Steroids are prescribed for children and young people undergoing anti-cancer treatment, or sometimes as a supportive measure. Steroids play an important role in the treatment of various cancers which include acute lymphoblastic leukaemia (ALL), lymphoma and brain tumours.
Steroids also have a role in the prevention of nausea and vomiting in certain chemotherapy regimens and symptom management in paediatric palliative care, where steroids are sometimes used in high doses for a few days.
What are steroids?
Steroids are naturally made by our bodies in small amounts. They help to control many functions including the immune system, reducing inflammation and blood pressure.
Steroids can also be made in the laboratory, most manufactured are corticosteroids, versions of hormones produced by the adrenal gland. Examples include Prednisolone, Dexamethasone, Methylprednisolone and Hydrocortisone (Cancer Research UK, 2023).
What do steroids do?
Steroids help control many body functions including:
- Reducing allergy and inflammation
- Keeping the balance of salt and water in your body
- Regulating blood pressure
- Helping your body turn food into energy
(Macmillan, 2022)
Why are steroids used in cancer treatment?
- To help destroy cancer cells and make other cancer treatments more effective
- To prevent or treat an allergic reaction
- As an anti-sickness drug
- To reduce cancer symptoms, such as pain caused by swelling (inflammation) around a tumour site
- To treat inflammation caused by cancer treatment
- To reduce your body’s immune response, for example after a bone marrow transplant
- To improve appetite
(Cancer Research UK, 2023)
GP note:
Steroids are very effective in the treatment of lymphoid malignancies such as Acute Lymphoblastic Leukaemia (ALL) and Non-Hodgkin’s Lymphoma. If either of these diagnoses is a consideration, corticosteroids must not be given before referral as they may partially treat the patient making confirmation of the diagnosis difficult and risking tumour lysis syndrome (Adeyinka and Bashir, 2024). Treatment with corticosteroids in the 4 weeks prior to diagnosis may make a patient ineligible for the current ALLTogether trial and therefore may have an adverse impact on prognosis (Cancer Research UK, 2025).
Side Effects
Unfortunately, there are many common side-effects of corticosteroids:
- Avascular necrosis
- Steroid Myopathy
- Challenging behaviour
- Increased appetite and significant weight gain
- Stomach upset / Gastrointestinal Irritation, Bleeding, Ulceration (Proton Pump Inhibitor’s (PPI’s) can be used prophylactically and for treatment).
- Hearing loss
- Immunosupression
- Hypertension
- Hyperglycaemia
- Acne
- Pituitary-adrenal axis suppression
- Altered sleep patterns and fatigue
- Osteopenia and osteoporosis
Less common effects include psychiatric disorders and increased intraocular pressure. The multi-disciplinary team (MDT) treating children and young people with cancer will face a challenge in reaching a balance between maximising the anti-cancer effect of steroids whilst minimising the short- and longer-term side-effects of the drug. Understanding the side-effects of steroids and how these may present in a clinical setting, will help the MDT in providing the best care for child or young person with cancer.
References
Adeyinka, A. and Bashir, K. (2024). Tumor Lysis Syndrome. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK518985/ [Accessed 1 Aug. 2025].
Macmillan. 2022. Steroids. Available from: https://www.macmillian.org.uk/cancer-information-and-support/treatments-and-drugs/steroids. (Accessed 7th March 2025).
Cancer Research UK (2023) Steroids. Available from: Steroids (dexamethasone, prednisolone, methylprednisolone and hydrocortisone) | Cancer information | Cancer Research UK. (Accessed 1st August 2025).
Cancer Research UK (2025) A study looking at treatment for children and young adults with newly diagnosed acute lymphoblastic leukaemia (AllTogether-1). 2025. Available from: https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-study-looking-at-treatment-children-young-adults-with-newly-diagnosed-acute-lymphoblatic-leukaemia-alltogether1#undefined (Accessed 1st August 2025).
Last updated January 2026