Corticosteroids: Steroids in Cancer Treatment

The steroids used in cancer treatment are actually part of a class called corticosteroids.

Adrenal glands in our bodies naturally make corticosteroids, and in our bodies they have several functions:

• Regulating metabolism
• Regulating sodium levels
• Regulating blood pressure
• Controlling inflammation
• Affecting mood and behavior
• Reducing allergies

Steroids in Cancer Treatment

There are three primary man-made steroids used in cancer treatment:

1. Prednisolone
2. Methylprednisolone
3. Dexamethasone

Steroid Purpose in Cancer Treatment

Oncologists prescribe steroids for some cancer patients for a variety of reasons. One of the most common places to find steroids is in the R-CHOP combination chemotherapy regimen, in which the "P" represents prednisolone.

However, steroids also help to reduce the inflammation in the tissues created by some tumors. Steroids can also help treat nausea or vomiting as a result of chemotherapy treatment, and steroids can help to boost a patient's appetite, which is crucial when one is receiving anti-cancer treatments.

Finally, steroids are used to suppress the immune system following a stem cell transplantation. In that case, the patient may be on steroids for weeks or months at a time. Otherwise, cancer patients don't tend to spend too much time on any steroid.

In the event that a patient is kept on a steroid for an extended period of time, he or she will likely need to work with his or her health care team to be weaned slowly off steroids, since coming off them can lead to extremely unpleasant withdrawal symptoms.

When cancer patients are taking steroids, they need to be careful about staying a safe distance away from people who are ill with a contagious infection. On top of that, steroids mean that the patient cannot receive a live vaccine. Both of these issues are a consequence of the way steroids lower the immune system response and make the patient vulnerable to infections.

Steroid Side Effects in Cancer Treatment

Not all patients on steroids will experience side effects, and those that do generally do so because they were on the medications for longer than a few weeks.

The most commonly reported side effects include:

• Heartburn
• Weight gain
• Infections
• Sleep disruption
• Swollen extremities (due to water retention)
• Mood changes
• Behavioral changes

Conditions like prednisone psychosis or steroid psychosis can also occur. These are interchangeable terms that refer to a rather rare development among patients on high doses of these steroids who begin to display symptoms of psychosis, including anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, agitation, hallucinations, intermittent memory impairment, disturbances in body image, delusions, apathy and hypomania. Fortunately, this is a treatable condition and not likely to cause any long-term problems.

Photo: Pexels