Steroids

I’m Alison one of the Cancer Information Nurse Specialists, welcome to the online community. 

I am sorry to hear that you mum Bex22 has been recently diagnosed with stage 4 cancer, this is obviously a very worrying and upsetting time for you. 

Steroid treatment is often prescribed for various medical conditions, but it’s essential to understand why stopping it abruptly can have consequences. Steroids, (dexamethasone, prednisolone, methylprednisolone and hydrocortisone help to control many functions including the immune system, reducing inflammation and blood pressure.

If your mum been taking steroid tablets for an extended period (more than a few days), suddenly stopping them can be problematic.

Adrenal glands, located above the kidneys, produce hormones (including cortisol) that are crucial for the body’s normal functioning.

Long-term steroid use suppresses the adrenal glands’ natural production of these hormones. When you stop steroids suddenly, your mum’s adrenal glands may not immediately resume normal hormone production.  This condition is known as adrenal insufficiency.

Adrenal insufficiency can lead to symptoms such as fatigue, weakness, low blood pressure, and electrolyte imbalances. Stopping steroids abruptly can cause withdrawal symptoms.  To prevent adrenal insufficiency and withdrawal, doctors usually recommend gradually reducing the steroid dose.

This tapering process allows the adrenal glands to gradually resume hormone production.

It would be best Bex22 to speak to your mum’s treatment team to discuss and to keep in mind that individual responses to steroid withdrawal can vary.

Best wishes

Alison Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref/ JH

Thanks for your reply, I think why I’m so confused is that they said she only has weeks not months left they thought she had dementia but after a ct to grade it as she was declining so fast. Sadly they found it was cancer in the brain but they also found it in her lungs, glands, and bones so not treatable and straight onto palliative care. She’s doesn’t seem in pain and is eating well and drinks ok. She was put on fluid to flush calcium and so why would it matter if she was left on them if they made her feel better for the short time she has left with us. I can’t ask her treatment team as they only want to deal with one contact in the family which is my dad and I don’t want to ask my dad to ask them as he’s already struggling. Thanks Bex

Hi Bex22 

Thanks for getting back in touch.  

My name is Paula and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line. 

I hope you found my colleague Alison’s response to your written enquiry helpful to look at. As Alison explained steroids can be prescribed for several reasons which her hospital team would have considered based on mum’s symptoms.  

I am sorry to hear mum’s recent CT scan confirmed her confusion was down to cancer in her brain and not dementia. The steroids will help with any new symptoms that may have risen due to her cancer.  

We understand your concerns in stopping the steroids, especially when Mum has been given such a short prognosis of weeks, and her symptoms have improved whilst being on them. Often, the risk and side effects of steroids start to outweigh the benefits, and this is why they are usually only given for a short period of time.  

Sometimes they can be continued for a longer period, but this is a case-by-case decision and only her treatment team will be able to explain why they feel this wouldn’t be in your mum's best interest. 

It’s good to hear mum is now having palliative care support. If you are finding it difficult to speak to mum’s team, it may be worth speaking to the palliative care team. They are there to support not only mum but families too.  

It’s always difficult when a loved one has a terminal diagnosis. It is important to look after yourself too. Some people find it helpful sharing their experiences with others.  

You can also talk to one of our nurses on the support line. Sometimes giving us a call can help. It’s a free phone number on 0808 808 0000 and we are here 7 days a week, 8am-8pm or email us.  

I hope this information has been helpful, please don’t hesitate to get back in touch. 

Ref: PW/AC