Steroids occur naturally within our bodies, but can also be made in the laboratory for medical purposes. They help reduce inflammation and control different functions in our bodies such as the immune system or the way the body uses food. One of their key functions is to reduce inflammation/swelling and ease associated symptoms, such as headaches.
When your child has a tumour in their brain it is not only the tumour itself that causes some of the symptoms they may have, but also the swelling surrounding the tumour. This swelling puts pressure on surrounding tissues making the effects of the tumour wider reaching. This pressure can cause symptoms such as headaches, sickness and seizures (fits).
To help reduce the swelling, Children with Cancer may be prescribed steroids such as Prednisone or Dexamethasone as part of their treatment. As steroids are fast-acting drugs this could mean that some of the effects caused by the tumour reduce quite quickly. This does not mean, however, that the size of tumour itself has been reduced.
If your child is having Radiation Therapy or Surgery as part of their treatment, they may be given steroids afterwards to help bring down swelling caused by these treatments. Also, if your child is having Chemotherapy, a low dosage of steroids may be given if they experience nausea.
There are different ways that steroids can be taken, including:
- Orally (as tablets or liquid medicine)
- By injection (to the vein or muscle)
The most common way for children to take steroids is in tablet form. The tablets are small and should not be too difficult for your child to swallow.
Generally, your child will only take steroids for a few days or weeks. You will be given instructions from your child’s doctor about exactly when and for how long your child will need to take steroids.
Common side-effects of steroids include:
Increased Appetite & Weight Gain
Taking steroids may make your child feel hungrier, and they might find it difficult to maintain their former weight. Their appetite will go back to normal once they stop taking the steroids, but some people need to watch their diet and exercise levels to lose the extra weight.
Swollen Hands, Feet or Ankles from Water Retention
Due to the changed salt and water balance in your child’s body, you may notice that their ankles, feet or hands swell. If they have swollen ankles, they need to avoid standing for long periods of time and put their feet up when sitting down.
Increased Risk of Infection
Tell your specialist immediately if you notice your child has any signs of infection (such as inflammation, redness, soreness or a temperature), as they may need to take antibiotics.
Changes in Blood Sugar Levels
If your child is taking steroids for a long time or they are on a high dose, their blood sugar levels may be affected. Let your specialist know if your child feels thirstier than usual or if they need to pass urine more frequently, as these can be symptoms of high blood sugar levels.
Changes in Mood & Behaviour
Your child may feel more anxious or emotional while they are taking steroids, and then feel tired and low for a while after they stop taking them.
Difficulty in Sleeping
Some people find that taking steroids leads to difficulty sleeping. It may help for your child to take their tablets first thing in the morning.
Longer-term use of steroids (more than a few months), can cause other side-effects including:
- Skin feeling thinner
- Bruising more easily
- Legs feeling weaker
Your child’s doctor, nurses, or dietitian may suggest foods low in salt (sodium). Alternatives to salty foods include foods highly seasoned using other spices. High-sodium foods, such as most snack chips and pretzels, processed foods, or frozen meals should be avoided. (Those labelled “reduced sodium” are usually OK.) Also be aware of extra calories your child may not need at this time, like those in sodas and juices.
Encourage your child to eat fresh, nutritious, filling foods, such as fruits and vegetables, homemade soups, non-processed meats, dairy products, breads, and pastas.
Your child does not have to feel deprived of his or her favourite foods, but some changes in the recipe might be wise. Consider thin crust pizza with low sodium cheese for the pizza lover, and baked chicken tenderloin strips and baked potato fries for the chicken nugget and french fry lover. No food is especially bad, but how it is prepared or the portion size can be unhealthy.
Coping With Emotional & Behavioural Side-Effects
The emotional and behavioural side-effects that steroids may cause can be difficult to cope with, but it is important that your child takes them to reduce swelling and relieve pressure on their brain. You may find the following practical suggestions helpful:
- Allow your child to burn off excess energy
- Keep a diary of your child’s mood swings
- Be aware of potential effects of mood swings on siblings
- Discuss difficulties with your child’s health team
Important Points to Remember
Steroids help with symptom management rather than treating the tumour itself
It is important that your child keeps taking steroids for as long as their doctor tells them to.
When taking steroids your child’s body will start to produce less of its own steroids naturally, so stopping steroids suddenly can make your child unwell.
The type of steroids used for brain tumours are NOT the anabolic steroids that are used by some athletes to build muscle.
Chickenpox is often more severe in children having steroid treatment. They and other family members may be given an injection for protection.
Children on steroids should not be given ‘live’ vaccines including the MMR (measles, mumps and rubella) injection nor the BCG injection (which protects against tuberculosis).
If your child is taking a high dose of steroids for a long time, their growth may be affected.