Steroids and Cancer

Steroids are substances that you make naturally in your body. They can be replicated in the lab to help treat certain side effects or symptoms, or to increase the effectiveness of certain chemotherapy drugs. Steroids play important roles in several different mechanisms throughout the body, including fight and flight (stress) and immune responses.

People will often think of a muscled, Arnold-Schwarzenegger-type figure when hearing the term ‘steroids’. And you’d be right, the controversial medication that bodybuilders use to increase muscle mass is a type of steroid, but they are called anabolic steroids. Due to their side-effects and the legal issues associated with these types of steroids, it’s unlikely you will be prescribed them. The steroids used for cancer treatment, on the other hand, are called corticosteroids. Common steroids prescribed for cancer patients are:

• Dexamethasone

• Prednisolone

• Hydrocortisone

• Methylprednisolone

Why would I be prescribed steroids with cancer?

Corticosteroids, or just steroids, can be prescribed for a wide-range of conditions. Steroids help reduce inflammation and are a great sidekick to some chemotherapy regimes.

Steroids can be prescribed to cancer patients for the following reasons:

• As treatment for some bone marrow cancers
• Increase efficacy of some chemotherapy agents
• Reduce nausea and vomiting caused by chemo
• Decrease risk of allergic reactions to chemo
• Stimulate appetite
• Reduce pain associated caused by inflammation

“Taking steroids in the morning rather than before bed can reduce insomnia and the feeling of being jittery at night-time.”

Common steroid side effects

Steroids prescribed during cancer treatment are usually prescribed for a period of time. You may start experiencing symptoms relating to steroids but may not have been told about them. Steroids can cause the following side effects:

• Mood changes (anxiousness/feeling jittery)
• Insomnia
• Increased appetite
• Stomach cramps
• Acne and thinning of the skin
• Weight gain
• Fluid retention
• Steroid induced diabetes

Many of these side effects are manageable and can be lessened if known about beforehand. For example, taking steroids in the morning rather than before bed can reduce insomnia and the feeling of being jittery at night-time.

People that have stomach ulcers or acid reflux may experience stomach cramps or find their ulcers worsening once on steroids. Medications such as proton pump inhibitors can be prescribed to help reduce acidity and the stomach issues caused by steroids.

Steroids and weight gain

There is an opinion that cancer patients undergoing chemotherapy or other treatments will lose weight, and for many this can be true. But with the current advances in anti-nausea medications and steroids themselves, people often find themselves putting on weight.

Weight gain for some people can be distressing; it can lead to low self-esteem and confidence. For many, they are not told that they may experience weight gain, but nutrition advice revolves around eating when feeling up to it. Keeping up your nutrition during cancer treatment is pivotal to maintaining energy levels, and alleviating fatigue, improving mood and sleep patterns. But if you do find you’re struggling between the two and resulting in unwanted weight gain, ask to speak to a nutritionist who will be able to provide you with some tips to finding a balance.

Steroids can also cause you to retain water. Fluid retention can make you look puffy in your face. The so-called “moon face” look should subside once your reduce or finish using steroids.

Is there anything else I should look out for while taking steroids?

Steroids can result in lowering your immunity and increasing your risk to infection. It is important that when undergoing cancer treatment that includes steroids, you seek advice immediately if you become unwell or start developing fever-like symptoms. You may feel silly, or over-concerned, but your doctor and nurse would prefer you to be over-cautious and come in immediately at the first sign of infection and be treated properly.

If you are diabetic and taking steroids, it is important to monitor your sugar levels and liaise with their GP or diabetic nurse specialist for advice. Steroids can also induce diabetes in some people. Although a rare side effect, if not picked up quickly can be dangerous for your health. Your nurse will be checking your blood sugar levels regularly (the test is a small finger prick), but contact your doctor immediately if you experience the following symptoms:  

• Urinating frequently (more than usual)
• Constant thirst
• Increased fatigue

Alleviating the side effects of steroids and cancer treatment

The following products can all help ease the side effects associated with steroids:

Steroids and Skin Issues

Steroids can cause acne or lead to thinning of the skin; causing it to be more delicate than usual. The Defiant Beauty Smooth Skin Balm contains St. John’s Wort (St john wort should not be used in any form if you are taking antidepressants) and calendula, which helps with skin rejuvenation as well as keeps skin smooth and hydrated.

Steroids and Appetite

Steroids can cause stimulate your appetite, causing you unwanted weight gain. Choosing healthy snacks can keep your energy levels up without leading too much weight gain. 

Steroids and Stress / Anxiety

Steroids can cause mood changes in some people. These changes in mood can present as anxiety and increased stress levels. During these bouts, it can be difficult to calm the mind and focus on the present. The Cancer Survivors' Companion is a reassuring book that acknowledges the emotions that occur during a cancer diagnosis and provides tips and support to get you through them.

Steroids and Difficulty Sleeping