Chemotherapy is a systemic treatment designed to eliminate rapidly dividing cancer cells, but it also affects many healthy cells, leading to various side effects. Feeling cold, or experiencing cold sensitivity, is a very common experience during treatment. The reasons for this sensation are varied, ranging from simple fatigue and metabolic changes to more serious underlying medical conditions. Understanding the specific cause of the cold sensation is paramount for proper management and safety during therapy.
Chemotherapy and Generalized Temperature Dysregulation
Chemotherapy treatments can disrupt the body’s internal thermostat, which is located in the hypothalamus. This disruption can cause a generalized feeling of coldness regardless of the ambient temperature. The systemic stress placed on the body often results in significant fatigue and a slowdown of the basal metabolic rate.
A lower metabolic rate means the body generates less internal heat, contributing to a sustained chill even in a warm environment. Some chemotherapy agents can also induce inflammation, which alters temperature-regulating signals. This systemic impact can leave a patient feeling perpetually cold and unable to warm up easily.
Chills as a Critical Sign of Infection
A sudden onset of severe chills, sometimes accompanied by uncontrollable shaking known as rigors, can signal a serious medical emergency, especially when paired with a fever. This combination is a classic symptom of febrile neutropenia, an infection that occurs when the body’s primary defense mechanism is compromised. Neutropenia is a condition where the number of neutrophils, a specific type of infection-fighting white blood cell, drops dangerously low.
Chemotherapy suppresses bone marrow function, where neutrophils are produced. Because the immune system cannot mount a typical inflammatory response, a fever is often the only initial sign of a life-threatening infection. Healthcare providers define a fever in this context as a single oral temperature of 100.4°F (38.0°C) or greater.
Experiencing chills along with this temperature requires immediate contact with the oncology care team, as it is considered an oncologic emergency. Urgent medical attention is necessary, often involving a trip to the hospital for immediate intravenous antibiotics. This response prevents the infection from rapidly progressing to sepsis, even if the patient feels well otherwise.
Specific Medical Conditions Causing Cold Sensations
Beyond systemic dysregulation, two common side effects of chemotherapy can directly cause cold sensations: anemia and chemotherapy-induced peripheral neuropathy (CIPN). Anemia involves a decrease in red blood cells or a reduced ability to transport oxygen throughout the body. Red blood cells carry oxygen, which is necessary for cellular metabolism and heat generation.
When oxygen delivery is impaired, the body’s tissues, particularly the extremities, receive less oxygen and feel cold. This generalized coldness from anemia is a continuous sensation. Conversely, CIPN is nerve damage caused by specific chemotherapy agents, such as oxaliplatin.
CIPN can make the hands, feet, and throat abnormally sensitive to cold temperatures. This nerve damage causes a hypersensitivity known as cold dysesthesia. Exposure to cold air, objects, or beverages causes an unpleasant or painful sensation because the chemotherapy irritates the sensory nerve endings.
Managing Coldness and When to Contact the Care Team
For the generalized feeling of coldness caused by metabolic changes or mild anemia, several practical strategies can help increase comfort. However, it is paramount to distinguish between this manageable coldness and the urgent signs of infection.
Managing Generalized Coldness and CIPN
Layering clothing is highly effective, as it traps insulating air and allows for quick adjustments to temperature changes. Drinking warm liquids, such as broth or herbal tea, can help raise the core body temperature internally. Gentle movement, such as walking, can also improve circulation and generate internal heat.
For those experiencing CIPN, completely avoiding cold exposure is the most effective management technique. This means using gloves, wearing warm socks, and avoiding ice water or iced foods. For persistent coldness related to anemia or neuropathy, a discussion with the doctor can lead to specific medical interventions.
When to Contact the Care Team
Any time a cold sensation is accompanied by a temperature of 100.4°F (38.0°C) or higher, or if the chills are severe and involve rigors, the patient must contact their oncology team immediately. Do not take fever-reducing medication until speaking with the care team. Taking medication can mask the severity of the fever, delaying necessary urgent treatment.