed off by the chemo. Another is that the tumours are just growing. Only a proper check can sort this out.

Being confused/distant could be a liver problem. But it could be a lack of sleep due to the pain.

What you are up against is that almost everything has several explanations. And, we are all programmed to think the worst is most likely. Hopefully that isn't the case, and you can get some of this sorted out soon.

Hi mark and thanks again for replying, When his temperature has gone up, I've always been told to text his bupa chemo nurse which I've done religiously, she's texted back, " take again in 15 mins" which I've done sometimes it comes down sometimes doesn't, but she seems to think its ok, ( I don't agree with this but what can I do?) ? A few weeks back after infusion his temp dropped rapidly to 34.4 again I texted again given same instruction and told not to worry too much. It IS worrying! I feel in the dark fumbling around, and his sudden weight loss is worrying me too. Almost a stone in little over a week, no appetite and very tired. His chemo nurse visits tomorrow to take bloods at 8 am. I think I need to ask a few questions to put my mind at rest. I'd hate to be doing the wrong thing for him and risking more health problems Thanks again for your reply mark Laine x

I hate to challenge your nurse advisor, but the protocols I have seen for Acute Oncology, and I have been part of a review team for just such a service, say that a raised temperature during or within a short time of chemotherapy requires urgent medical assessment. Unless it can be excluded, then sepsis has to be assumed, with immediate antibiotic treatment.

By all means show this comment to your chemo nurse, and ask if there is a reason why s/he does not agree.