Chemo/steroids

Toni08

Good morning everyone,
I hope that everyone is enjoying their weekends as much as possible and keeping cool. My dad had his third round of chemo this week. He is a month out from rads. Due to the severe chemo related complications he had the previous 2 times, they wanted to wait until he had time to regain strength before another round.

I kept expecting him to feel sick but we experienced the opposite. He came home everyday with energy, no nausea, and …hungry! He said that this time around, they gave him a steroid to help him recover faster. Being that this is working so well, I’m wondering why they didn’t give it before or why they seem to give it to some and not others. I searched the site and saw some got it and some didn’t. So my questions are 1. What does the steroid do? And 2. Is there a guideline for giving it? Do they only give it to patients not having radiation at the time? Is there some explanation as to why they wouldn’t give it in the first place.
I am very happy this session has gone so well, I’m just looking for some insight and clarity into the whens and whys of the the drug in treatment or really some justification as to why he had to suffer almost a month in the hospital when it could have been avoided.

Thank you and god bless!

denistd

C hemo Steroids
I believe it has something to do with the kidneys, if dad had cisplatin it can cause damage to his kidneys, it did mine, steroids are bad for kidneys.

jim and i

denistd said:

C hemo Steroids
I believe it has something to do with the kidneys, if dad had cisplatin it can cause damage to his kidneys, it did mine, steroids are bad for kidneys.

I agree with denistd.
I agree with denistd. Steroids are bad on kidneys and so is ciplatin. My husband was in hospital after his 2nd chemo and they canceled the third because of kidneys. Your dads kidneys must be better for them to give him steroids and chemo. My husbad's last chemo was canceled.

Toni08

jim and i said:

I agree with denistd.
I agree with denistd. Steroids are bad on kidneys and so is ciplatin. My husband was in hospital after his 2nd chemo and they canceled the third because of kidneys. Your dads kidneys must be better for them to give him steroids and chemo. My husbad's last chemo was canceled.

more info
My dad was on cisplatin originally and he had some days of bad readings for his kidneys, but the readings returned to normal. They switched the type of chemo this time and so they must not be very concerned about his kidneys on this combo.

Thanks for the insight!

nwasen

chemo/steriods
I was given a bag of things including steroids before each round of chemo, which was Cisplatin/ I never had a problem afterwards. I had 7 chemos, once a week.
I did find after that treatment I was almost like I was on speed. Tons of energy and would stay up very late that night!

DrMary

A mixed bag
The steroid (assuming it's dexamethasone) seems to do several things - it actually makes the Emend work better (and, by extension, I'd expect it would also have a synergystic effect on Ondansetron, as I think both antinauseas work on the same centers - they often give all three together). It can be an antinausea drug on its own (many say it did nothing for them, but it is the only thing that worked when nothing else did for us).

It can cause heartburn and hiccoughs (we used Prilosec for the first and the second just went away on its own after a few days). Very long-term use causes bone-softening - you only see this in folks who take it for years, such as folks with lupus.

It reduces/prevents inflammation. I have to say I wonder if this helped keep Doug's throat less inflamed during radiation (it was pretty bad, but not as bad as others have reported). This also is why doctors don't prescribe it for more than the first 5 days of chemo (and some not at all) - it will mask symptoms of infection and can lower the immune response to viruses. We dealt with this by watching Doug like a hawk for signs of infection (any slight raise in temperature, aches, increased sore throat, glassy eyes - he got a bit sick of my checking him out several times a day) and by keeping him away from sick people.

And yes, it can give you more energy and make you feel great. When we started Doug back on the dexamethasone, he had about 3 weeks of radiation left. He seemed much better in those last 3 weeks than in the previous 2, but then he also was able to eat, which he hadn't been able to do for almost a month.

Your mileage may vary, but I think that if it makes him feel better, go for it. I'm sure your doctor is watching his kidneys, and feels its safe (I also found some animal studies showing that it protected kidneys from damage in some cases - mostly when kidney cells were deprived of nutrients).

One caution - try very hard to take it as regularly as possible; it's a bad one to "skip a pill" when you've been taking it for a while. If he takes it for more than 2 weeks, your doctor should taper him off over 3-5 days rather than just stopping abruptly. The side effects of stopping suddenly are unpleasant - your body really does get used to it - but we had no problems when we tapered off gradually.

Toni08

DrMary said:

A mixed bag
The steroid (assuming it's dexamethasone) seems to do several things - it actually makes the Emend work better (and, by extension, I'd expect it would also have a synergystic effect on Ondansetron, as I think both antinauseas work on the same centers - they often give all three together). It can be an antinausea drug on its own (many say it did nothing for them, but it is the only thing that worked when nothing else did for us).

It can cause heartburn and hiccoughs (we used Prilosec for the first and the second just went away on its own after a few days). Very long-term use causes bone-softening - you only see this in folks who take it for years, such as folks with lupus.

It reduces/prevents inflammation. I have to say I wonder if this helped keep Doug's throat less inflamed during radiation (it was pretty bad, but not as bad as others have reported). This also is why doctors don't prescribe it for more than the first 5 days of chemo (and some not at all) - it will mask symptoms of infection and can lower the immune response to viruses. We dealt with this by watching Doug like a hawk for signs of infection (any slight raise in temperature, aches, increased sore throat, glassy eyes - he got a bit sick of my checking him out several times a day) and by keeping him away from sick people.

And yes, it can give you more energy and make you feel great. When we started Doug back on the dexamethasone, he had about 3 weeks of radiation left. He seemed much better in those last 3 weeks than in the previous 2, but then he also was able to eat, which he hadn't been able to do for almost a month.

Your mileage may vary, but I think that if it makes him feel better, go for it. I'm sure your doctor is watching his kidneys, and feels its safe (I also found some animal studies showing that it protected kidneys from damage in some cases - mostly when kidney cells were deprived of nutrients).

One caution - try very hard to take it as regularly as possible; it's a bad one to "skip a pill" when you've been taking it for a while. If he takes it for more than 2 weeks, your doctor should taper him off over 3-5 days rather than just stopping abruptly. The side effects of stopping suddenly are unpleasant - your body really does get used to it - but we had no problems when we tapered off gradually.

Thank you!
Very informative. His chemo session was three days and he took the steroids on those 3 days but was hesitant to take them after and today didn't take any so its not long term. He is very concerned about long term use and becoming dependent on any of the drugs they have given him so far. But the effects are as you described..like on speed. He came home and made smoothies and was full of energy. My sister joked about marijuana.

It got him through. My only concern now based on the information you gave is that he will not be seeing the doctor in the next week so will not be closely monitored for small changes.

DrMary

Toni08 said:

Thank you!
Very informative. His chemo session was three days and he took the steroids on those 3 days but was hesitant to take them after and today didn't take any so its not long term. He is very concerned about long term use and becoming dependent on any of the drugs they have given him so far. But the effects are as you described..like on speed. He came home and made smoothies and was full of energy. My sister joked about marijuana.

It got him through. My only concern now based on the information you gave is that he will not be seeing the doctor in the next week so will not be closely monitored for small changes.

No worries
It clears your system in a day or so and he only took it for 3 days. Doug took it for about 3 months, and during both chemo and radiation.

Those first three days are golden - after that, the Emend quits working, so they don't prescribe it for longer, and so there's no reason to take the dexamethasone after that as well (Doug was obviously a special circumstance). Some folks get some nausea for the next 4 days, which is what the other drugs (like Zofran and Compazine) are for. You really can't get dependent on those and they are best taken regularly (Zofran has no effect on the CNS - it won't get you high - and Compazine is about the same as taking a Benedryl in terms of recreation).

However, if he has no nausea now (when did he get the chemo?) there's no reason to take anything - it can be nice to be done with pills after all this treatment.

Skiffin16

Dexamethasone
They gave me the above after my second round of Cisplatin, Taxotere and 5FU. Mainly for extra energy and to counteract the fatigue from the Chemp.

It shot my glugose levels up by 40+ points and this seems to be common in some people.... I didn't like it and especially didn't like it elevating my glucose levels so much, so I only used it that first time....

That was just me, and I'm certainly not endorsing not taking prescribed meds.... I did mention it to my Chemo MD, and she didn't have a problem with me not taking it.

Best,
John