Corticosteroids (glucocorticoids) for cancer and cancer pain

Examples

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Brand Name	Generic Name
Dexamethasone Intensol	dexamethasone

Brand Name	Generic Name
Hydrocortone	hydrocortisone

Brand Name	Generic Name
Medrol	methylprednisolone

Brand Name	Generic Name
Prelone	prednisolone

Brand Name	Generic Name
Prelone	prednisone

How It Works

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Corticosteroids are strong anti-inflammatory drugs. They are used to reduce swelling that causes cancer pain.

Corticosteroids are available as pills, syrups, injections, and intravenous (IV) solutions. The type and extent of a disease determines the exact dose and schedule of administering these drugs.

Why It Is Used

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Corticosteroids reduce swelling (inflammation) that causes cancer pain. They are used with other drugs, such as ondansetron and aprepitant, to control and prevent nausea and vomiting caused by chemotherapy.

How Well It Works

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Corticosteroids work well to reduce swelling and pain caused by cancer.¹ When they are used with other drugs, such as ondansetron and aprepitant, they may control and prevent nausea and vomiting caused by chemotherapy.²

Side Effects

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Side effects are common with steroids and can include:

• Nausea, vomiting, stomach upset, or ulcers. To reduce these side effects, take your pills with a full glass of fluid and a small snack.
• Fluid retention, causing swelling of the hands and feet.
• Increased appetite.
• Increased risk of infection.
• Preexisting diabetes getting worse.
• Menstrual period changes.
• Changes in behavior, such as symptoms of paranoia or psychosis.
• Muscle wasting. You may notice that it is difficult to climb stairs or rise from sitting to standing without assistance.

Some problems may occur with long-term use. These include:

• Osteoporosis.
• Cataract formation.
• High blood pressure.
• Development of diabetes.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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During treatment with corticosteroids, do not take any other prescription or nonprescription medicines, including herbal products, without first talking to your doctor. Many other drugs can interact with corticosteroids, resulting in side effects or changes in how well the drugs work.

Do not stop taking corticosteroids suddenly. Withdrawal effects can occur, so it is very important to take the prescribed dose at the times recommended by your doctor. You will be given instructions on how to reduce (taper) your dose gradually at the end of your treatment. Have your doctor write these instructions out for you. If you have any questions about how to taper your dose, call your doctor. Tapering is usually only necessary if you use corticosteroids for a long time. It may not be necessary if you use the steroids only for short periods.

Dexamethasone, if given too rapidly by IV, may cause temporary itching or burning in the vaginal or rectal area. This goes away after a few minutes.

To minimize side effects of oral corticosteroids, take your pills with a full glass of liquid and a small snack.

Corticosteroids should be used during pregnancy only if the benefits to the mother outweigh the risks to the fetus. If you are or may be pregnant, talk to your doctor before using corticosteroids. This drug can pass through your body into breast milk and should not be used while you are breast-feeding.

Avoid sources of infection. Wash your hands frequently, and keep them away from your mouth and eyes. Your immune system may be weakened while you are taking corticosteroids.

Steroids used to treat cancer and cancer pain are not the same as steroids used by body builders (anabolic steroids).

Do not use alcohol or street drugs while you are taking corticosteroids. Tell your doctor if you need more pain relief.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Foley KM (2005). Management of cancer pain. In VT DeVita Jr et al., eds., Cancer: Principles and Practice of Oncology, 7th ed., pp. 2615–2649. Philadelphia: Lippincott Williams and Wilkins.

2. Kris MG, et al. (2006). American Society of Clinical Oncology guideline for antiemetics in oncology: Update 2006. Journal of Clinical Oncology, 24(18): 2932–2937.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer	Michael Seth Rabin, MD - Medical Oncology
Last Updated	October 30, 2007