Steroids and hormones

Hormones are natural substances in the body. Corticosteroids (or steroids), such as cortisol, are produced by a small gland (the adrenal gland) on top of each kidney. Estrogens are female hormones produced by the ovaries. Androgens, such as testosterone, are produced by the testicles.

Testosterone can promote growth of prostate cancer. That is why men with prostate cancer may take anti-androgen drugs to slow the cancer growth. Estrogens are rarely used to treat prostate cancer.

Some breast cancers depend on estrogen to grow. Drugs that block estrogen or reduce its production (such as tamoxifen or aromatase inhibitors) are used to slow the growth of these breast cancers or keep them from coming back.

Corticosteroids are used to treat many different kinds of cancer. They also help reduce nausea, improve appetite, and reduce swelling caused by cancer in the brain.

What to look for

• Corticosteroids can cause short-term side effects such as:
• Mood changes
• Trouble sleeping
• Fluid retention
• More facial hair
• Increased urination
• Increased thirst and appetite
• Muscle weakness
• Fat build-up in the cheeks, abdomen, and the back of the neck
• Prolonged high doses can cause osteoporosis (bone thinning), which raises the risk of broken bones (fractures).
• Estrogens can cause short-term side effects. In women, estrogens can cause fluid retention and vaginal discharge or bleeding. In men, they can cause tender and swollen breasts and less interest in sex.
• Estrogen-blocking drugs such as tamoxifen can cause hot flashes and vaginal dryness and discharge in women.
• Androgen-blocking drugs may cause hot flashes in men, as well as less interest in sex, decreased sexual performance, tiredness, and mood changes.

What the patient can do

• Talk with your doctor about what to expect from the hormones you will be taking.
• Cut back on your salt intake.
• Watch your calorie intake to avoid too much weight gain.
• Take your medicines as directed.
• Remember that these side effects are short lived and will get better after the steroid or hormone treatment is done.
• Do not suddenly stop taking your medicines. Talk with your doctor if there are problems.

What caregivers can do

• Find out what medicines the patient is on. Talk with the doctor so that you will have some idea what to expect while the patient is on hormone therapy.
• Watch for mood swings.

Call the doctor if the patient:

• Is vomiting or having pain in the abdomen
• Has mood swings that are disturbing you and others
• Is having trouble sleeping
• Becomes short of breath (See the section called "Shortness of breath.")
• Becomes dehydrated (See the section called "Fluids and dehydration.")
• Has a fever of 100.5° F or higher when taken by mouth
• Has stools that look black like tar or contain blood
• Has pain

For more in-depth information on the specific hormones you are taking, contact your American Cancer Society at 1-800-227-2345, or visit www.cancer.org.