Steroids are chemicals that are produced by glands in our bodies. They regulate many of our natural functions, from our body temperature and blood pressure to our emotions.
Pharmaceutically produced, synthetic steroids are used for a number of reasons in medicine. Steroids are a key component in the treatment of leukemia, lymphoma and myeloma.
What Steroids are Used in Cancer Therapy?:
When we think of someone “taking steroids,” we often think of muscle-bound pro athletes or weight lifters in skimpy garments, flexing for the camera. These types of steroids are called anabolic-androgenic steroids, and are not typically used in cancer care.
Most often, the steroids used in cancer patients are called corticosteroids. Examples of these types of steroids are:
- Prednisone (Prednisolone)
- Dexamethasone (Decadron)
Why Do I Need Steroids?:
In the treatment of blood and marrow cancers, steroids can serve a number of functions. Some examples include:
- To help prevent an allergic reaction to a blood product transfusion or medication
- Treatment of graft-versus-host disease (GVHD) following stem cell transplant
- As part of your chemotherapy regimen
- To reduce swelling in spinal cord compression of myeloma
- To decrease inflammation
- To help control nausea and vomiting
- To help increase your appetite
- To treat pain
- To treat skin reactions
Side Effects of Steroid Use:
The side effects of steroids tend to be worse when they are taken at higher doses and over long periods of time. Long-term side effects of steroids include:
- Immune suppression and infections
- Weight gain
- Psychosis or mood swings
- Stomach ulcers
- Elevated blood pressure
- Problems sleeping
- Elevated blood sugar (especially important if you are a diabetic)
- Osteoporosis (brittle bones)
- Swollen hands or feet
Taking your medication with food can help with some of the problems that steroids can cause to your digestive tract. You may also choose to take these types of medications early on in the day so that they are less likely to impact your sleep at night.
As with many medication side effects, your specialist, nurse, or pharmacist can often provide you with strategies to help control or minimize them. Keep them informed of any concerns you experience.
Impact of Steroids on Mood:
Many of us have heard the expression "'roid rage". It is often used to describe angry behaviors and outbursts of individuals who take anabolic steroids, but corticosteroids can also have serious effects on mood as well.
These reactions can range from irritability, restlessness, and anger all the way to paranoia, confusion, and mania. Conversely, it is not uncommon to have a low mood or even depression after you stop taking them.
Sometimes it can be difficult to determine the source of these feelings. Yes, you are on steroids, but you are also getting treated for cancer and trying to carry on a somewhat normal life -- no kidding you are more emotional than usual! Cut yourself a little slack.
But if your mood changes are impacting your quality of life or relationships, speak to your healthcare team about it. If these feelings are severe, you may need to seek immediate assistance.
Important Points About Taking Steroids:
As with most cancer treatment medications, it is very important to take steroids exactly as your doctor describes. Here are some good questions to ask your healthcare team about your steroids before you start:
- How long will I be expected to take this medication?
- Who can I contact if I have a serious reaction to this medication?
- What if I miss a dose?
- What if I vomit up my medication?
Taking steroid medications has an impact on how much natural steroid your body produces. For this reason, when your steroids are no longer needed as part of your therapy, your doctor will often taper the dose off instead of stopping them abruptly. It is extremely important that you do not stop taking this medication unless you are told to by your doctor. Stopping these drugs suddenly can have very serious consequences.
Summing it Up:
Steroids are the unsung heroes of cancer care. While chemo and radiation get all the accolades for killing cancer, steroids work quietly behind the scenes, preventing and minimizing complications and even making other therapies work better. They play a big role in the treatment of blood and marrow cancers.
However, these drugs do have a number of side effects that you should be on the lookout for. As with any adverse effect, keep your healthcare team in the loop with anything that you are experiencing or that you are concerned about.
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