How Are Corticosteroids Used for Prostate Cancer?

Corticosteroid medications, also known as steroids, are a class of drugs designed to mimic naturally occurring corticosteroids produced by the adrenal cortex above the kidneys. Corticosteroids are classified further as glucocorticoids and mineralocorticoids, which carry out a wide range of functions in the body. Some of these functions can aid in the relief of bone pain, inflammation, and nausea and vomiting that come along with cancer or the treatment of cancer.

What are corticosteroids?

Corticosteroids can be administered orally (in tablet or liquid form), or via an injection, depending on the type taken and the intention of treatment. Steroid treatments are used in a variety of conditions, including advanced cancers, autoimmune conditions, respiratory conditions, endocrine disorders, and more.

Common corticosteroids used to treat prostate cancer include prednisone and dexamethasone, among many others. Individuals taking corticosteroids should not stop them abruptly. When stopping steroids, your dose may need to be decreased slowly over time by your doctor to prevent serious reactions. These individuals should also be monitored for hormonal imbalances, mood changes, serious infections, changes in blood pressure, changes in blood sugar levels, changes in vision, or changes in bone density.^1,2

How do corticosteroids help treat prostate cancer?

As mentioned previously, steroids, as a class, help regulate numerous processes in the body that help keep us healthy. The class of steroids can be further broken down into glucocorticoids and mineralocorticoids that regulate the body’s immune and inflammatory responses, among others. Glucocorticoids are more commonly used in cancer therapy. Often glucocorticoids are referred to as corticosteroids.

For the treatment of prostate cancer, specific corticosteroids can be prescribed alone or in combination with other therapies (such as chemotherapy, radiation, or palliative care options) for treatment or to aid in symptom or side-effect management.

Examples of symptoms that may be alleviated as a result of treatment with corticosteroids include nausea, vomiting, sensitivity reactions to radiation or chemotherapy, bone pain, and back pain. Steroids can also help increase your appetite when your current treatment options are reducing it or making you nauseous. Steroids are typically the first choice for short-term treatment of bone pain related to cancer metastasis.^1-3

What are possible side effects?

The most common side effects of taking corticosteroids include swelling or fluid retention, high blood pressure, mood or behavior changes, weight gain, increased appetite, insomnia, upset stomach, and changes in blood glucose (blood sugar) levels. Corticosteroid injections may also cause injection site reactions. These are not all the possible side effects of corticosteroids. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with corticosteroids.⁴

Other risks

Several rare but more serious side effects can accompany taking corticosteroids, including the development of serious infections. Alert your provider immediately if you notice any signs of an infection, including fever, chills, or flu-like symptoms. Additionally, individuals taking corticosteroids should avoid receiving live vaccinations during treatment, as well as avoid exposure to chickenpox or measles. If contact with chickenpox or measles occurs, seek medical attention immediately.

While taking corticosteroids, there is also a risk of developing extreme mood changes, high blood pressure, hormonal imbalances, changes in vision, or a reduction in bone density. Your provider will help monitor you for serious complications as a result of any of these side effects, however, it is important to seek medical attention if you notice any new or worsening signs of any of these conditions. Seek emergency medical attention immediately if mood changes lead to extreme depression or thoughts of suicide.

Before starting corticosteroids talk to your provider if you:

• Have any ongoing infections or could be exposed to infection during treatment
• Are scheduled to receive a vaccine
• Are taking any immunosuppressant medications
• Have anxiety, depression, or any other mental health-related condition
• Have diabetes, kidney conditions, or any other condition that may affect your body’s blood glucose levels
• Have high blood pressure
• Have a GI ulcer
• Are sexually active and have a partner who may become pregnant
• Are allergic to steroid-containing medications
• Have any other medical conditions
• Are currently taking any other medications (prescription and over-the-counter), vitamins, or herbal supplements

You should also contact your provider if you notice any signs of an allergic reaction to the medication, including chest pain, fever, flu-like symptoms, or difficulty breathing. It is also important to consult the prescribing information for any other medications prescribed with your corticosteroid.⁴

Taking corticosteroids

Corticosteroids can come in a variety of dosages based on the medication prescribed. Corticosteroids can be taken orally as a tablet or liquid, however, they can also be administered via an injection. Your provider will determine the appropriate dosage and administration schedule for you. They will also determine the appropriate dosage and administration schedule of any other medications taken with your corticosteroid, such as chemotherapy treatments.

It is important to follow your provided schedule exactly as instructed, and not to stop taking your corticosteroid or any accompanying medications on your own or abruptly, as withdrawal symptoms may occur including muscle stiffness, fatigue, joint pain, nausea, vomiting, confusion, or fever. The dose of your corticosteroid can be adjusted as needed by your doctor. Patients should talk to their doctor if they have any questions, or if they have questions regarding their corticosteroid regimen.^1-4