Corticosteroids for Prostate Cancer

Corticosteroid drugs are also known as steroids. They are designed to act like natural hormones made by the adrenal gland. Corticosteroid hormones help control many processes in the body, including immune function, inflammation, and blood pressure.^1,2

Corticosteroids may help treat advanced cancers, autoimmune conditions, and other chronic conditions. For people with prostate cancer, they can help relieve bone pain, inflammation, nausea, and other symptoms. However, corticosteroids may interfere with certain hormone treatments. Talk to your doctor about whether corticosteroids are right for you.^3,4

What are corticosteroids?

Steroids are hormones that help regulate many processes that keep us healthy. There are 2 classes of steroids. Glucocorticoids regulate glucose metabolism and immune system function. Mineralocorticoids regulate salt and water balance. Glucocorticoids are the type most often used to treat prostate cancer.^1,2

How do corticosteroids help treat prostate cancer?

Glucocorticoids work by binding to proteins called glucocorticoid receptors. This causes cells to produce anti-inflammatory chemicals. Reducing inflammation can ease the side effects of cancer treatments.^1,2

Corticosteroids may also impact the prostate cancer itself. They reduce production of a hormone called androgen. This is similar to how hormone therapy works. If standard hormone therapy does not work, corticosteroids may be a secondary option to relieve symptoms.³

You may use corticosteroids alone or with other cancer treatments. Doctors may suggest corticosteroids for people with prostate cancer to:^1-4

• Help treat cancer that still progresses even when the person is on hormone therapy (castration-resistant prostate cancer) in combination with other medications
• Reduce fluid retention caused by certain hormone treatments
• Ease nausea or vomiting caused by cancer treatments
• Reduce sensitivity to radiation or chemotherapy
• Increase appetite when other treatments are reducing it
• Treat bone pain caused by cancer spreading to the bones

However, corticosteroids may actually reduce benefits of some cancer treatments in certain situations. This may happen because corticosteroids can cause some cancers to become resistant to certain hormone therapies. More research is needed to understand how corticosteroids affect prostate cancer progression.^1,3

What are examples of corticosteroids?

Common corticosteroids used to treat prostate cancer include:^1,3

• Prednisone
• Prednisolone
• Dexamethasone
• Hydrocortisone

The right corticosteroid for you depends on many individual factors. And corticosteroids may be combined with other drugs. For example, prednisone combined with hormone therapy is often a first-line treatment for advanced prostate cancer.^4,5

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. The most common side effects of corticosteroids include:^1,2

• Swelling or fluid retention
• High blood pressure (hypertension)
• Mood or behavior changes
• Weight gain
• Increased appetite
• Trouble falling or staying asleep (insomnia)
• Upset stomach
• Changes in blood sugar (glucose) levels
• Injection site reactions

These are not all the possible side effects of corticosteroids. Talk to your doctor about what to expect when taking corticosteroids. You also should call your doctor if you have any changes that concern you when taking corticosteroids.

Other things to know

Take corticosteroids as your doctor prescribes. They may be taken by mouth or by injection. Your doctor will determine the best dose, administration method, and treatment schedule. Do not stop taking corticosteroids abruptly. Withdrawal can cause serious symptoms.²

Corticosteroids suppress the immune system, which can increase the risk of serious infections. The risk is higher when taking long-term or high-dose corticosteroids. Talk to your doctor if you notice any signs of infection, including:²

• Fever
• Chills
• Muscle aches
• Headaches
• Feeling cold and shivery

Avoid live vaccinations during treatment. Take steps to reduce exposure to chickenpox or measles. If you come into contact with chickenpox or measles, seek immediate medical attention.²

Before beginning treatment for prostate cancer, tell your doctor about all your health conditions. This includes:²

• Any ongoing infections or risk of infection during treatment
• Planned vaccines
• History of anxiety, depression, or other mental health condition
• History of diabetes or kidney conditions
• History of high blood pressure
• Allergies
• Pregnancy or plans to become pregnant

Also, tell your doctor about any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs. Immunosuppressant and other drugs can increase the risk of corticosteroid side effects.²