Patients with advanced cancer are being given steroids without monitoring or any clear benefit.
A study of 100 patients with advanced cancer at St Joseph's Hospice in London, one third of whom were taking steroids, showed that only eight felt they had benefited from the drugs.
Steroids are given to cancer patients for specific anti inflammatory effects. Some studies made a link between the use of steroids in older breast cancer patients and a slowing of the progression of their cancer by as long as a year.
In most cases, the patient's response to steroid hadn't been monitored. Fifteen of the 28 patients answering the questionnaire did not know why they were taking the drugs, and 16 didn't know whether the dose was to be reduced or continued.
Nearly a quarter of the patients on steroids had severe side effects associated with steroid use, including moon face, severe osteoporosis and muscle wasting. And only eight of the steroid patients knew of the dangers of stopping steroids suddenly.
The hospice results jibe with those of another study showing that one third of several hundred patients with advanced cancer receiving steroids developed oral candidiasis; in one in 20 treatment with steroids was stopped because of unacceptable side effects. "If this sample is representative it seems that, once started, corticosteroids are stopped only rarely and that the impact of the treatment is not adequately monitored," said an accompanying editorial.