Steroids are often used in the care of individuals with brain tumors. These medications help manage symptoms arising from the tumor or its treatment. While part of the treatment plan, steroids do not target the tumor itself; they primarily address the body’s response to it.
Why Steroids Are Used for Brain Tumors
Steroids, particularly dexamethasone, are used to reduce swelling around a brain tumor. This swelling, known as cerebral edema, occurs when fluid accumulates in the brain tissue surrounding the tumor or in areas affected by treatment like surgery or radiation. Dexamethasone, a synthetic corticosteroid, works through its anti-inflammatory properties to decrease this fluid buildup, alleviating pressure inside the skull.
This decrease in intracranial pressure improves patient symptoms. These often include headaches, nausea, vomiting, weakness, drowsiness, speech difficulties, or seizures. Steroids can lead to symptom improvement within 48 hours, effectively managing symptoms and improving a patient’s quality of life.
How Long Steroids Are Typically Prescribed
The duration for which steroids are prescribed for a brain tumor varies for each individual, with no standard length of time. Medical teams adjust steroid use based on a continuous evaluation of several factors.
Factors include the tumor’s type and location, which affect brain swelling. Patient symptoms are also key; as they improve, steroid need may decrease. Response to other treatments like surgery, radiation, or chemotherapy also influences duration, as they can reduce tumor size or swelling.
Side effects also determine duration. If they become unmanageable, the medical team may reduce or stop steroids sooner. Overall patient health and medication tolerance also contribute.
While often prescribed for short periods (days to weeks), longer-term use is sometimes necessary for ongoing symptom management. For some patients with a shorter prognosis, steroids may be continued to maintain comfort and function through their end-of-life period. Decisions are made by the medical team, requiring ongoing assessment and communication.
Managing Side Effects of Steroid Use
Steroid use, especially at higher doses or for extended periods, can lead to various side effects. Common effects include increased appetite and weight gain, sometimes manifesting as a rounded face or fat accumulation. Fluid retention is another side effect, leading to swelling in the hands, feet, or legs.
Mood changes can include irritability, anxiety, euphoria, or depression. Sleep disturbances, such as insomnia, are also reported. Steroids can elevate blood sugar levels, potentially leading to steroid-induced diabetes.
Physical side effects include muscle weakness and thinning skin, making it more prone to bruising. Patients may also experience increased susceptibility to infections, including oral thrush. Stomach irritation or ulcers are possible, which is why steroids are often advised to be taken with food or milk. Long-term use can also decrease bone density, contributing to osteoporosis.
Managing these side effects involves collaboration with the medical team. Strategies include taking medication with food to reduce stomach upset and taking doses in the morning to minimize sleep disruption. Adopting a healthy diet can help manage weight gain, and blood sugar and blood pressure levels are typically monitored regularly. Patients are encouraged to communicate any side effects they experience, as adjustments to the treatment plan or additional medications can often help alleviate these issues.
Safely Reducing and Stopping Steroids
Stopping steroid medication abruptly is not recommended due to potential health consequences. The body’s natural production of steroids can be suppressed when external steroids are introduced, leading to adrenal insufficiency if stopped suddenly. Additionally, there is a risk of rebound swelling, where the brain edema controlled by steroids returns or worsens.
For these reasons, the process of reducing and eventually stopping steroids is always a gradual one, known as tapering. This involves slowly decreasing the dosage over time, under the strict guidance of the medical team. The specific tapering schedule is highly personalized, taking into account the patient’s current condition, the severity of their symptoms, and how they are responding to other treatments.
During the tapering process, patients might experience various symptoms as their body adjusts, such as fatigue, body aches, a temporary return of some original symptoms, or mood changes. It is important for patients to report any new or returning symptoms to their healthcare providers promptly. All adjustments to steroid dosage must be made under careful medical supervision to ensure safety and effectively manage any withdrawal effects.