Steroids

Steroids are substances that are naturally produced in the body. They help to control many of the different ways our bodies work. They regulate:

• the way the body uses fats, proteins and carbohydrates
• the immune system
• the balance of salt and water in our bodies
• inflammation.

Steroids can also be made in a laboratory as drugs. They can be used in cancer treatment: 

• to help destroy cancer cells and make other cancer treatments more effective
• to prevent or treat an allergic reaction 
• as anti-sickness drugs
• to improve appetite
• to reduce cancer symptoms, such as pain caused by swelling (inflammation) around a tumour
• to treat inflammation caused by cancer treatment.

The most commonly used steroids are:

• hydrocortisone
• dexamethasone
• methylprednisolone 
• prednisolone.

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

We explain the most common side effects of this treatment here. We also include some that are less common. 

You may get some of the side effects we mention, but you are unlikely to get all of them. And you may have some side effects, including rarer ones, that we have not listed here. 

Other cancer treatments may cause different side effects. If you are also having other cancer treatment, you may have other side effects.

Always tell your doctor, nurse or pharmacist about any side effects you have. They can give you: 

• drugs to help control some side effects 
• advice about managing side effects. 

It is important to take any drugs exactly as explained. This means they will be more likely to work for you.

Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Steroids can irritate the stomach lining. If you have indigestion or pain in your tummy, let your nurse or doctor know. They can prescribe drugs to help reduce stomach irritation.

To help protect your stomach, you should take your tablets with food. Some steroid tablets are coated to help reduce irritation.

Steroids can raise your blood sugar levels. Your nurse will check your blood regularly for this. They may also test your urine for sugar. If you have a raised blood sugar level, you may: 

• feel thirsty
• need to pass urine more often 
• feel tired. 

Tell your doctor or nurse if you have these symptoms.

If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need to change your insulin or tablet dose.

This treatment can cause a build-up of fluid in the body. This will slowly get better after treatment ends. Contact the hospital on the 24-hour number if you:

• are gaining weight 
• have swelling in your face, legs or ankles.

They can give you advice and treatment to help.

Steroids can make you feel hungrier than usual and you may gain weight. This is useful if you have a poor appetite. But it can be an unwanted side effect for some people. Your appetite should go back to normal when you stop taking steroids. If you are worried about gaining weight, talk to your doctor or nurse. 

If you have high-dose steroids, or steroids and other cancer treatments at the same time, you may have an increased risk of infection. Tell your doctor if you notice signs of infection. This can include a cough, a sore throat or a temperature above 37.5°C. 

To reduce the risk of getting an infection: 

• wash your hands thoroughly before eating, and after using the toilet  
• avoid people with an infection, such as a cold
• avoid crowds or public places where there is a risk of getting an infection.

If you have periods, these may become irregular or stop during treatment. Periods usually return to normal once treatment has finished. This also depends on what other cancer treatments you have, such as chemotherapy.

Steroids can affect your mood and behaviour.  They can cause:

• feelings of anxiety or restlessness
• mood swings (moods that go up and down)
• low mood or depression.

Sometimes, when taken in higher doses, steroids can cause confusion or changes in thinking. This can include having strange or frightening thoughts.

If you notice any changes in your mood or behaviour, tell your doctor or nurse. They may make some changes to your treatment if the side effects are causing you problems.

Some people find it more difficult to sleep while taking steroids. Taking your steroids in the morning may help. If you take steroids twice daily, you could take them in the morning and early afternoon.

You should be given a steroid emergency card if you are taking: 

• high doses of steroids
• steroids for longer than 4 weeks
• repeated courses of steroids. 

• stopping your steroid treatment or missing a dose may make you unwell
• your body may not naturally make extra steroids that are needed during a serious illness or after an injury.  

It is important to take steroids exactly as prescribed by your doctor.

After you stop taking steroids, your body starts making its own steroids again. But it can take a few days for this to happen. If steroid treatment is suddenly stopped, you may have withdrawal effects. These include:

• a fever
• aching muscles or bones
• feeling generally unwell.

To prevent this, your doctor may gradually reduce the dose. This gives your body a chance to adjust and get used to making its own steroids again.

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.