Corticosteroid drugs have been used for many years to treat multiple myeloma. With the development of many new drug treatments in recent years, these new drugs are often used in combination with corticosteroid drugs for myeloma.
Corticosteroids are substances produced by your adrenal glands. Corticosteroids are necessary to help regulate your body’s immune responses, inflammation, metabolism and a number of other important functions.
The effects of corticosteroids on immune function make them effective for fighting cancer. Synthetic corticosteroids appear to cause programmed cell death in myeloma cells, a process known as "apoptosis." They also prevent myeloma cells from producing cytokines--small proteins cancer cells use to communicate with one another. Common corticosteroid drugs used in multiple myeloma treatment include dexamethasone, prednisone, prednisolone and methylprednisolone.
By reducing inflammation around tumors, corticosteroid drugs also help to alleviate the pain caused when tumors exert pressure on nerve endings. Your doctor may prescribe corticosteroid drugs to help relieve sickness associated with chemotherapy, increase your appetite during treatment, and regulate your body’s immune response to stem cell treatment.
Corticosteroid drugs can be taken as tablets or as an injection. Most people only take them for a few days or weeks. If you take them for longer, you may have to carry a steroid card or wear a medical alert bracelet to inform medical professionals that you are taking steroids. Corticosteroid drugs are often prescribed in combination with other drugs, such as bortezomib (Velcade®), lenalidomide (Revlimid®) and thalidomide (Thalomid®).
The side effects of corticosteroids depend on the dose and duration of your treatment. Some of the most common corticosteroids side effects include:
Corticosteroid drugs may harm your baby if you become pregnant while undergoing treatment, so take precautions to ensure you or your partner don’t get pregnant while taking this drug.
Additional side effects may be associated with taking corticosteroid drugs for a period of a few months or more. These include:
Most side effects of corticosteroids disappear in time, after corticosteroid treatment has stopped, and usually by gradually tapering the dose.
Corticosteroid drugs can help improve the efficacy of other drugs. Recently, studies have shown that a combination of lenalidomide (Revlimid®) plus a low dose of the corticosteroid, dexamethasone, in newly diagnosed patients improves survival rates with fewer side effects than Revlimid® with a high dose of dexamethasone.
A high dexamethasone dose usually begins with 40mg in four-day cycles (four days on, four days off) for the first few months. A low dexamethsone is 40mg or less once a week.
Cancer Research UK. (n.d.). Steroids (dexamethasone, prednisolone). Retrieved October 4, 2010, from http://www.cancerhelp.org.uk/about-cancer/treatment/cancer-drugs/steroids
International Myeloma Foundation. (2007). Understanding dexamethasone and other steroids. Retrieved October 4, 2010, from http://myeloma.org/pdfs/u-dex-eng_c1-web.pdf
Mayo Foundation for Medical Education and Research. (2009). Multiple myeloma: Treatment and drugs. Retrieved October 4, 2010, from http://www.mayoclinic.com/health/multiple-myeloma/DS00415/DSECTION=treatments-and-drugs
Myeloma Canada. (2010). Treatment options. Retrieved October 4, 2010, from http://www.myelomacanada.ca/en/treatment_options.htm
Seattle Cancer Care Alliance. (2010). New treatments for myeloma. Retrieved October 4, 2010, from http://www.seattlecca.org/diseases/new-treatments.cfm