When you hear the word "steroid" you may immediately think of muscle-bound body builders and the health risks they incur from abusing anabolic steroids — drugs that were originally intended for people with growth disorders, low levels of testosterone, and other health conditions.
If your child has been prescribed steroids for cancer, rest assured that he or she will not be taking anabolic steroids, but rather corticosteroids. Corticosteroids are made from a naturally occurring steroid in the body called cortisol.
How Cortisol Can Help
Cortisol is a hormone (like testosterone or estrogen) that can have therapeutic effects on the body. Synthetic versions of the hormone — including cortisone, hydrocortisone, prednisone, and methylprednisolone and dexamethasone — are prescribed to help:
- reduce nausea associated with chemotherapy or radiation
- kill cancer cells and shrink tumors as part of chemotherapy
- decrease swelling
- reduce allergic reactions (before blood transfusions, for example)
- lessen headaches caused by brain tumors
Some kids also find that taking steroids helps ease sleeping and eating problems, and just lets them feel better overall.
Steroids are sometimes taken by injection or through an Intravenous (IV), but also can be swallowed in pill or liquid form or applied as a cream.
As with many medications, side affects can be associated with steroids. Before your child begins taking steroids, ask your doctor what to expect. This way, you can plan ahead for any unsettling symptoms or adverse reactions, should they occur.
Temporary side effects may include:
- increased appetite
- weight gain — often in unusual places, like the cheeks or the back of the neck
- mood swings
- stomach upset or ulcers
- osteoporosis (a degenerative bone disease)
- vision problems
- high blood pressure
- increased blood sugar and, in some cases, developing type 2 diabetes temporarily (and kids who already have diabetes need to monitor their blood sugar levels more closely)
- for girls, irregular menstruation (missed or late periods)
Less common side effects include bruising more easily, difficulty fighting infections, acne flare-ups, and increased facial hair.
A child who develops several of these symptoms may have a condition called Cushing syndrome. Though not serious, Cushing syndrome can be distressing, especially for girls.
Symptoms may subside with changes to the way your child takes the medications; talk to your doctor about this.
Chances are, you and your child will probably find that any side effects are overshadowed by the benefits of the treatment, but check with your doctor about ways to make them easier to live with. And remember, most side effects are only temporary. Once treatment stops, side effects will, too.
Tips for Managing Treatment
Whether your child is on steroids for a week or months, it's important to always follow the recommended guidelines, and check first with a doctor before making any changes to treatment (for example, ask a doctor before taking the medicine at night if your child has been regularly taking it in the morning). Also, encourage your child to let you know about any adverse reactions during or after a steroid treatment.
More tips for safely taking steroids:
- Don't let your child quit "cold turkey." Always work with your doctor to end steroid medication — this is important because during treatment, the body manufactures less cortisol. Tapering off the medication gives the body a chance to get its own production back up to normal and avoid a potentially serious withdrawal.
- Carry the card. If your child will be taking pills at home, the doctor may provide a steroid card or a medical alert bracelet. Your child should have this card handy at all times (in a wallet, for example) so that in case of an emergency, the doctors or hospital will know your child is in treatment and needs the regular dose. (This is only for longer-term treatments; a child on a short course may not be given a card.)
- Never double-up after a missed dose. Try to set aside a specific time every day for your child to take the medication. If your son or daughter forgets a dose, call the doctor or nurse and ask what to do.
- No flush, no foul. If tablets are left over after treatment, give them to your doctor or a pharmacist. Don't flush them down the toilet or throw them away because they could contaminate your local water supply.
If you have any questions during your child's steroid treatment, speak with your doctor.
Reviewed by: Christopher N. Frantz, MD
Date reviewed: October 2012