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Emergencies & Red Flags

Chemotherapy Emergencies: — The Complete Warning-Sign Guide

On chemotherapy, some symptoms need the emergency department immediately, some need a same-day call, and some can wait. Knowing the difference can save your life.

Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026

  • Fever is never trivial — Fever with shaking chills is the most urgent emergency on any chemotherapy regimen — go immediately, do not call first.
  • Three tiers of urgency — Go now. Call today. Wait for your appointment. This page puts every common symptom into one of those three tiers.
  • When in doubt, call — An unnecessary call costs nothing. Missing a serious sign can cost everything.
  • Waiting overnight is the risk — Infection and bleeding can worsen within hours on chemotherapy. Same-day contact is always the safer choice.
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On chemotherapy, some symptoms are genuine emergencies that need the hospital now, some need a same-day call, and some can wait for your next appointment. Fever with shaking chills, difficulty breathing and heavy bleeding always mean go now. For everything else, this page shows you how to judge the urgency.

If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.

Call your oncology team today if you have any of these

  • You have any temperature, even mild, without shaking chills
  • You cannot keep fluids down for more than a few hours
  • You see blood in your urine or stool, even a small amount
  • New numbness or tingling in your hands or feet is getting worse
  • A new rash has appeared on your skin, in your mouth, or on your lips
  • You have unusual bruising, or pinpoint red dots under the skin
  • You feel too weak or unsteady to stand or walk safely

If you are worried right now, call

Our helpline is answered by clinical staff. If a symptom is on the list above, do not wait for a callback — call, or go to your nearest emergency department.

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Dr. Naresh Gundu
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Dr. Naresh Gundu

MBBS, DNB (Internal Medicine), DM (Medical Oncology)

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Medical Oncologist

Dr. C. Raghavendra Reddy

MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)

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Medical Oncologist

Dr. Bharati Devi Gorantla

MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)

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Medical Oncologist

Dr. Owais Mohammed

MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)

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Medical Oncologist

Dr. T. Raghavender Reddy

MBBS, DM (Medical Oncology), MD (Radiation Oncology)

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Medical Oncologist

Dr. N. Kiranmayee

MBBS, DM (Medical Oncology), MD (Internal Medicine)

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Dr. Muralidhar Muddusetty

MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)

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Dr. Raghavendra Naik
Surgical Oncologist

Dr. Raghavendra Naik

MBBS, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Mohammed  Imaduddin
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Dr. Mohammed Imaduddin

M.B.B.S, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Vinay Mamidala
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Dr. Vinay Mamidala

MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)

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Dr. Paila Gowri Naidu

MBBS, MS (General Surgery), M.Ch (Surgical Oncology), FMAS

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Radiation Oncologist

Dr. Venkata Sushma P

MBBS, MD (Radiation Oncology)

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Dr. Mohammed Imran

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Dr. Vajja Sandeep Kumar

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Dr. Sridhar Kamani

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Not sure whether this counts as an emergency?

Call the helpline. It is always better to check than to wait.

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Which symptoms can wait until your next appointment?

Mild nausea that your prescribed anti-emetics are controlling, expected hair loss, and predictable tiredness after a treatment cycle do not need a same-day call.

If any symptom is new, worsening, or worrying you, call. Your team cannot act on what they do not know, and an unnecessary call is never a problem.

System by system: where does your symptom belong?

SystemGo to emergency nowCall your team todayCan wait for appointment
Fever / infectionFever with shaking chills or rigorsAny temperature, even mild, without rigorsNone — all fever needs contact
BleedingBleeding not stopping; blood coughed upPink urine; blood in stool; unusual bruisingMinor bruising, not spreading
BreathingDifficulty breathing; chest pain at restBreathlessness clearly worse than yesterdayMild breathlessness, stable for days
GutSevere abdominal pain; cannot keep any fluid downPersistent vomiting; unable to keep fluids down for hoursMild nausea, controlled by prescribed medicine
Nervous systemSudden confusion; new weakness one side; severe headacheNumbness or tingling in hands or feet, worseningMild tingling, unchanged for days
Skin / allergySwelling of face or throat; hives rapidly spreadingNew rash anywhere; blistering in mouthMild dryness or itching, pre-existing
Typically startsAny point — including between cyclesAny point in the treatment cyclePredictable timing after each cycle

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Common questions

Frequently asked questions

What is febrile neutropenia and why is it the most dangerous emergency on chemotherapy?

Febrile neutropenia is fever combined with a very low white blood cell count, leaving your body almost unable to fight infection. An infection that a healthy immune system would contain can spread to the bloodstream within hours. This is why fever with shaking chills means go to the emergency department immediately — not call first, not wait until morning. Your oncology team may have given you a card with your personal threshold for acting; keep it with you.

How do I know if my temperature counts as a fever on chemotherapy?

Your oncology team will give you a specific threshold — it is usually lower than what most people think of as a fever. Write it down and keep it somewhere visible. Buy a thermometer before your first cycle if you do not have one. If you feel hot or are shaking and cannot take your temperature, treat it as a fever and go to the emergency department without waiting.

I have more than one of these symptoms. Should I call my team or go straight to emergency?

If any go-now symptom is present — fever with rigors, difficulty breathing, bleeding that will not stop, or confusion — go to the emergency department without calling first. A phone call adds delay when minutes matter. If all your symptoms are in the call-today tier, call and describe them together. When you are unsure which tier applies, go to emergency.

Will going to the emergency department delay my chemotherapy?

Possibly, but that is a secondary concern. An untreated infection or bleed can end your treatment course entirely. Emergency doctors contact your oncology team directly, and the assessment helps your oncologist decide about your next cycle. Going in when you need to protects your treatment — it does not threaten it.

Full index

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Blood Counts, Infection, Fever & Emergencies73

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