Ask the expert
Steroids in cancer treatment
Question
How and why are steroids used in the treatment of cancer?
Answer
Steroids are very helpful drugs in the treatment of cancer and have specific uses in different settings. When we talk about steroids in this context we are referring to ‘corticosteroids’, which are a type of steroid our body naturally produces. In normal circumstances our bodies produce these steroids to aid in the stress response, to aid in the immune response and to help regulate inflammation and the metabolism of carbohydrate and protein.
These wide-ranging effects may be useful to patients at varying stages of their cancer treatment.
One of the commonest uses of steroids in cancer treatment is as an anti-sickness medication for patients undergoing chemotherapy. As well as reducing nausea the steroid will often help the patient’s appetite while undergoing chemotherapy.
Steroids are sometimes used as anti-cancer drugs themselves as part of the chemotherapy regimen in the treatment of lymphomas and leukaemias. This is because steroids regulate the immune system and may stop cancer cells that have formed in the immune system from growing.
Patients with either primary or secondary brain tumours often benefit from steroids to reduce the inflammation and swelling around the tumours. This usually reduces the headache, nausea and drowsiness that may be caused by this swelling.
Steroids may be very useful for patients with advanced cancer of all types, particularly where appetite loss and weight loss are a concern. In this situation small doses of steroids may improve the patient’s appetite and general sense of well-being via their so-called ‘feel-good’ factor.
Steroids do have side effects however and it is important to talk through potential side effects with your doctor before starting steroid treatment.
Some of the commoner side effects that may occur are:
- Weight gain, often noticeable around the face
- Fluid retention
- Indigestion and heartburn and occasionally stomach ulcers
- Susceptibility to some types of infections
- Easy bruising
- Muscle weakness and wasting
In addition steroids may increase some patient’s blood sugar levels and this is particularly important in diabetic patients or patients with a strong family history of diabetes. If you are diabetic it is important to monitor your blood sugar levels closely while taking steroids, as it may be necessary to alter your diabetic medication. You should talk this over with your doctor. If a patient is likely to be taking steroids for a long period of time, the doctor or pharmacist should issue a ‘steroid card’ to be carried on the patient at all times. This is because in the event of an emergency it is important for the attending healthcare professionals to know that a patient is taking steroids.
Source: Nutrition in cancer Editorial Board
