Steroids and Cancer Treatment

What Are Steroids?

The word steroid might make you think of "roid rage" or side effects in athletes, weightlifters, and bodybuilders who use them. But if your doctor prescribed a steroid as part of your cancer treatment, don't worry. It's not "that" kind of steroid. It's an important cancer medicine.

Steroids are chemicals made normally by the body. Other steroids are manmade medicines. Both have many different jobs and help organs work properly. The most common steroids used include:

• hydrocortisone
• prednisone
• methylprednisolone
• dexamethasone

How Do Steroids Work?

Steroids can reduce (irritation and swelling) in the body. Sometimes they lower the body's ability to fight infection.

Steroids can help with cancer treatment in a variety of ways. They can:

• kill cancer cells and shrink tumors as part of chemotherapy
• decrease swelling
• reduce allergic reactions (before transfusions, for example)
• reduce nausea from chemotherapy and radiation 
• help headaches or other symptoms caused by brain tumors

What Are the Side Effects of Steroids?

Steroids used in medical treatments can have some side effects. Talk to your doctor and ask questions if you have concerns.

You may not have any side effects. But if they do happen, they'll only last as long as you take the steroids. When treatment stops, things will return to normal pretty quickly.

Some of the more common side effects of steroid treatments include:

• increased appetite
• weight gain, often in unexpected places such as the cheeks or the back of the neck
• mood swings
• trouble sleeping
• stomach upset or ulcers
• osteoporosis (weaker bones)
• higher blood pressure
• higher blood sugar than normal. Sometimes, people develop diabetes temporarily. If you already have diabetes, you'll need to do careful blood sugar level checks.
• for girls, missed or late periods
• bruising/stretch marks

Less common side effects include trouble fighting infections, acne flare-ups, and increased facial hair.

How Do People Take Steroids?

Doctors can prescribe steroids for cancer treatment in several ways:

• by an injection into the muscle (IM)
• through a vein (IV)
• by mouth (orally) as a liquid or pill
• as a cream applied to the skin

The doctors will give you all the details, but there are some things to remember when you take steroids by mouth for cancer treatment. Steroids, both the liquid and the pill form, have a bitter somewhat unpleasant taste.

To make sure you don't miss any doses:

• Mix the liquid steroid in a small amount of a tasty liquid, like your favorite juice.
• You can add a few drops of flavoring, like chocolate syrup or peppermint, to the spoon of medicine.
• Steroid pills are quite small and mixing them in applesauce or pudding can make them easier to take.

What Else Should I Know About Steroids?

Steroids can irritate the stomach. To protect it, you should take them with food in your stomach. The doctor might recommend stomach medicines, either prescribed or over the counter (such as Zantac, Pepcid, or Prilosec). It might help to start taking these medicines a couple of days before the steroids begin and continue taking them for a few days after the steroids are done.

Don't stop the steroids without your doctor's advice. If you notice anything strange while you take the steroids, tell the doctor right away. Sometimes, steroid medicine is decreased slowly over time (described as being weaned or tapered). Other times doctors may just stop the steroids. If this happens, your body could go through a type of withdrawal if it's placed under a stressful situation like a new fever or infection.

You might have a steroid card or medical alert bracelet. A lot of steroid treatments happen in a doctor's office or clinic. But some teens on long-term steroid treatment take pills at home, and might have a steroid card or wear a medical alert bracelet. You should keep this card on hand or wear the medical alert bracelet at all times. If there's an emergency, the card or bracelet will let doctors know about the steroids, which can change the treatment they give you.