Understanding Steroid Treatment
Steroids are often used to reduce the buildup of fluids around a tumor (edema) sometimes caused by the brain tumor or other treatments. Steroids are naturally occurring hormones. The steroids given to brain tumor patients are corticosteroids, hormones produced by small glands near the kidneys called the adrenal glands. They are not the same as anabolic steroids used by athletes to build muscle.
Steroids can temporarily relieve brain tumor symptoms (eg, edema), improve neurological symptoms, promote a feeling of well being, and increase appetite. Although the purpose of steroids is to reduce swelling, not the size of the tumor itself, they do have a toxic effect on certain tumor cells, particularly primary central nervous system lymphoma (PCNSL).
Steroids may be prescribed before, during, or after surgery. They may be started when the tumor is diagnosed if edema is seen on a magnetic resonance image (MRI) scan, or if swelling is causing pressure on the brain. Steroids may also be used to treat edema caused by radiation therapy.
For people with recurrent or metastatic brain tumors (caused by the spread of cancer from elsewhere in the body), steroids can help improve quality of life by reducing symptoms. When used in this way, steroids may increase the patient’s level of alertness, ability to be mobile, and/or ability to communicate and interact with others.
Although they can be given through an intravenous (IV) line or by injection into a muscle (IM), most people with a brain tumor take their steroids by mouth. The dose may need to be increased or decreased based on how the patient reacts to treatment. The doctor may recommend that the steroids be taken with food or milk to protect the stomach. The doctor may also prescribe a daily antacid. The patient will also be given instructions to slowly stop, or “taper” the drug when the doctor feels it is no longer needed.
Potiential Side Effects
Because steroids are hormones, patients who use them for long periods of time must be carefully monitored. The most common side effects are: weight gain; thinning of the skin; upset stomach; muscle weakness in the thighs, shoulders, and neck; “masking” or hiding a fever; mood swings; insomnia; pneumonia; and increased blood sugar levels (especially in patients with diabetes). Steroids can also interact with some seizure medications, either raising or lowering the seizure medicine levels in the blood, which can affect their effectiveness. Your doctor can explain other side effects that may occur with steroid use.
If you are using steroids, be sure to contact your doctor if you:
- Run a temperature—even if no other symptoms are present.
- Have blood in your bowel movements.
- Have stomach pain.
- Gain more than 5 pounds in one week.
- Develop a rash.
- Are very thirsty and/or are urinating a lot.
- Stumble or fall.
- Have chest pains or difficulty breathing, which may signal a medical emergency.
Find out more about resources and support available to patients with brain tumors and their loved ones.
It is important to note that the information provided here is basic and does not take the place of professional advice. If you have any questions about how brain tumors are treated, please contact your doctor.