What are steroids?

Steroids are medicines used to reduce swelling (inflammation) in the body. Swelling is the body’s response to injury, which can sometimes cause unwanted symptoms depending on the affected area. Steroids help to reduce the swelling and reduce these symptoms.

Why are steroids part of my cancer treatment?

If you have chemotherapy and radiation therapy to treat your cancer, you may have side effects.

These side effects include:

• Decrease in your appetite
• Pain
• Feeling like you will throw up (nausea)
• Throwing up (vomiting)
• Headaches
• Shortness of breath

You may get steroids to manage these side effects. Steroids can also be used to treat symptoms caused by brain tumors. If your cancer spreads to the brain (called “brain metastases”), steroids can treat your brain swelling.

Brain cancers can cause increased pressure inside the brain. The increased pressure can cause headaches, nausea, or vomiting. Steroids can be used for brain cancer to reduce this pressure.

How do I take my steroids?

You can take your steroids in two ways:

• Orally (by mouth). Oral steroids are pills or capsules that you swallow. If you cannot take oral steroids you might get intravenous (IV) steroids.
• Intravenous (IV). IV steroids are given to you through a thin tube into a vein in your arm.

What are the side effects of steroids?

Common side effects of steroids include:

• Increased blood sugar. Steroids can cause diabetes known as “steroid diabetes.” If you already have diabetes, steroids may worsen your diabetes. Signs of diabetes are:
  • Peeing more than usual.
  • Being more thirsty than usual.
• Swelling in the face and legs caused by excess fluid (edema).
• Burning in chest or throat after eating (heartburn).
• Sores (ulcers) in your stomach.
• Severe hip pain (steroids can damage the hip bone and cause pain).
• Arm and leg muscles become smaller (muscle wasting).
• Increased chance of getting the flu (reduced immunity).
• New white spots in your mouth (oral thrush).
• Lack of sleep (insomnia).
• Increased irritability and worry.

Other side effects of taking steroids include:

How to prevent side effects caused by steroids?

If you have any side effects, you should tell your doctor right away. Your doctor may use other medicines to treat the side effects. Your doctor may also lower the steroid dose to reduce side effects.

Before taking steroids, talk to your doctor about:

• How to manage pre-existing conditions (a health problem you had before cancer). For example, you should have your blood sugars checked by your doctor. If you have diabetes your doctor may suggest you check your blood sugars more often.
• Medicine to protect your stomach from ulcers and heart burn. Your doctor will give you medicine that lowers your stomach acid levels.
• Medicine to control your blood sugar.
• Using the lowest dose of steroid for the shortest amount of time. If you are on steroids for more than a week, your doctor will taper your steroids. Tapering steroids means your doctor will slowly lower the level of steroids you are on over time until it is safe to stop.
• When you are on steroids for more than a week, you cannot safely stop taking them all at once. This is why your doctor will lower the amount of steroid you are taking a little bit at a time. Your doctor will set up a “steroid tapering schedule.”
• To taper your steroids, your doctor will lower your dose by half every five days. This will continue until you reach 2 mg of steroids. After you are on 2 mg of steroids every day for a safe period of time, you will take 2 mg of steroids every Monday, Wednesday and Friday. Once your doctor says it is safe, then you can stop taking your steroids.

Example of a steroid tapering schedule

Below is an example of a steroid tapering schedule.

Starting dose: 16 mg