Steroids: Pros and Cons

Tinyfrog · January 2017

Can you please tell me about your experience with steroids in chemotherapy.

I am starting chemo Feb 1 for HER2 - weekly Taxol and Herceptin for 12 weeks, Herceptin every 3 weeks for 9 months.

After repeated inquiries about the use of steroids, I just found out that the oncologist has noted in my file to "minimize steroids in chemotherapy as much as possible,' owing to a false medical condition she never confirmed with me, nor has any reason to believe is accurate based on my conversations with her, and that there are no medications in my file that I would be taking for this condition if I had it. I am very disappointed that she would make such a decision in my treatment without ever discussing it with me, and risk any sort of severe reaction that the steroids are meant to alleviate - something I would have never known about, had I not seen steroids mentioned in this forum and asked about it.

Given that it's the weekend, I can cool down a bit before writing her. But I also would like some feedback on anyone's experience with them.

I looked up the pros and cons of steroids. And many healthy people have had side effects like agitation and insomnia because it increases energy - so maybe I would want to minimize steroids anyway. But on the other hand, some have said it helps with their fatigue as well - aside from it's purpose of reducing chemo shock, and also I think I read and can treat cancer, as well.

Tinyfrog · January 2017

Hi KB870 - Thank you so much for that information. I read on a UK site that several other people described a similar reaction.

MinusTwo · January 2017

My docs prescribed steroids for nausea. It worked - I never had nausea. I took the steroids am & pm the day before chemo and the day of chemo. But that third day I only took one, and then one the 4th day. A friend who had lung cancer said that was a great way to taper off & avoid the crash as long as I wasn't nauseated. Worked great for me, but his is "off label" so you might want to check w/your doc.

Tinyfrog · January 2017

Hi MinusTwo. Thank you so much for sharing. From what I've read, it seems as though many people are given steroid pills to take by themselves before and after chemo - in addition to the steroids and benadryl in their IV right before chemo. And please, anyone correct me if I am wrong, but I am getting the idea that sometimes certain steroids are actually given not just to alleviate side effects, but as cancer treatment. I haven't been prescribed the pills, but I do think it's standard in IV before Taxol, unless otherwise stated, as my oncologist has. I don't know if I'm going to be the one that has a hypersensitive reaction because my doctor has instructed not to use it. With my luck, that would probably be the case. I have heard that steroids can increase appetite too, can cause weight gain, and make you puff up like a blowfish. So, I'm trying to figure out if I'm assuming a risk or allergic reaction by not speaking out, or will speak out and get on steroids, and then have bad side effects from that. Is the Taxol just for nausea or is it also for the allergic reaction? The benadryl for sure, I think is for the allergic reaction.

SpecialK · January 2017

tinyfrog - my understanding regarding steroids as cancer treatment are most usually related to the steroidal component of Aromasin, the aromatase inhibitor anti-hormonal. Steroids given during chemo are for nausea control, inflammatory bone pain, and to potentially stave off an allergic reaction. Unfortunately, the steroids themselves can cause as difficult a problem as they may prevent. My oncologist only gave me steroids on the day of chemo for the first three infusions - he wanted to see how I did without taking any additional before/after dosing. I did develop a rash after taking an antibiotic for a UTI, and because there was no way to know if the rash was from the antibiotic or the chemo agents, I had to take additional steroids for the remaining three infusions. You might be able to get away with IV Benadryl only, no steroids, if there is some particular reason or co-morbidity that would necessitate eliminating the steroid at infusion time. Are you receiving weekly Taxol? If so you may not need any pre or post dosing because the dose of Taxol is smaller. If you have a dose dense regimen, or for those of us who had Taxotere every 21 days - the dose is larger and may require additional steroid use. I also did what minus described above - on the last 3 infusions, I tapered off on the post dosing so as to avoid the crash. Off label, but it worked well.

MinusTwo · January 2017

I did not have steroids in my infusions. Just pills for the day before, day of & day after. I had benedryl only with the first infusion - and no allergic reaction so we opted out for the other 5 infusions. It made me too groggy to drive home. I had none of the side effects you are have listed with the steroids - bloating, weight gain, etc. Just kept me moving & gave me energy & feeling pretty good for one more day before the chemo side effects took over.

Tinyfrog - can you go ahead & enter your diagnosis and treatment? Or make it post so we can see your stats that we are responding to.

Tinyfrog · January 2017

Hi MinusTwo - How were you able to list your diagnosis and treatment in that format without going through the drop down menus, forcing you to select from only the options they've offered? My diagnosis doesn't fit in the boxes they've given me - this is close enough but won't match what I write about. As well as, every time I do make a selection, save and exit, it comes up as something different on the treatment page, and then not at all on this page. Frustrating.

Tinyfrog · January 2017

I've put in the treatment and surgeries but it's not reflected.

keepthefaith · January 2017

I had steroids pills while doing chemo and hated them. NO sleep for a week and then severe fatigue when I "crashed". Weight gain. I did not take the full recommended dose....eh. I'm sure it has some benefits, but I am not a fan.

MinusTwo · January 2017

TinyFrog - I think it has to do with clicking the privacy settings. I'm not really computer savy and they've changed the format several times.

Jennie93 · January 2017

I had TCx6 and was not given any kind of steroid pills or any other pills to take (had a script for Compazine if needed for nausea, but didn't need them). Not sure if they put any in the IV with chemo. I know they did a whopping dose of Benadryl before the chemo, to prevent reactions. It made me very sleepy. Would just doze through chemo, luckily had DH to drive home.

Tinyfrog · January 2017

MinusTwo - Thanks for the advice. I had to flip on the public setting for each individual listing.

Jennie93 - Thank you for your input. I don't know how much latitude the nurse has to adjust steroids on her own. I mean, I would think that you would use common sense to adjust steoid dosage as needed, and as the person is reacting in the moment. But perhaps, on the other hand the exact amounts could be dictated by the MO. The MO and the infusion place are in different buildings, run by different people. Thanks for the heads up on the impact of benadryl. I can have someone drop/pick me up the first 2 times, but then I'm on my own. I guess I can learn enough the first 2 times to plan for uber later if I need to.

Steroids: Pros and Cons

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