Corticosteroids (glucocorticoids) for cancer and cancer pain

How It Works

Corticosteroids are strong anti-inflammatory drugs. They are used to reduce swelling that causes cancer pain.

Corticosteroids are available as pills, syrups, injections, and intravenous (IV) solutions. The type and extent of a disease determines the exact dose and schedule of administering these drugs.

Why It Is Used

Corticosteroids reduce swelling (inflammation) that causes cancer pain. They are used with other drugs, such as ondansetron and aprepitant, to control and prevent nausea and vomiting caused by chemotherapy.

How Well It Works

Corticosteroids work well to reduce swelling and pain caused by cancer. ¹ When they are used with other drugs, such as ondansetron and aprepitant, they may control and prevent nausea and vomiting caused by chemotherapy. ²

Side Effects

Side effects are common with steroids and can include:

• Nausea, vomiting, stomach upset, or ulcers. To reduce these side effects, take your pills with a full glass of fluid and a small snack.
• Fluid retention, causing swelling of the hands and feet.
• Increased appetite.
• Increased risk of infection.
• Preexisting diabetes getting worse.
• Menstrual period changes.
• Changes in behavior, such as symptoms of paranoia or psychosis.
• Muscle wasting. You may notice that it is difficult to climb stairs or rise from sitting to standing without assistance.

Some problems may occur with long-term use. These include:

• Osteoporosis.
• Cataract formation.
• High blood pressure.
• Development of diabetes.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

During treatment with corticosteroids, do not take any other prescription or nonprescription medicines, including herbal products, without first talking to your doctor. Many other drugs can interact with corticosteroids, resulting in side effects or changes in how well the drugs work.

Do not stop taking corticosteroids suddenly. Withdrawal effects can occur, so it is very important to take the prescribed dose at the times recommended by your doctor. You will be given instructions on how to reduce (taper) your dose gradually at the end of your treatment. Have your doctor write these instructions out for you. If you have any questions about how to taper your dose, call your doctor. Tapering is usually only necessary if you use corticosteroids for a long time. It may not be necessary if you use the steroids only for short periods.

Dexamethasone, if given too rapidly by IV, may cause temporary itching or burning in the vaginal or rectal area. This goes away after a few minutes.

To minimize side effects of oral corticosteroids, take your pills with a full glass of liquid and a small snack.

Corticosteroids should be used during pregnancy only if the benefits to the mother outweigh the risks to the fetus. If you are or may be pregnant, talk to your doctor before using corticosteroids. This drug can pass through your body into breast milk and should not be used while you are breast-feeding.

Avoid sources of infection. Wash your hands frequently, and keep them away from your mouth and eyes. Your immune system may be weakened while you are taking corticosteroids.

Steroids used to treat cancer and cancer pain are not the same as steroids used by body builders (anabolic steroids).

Do not use alcohol or street drugs while you are taking corticosteroids. Tell your doctor if you need more pain relief.

Natural Pain Relief for Back Pain

Eight out of 10 adults in America have—or will soon experience—back pain brought on by the wear and tear of living. It seems simple to pop a pill for the pain, but why not avoid the side effects by trying natural possibilities first? You can turn to natural healing practices and herbs to alleviate back pain. The Chinese medical perspective According to Chinese medicine, the skeletal structure, bones, and lower back are part of the kidney network. Kidney energy tends to diminish as we age, more rapidly with unhealthy diet, excessive strain, and youthful indiscretions such as drug and alcohol use. Weakness in the kidney network results in symptoms of lower back pain, as well as general weakness, fatigue, and other signs of premature aging. Replenishing kidney energy is a slow and difficult process; that is why it is essential to preserve kidney energy. Fortunately, through qigong exercises, herbs, proper diet and lifestyle, you can slow down its depletion and even regenerate certain aspects of kidney energy, and in the process, ease some of your back pain. Try these tips! 1. Eucommia for your aching back Eucommia is a traditional ingredient in herbal formulas for back and joint pain and helps to strengthen your bones, tendons, and ligaments. Western studies with rats have discovered that both the leaves and the bark of eucommia contain a compound that encourages the development of collagen, an important part of connective tissues like skin, tendons, and ligaments. A typical dosage is 350 mg twice a day. You can also try the traditional Chinese Arthritis/Joint formula, which includes eucommia and other herbs that support a strong back. 2. Press here for relief Lower back pain is one of the most common problems that we treat at the Tao of Wellness. We use acupuncture and bodywork to reduce pain, which has proven quite effective. Like acupuncture, acupressure is the art of acupuncture without needles, where you use your own fingers to stimulate a specific acupoint. The combination of the following two acupoints is good for strengthening the kidneys and alleviating back pain: • Find the acupoint: Forceful Torrent (Ki-3), which is in the depression between the inner anklebone and the Achilles tendon of the right foot. Apply steady pressure with your right thumb until you feel soreness. Hold for 3 minutes. Repeat on the left foot. • Find the acupoint: Supporting the Core. It's in the middle of the popliteal crease behind the knee of the right leg. Apply pressure with your right middle finger until you feel soreness. Hold for 3 minutes. Repeat on your left leg. You can also massage the parts or your back that are in pain. Tonic oil, which consists of oils of camphor, peppermint, eucalyptus, fennel, and wintergreen, can be massaged into your back for relief from minor aches and pains. For a traditional blend of tonic oil in a pure sesame oil base, click here. 3. Tasty treats for back pain Make a delicious anti-inflammatory cocktail by mixing equal parts of unsweetened black cherry juice with dark grape juice and drink 3 to 6 glasses a day until the pain has eased. Also, feature more pineapple in your diet. Pineapple contains an enzyme called bromelain, which is a natural anti-inflammatory that helps with back pain, as well as muscle and joint pain. 4. Exercise can ease your back Most back pain is caused by the wear and tear of living, which over time weakens our skeletal structure, in the form of bone loss or a displaced disk. Research conclusively shows that exercise early in life builds bone mass and strengthens the skeletal structure, helping to prevent injury down the road. The good news is that if you are advancing in age, regular exercise can slow the progress of degenerative bone disorders. Generally for a healthy back, I recommend a combination of exercises: a 30-minute daily walk, moderate weight training to strengthen muscles and bones, and tai chi or qigong to build endurance and flexibility. A good form to choose is Dao-In qigong, which is gentle on the body and great for loosening up the back. You can look for a local tai chi practitioner to teach you or learn from an instructional DVD. During acute back pain, exercise may be difficult or too painful. Until you are mobile, bed rest is the best.

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Arab Pekerjakan Robot di Pusat Perbelanjaan - techno.okezone.com

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Trigger Point Injection (TPI) for Pain Management

Trigger point injection (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

Trying to Manage Chronic Pain? Take This Self-Assessment to Get Your Personal Health Report

What Happens During Trigger Point Injection?

In the TPI procedure, a health care professional inserts a small needle into the patient's trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain medication, a dry-needle technique (involving no medications) can be used.

When Is Trigger Point Injection Used?

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. TPI also is used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments. However, the effectiveness of TPI for treating myofascial pain is still under study.

WebMD Medical Reference

Can This Natural Hormone Actually Heal Brain Injuries & Strokes?

Why do some females recover from brain injury much faster and more completely than males?

The answer may have far-reaching implications for the treatment of traumatic brain injury, stroke, and other neurological disorders.

Neuroscientist Dr. Donald G. Stein and his colleagues have been investigating this question and have discovered something remarkable -- that the hormone progesterone neuroprotective effects that improve outcomes and reduce mortality following brain injuries. confers profound

Progesterone provides powerful neuroprotection to the fetus, particularly in late pregnancy, when it helps suppress neuronal excitation that can damage delicate new brain tissue. Dr. Stein and his colleagues have found that in addition to protecting the fetal brain, progesterone also protects and heals injured brain tissue.

Lidocaine Reduces Pain and Anxiety From Peripheral IV Cannula Insertion

      Injected buffered lidocaine or lidocaine cream can reduce the pain and anxiety associated with intravenous cannula insertion, according to study findings reported in the August issue of the Annals of Emergency Medicine. Between the two, injected lidocaine is more effective in alleviating pain.         Many patients who present to the emergency department require placement of a peripheral IV line, which frequently causes pain and anxiety, Dr. Candace McNaughton, from Vanderbilt University, Nashville, Tennessee, and colleagues note.        Most IV placements in the ER are done without local anesthesia, the researchers point out. This may be due to "time constraints, difficulty with their application, perceived ineffectiveness, a belief that use of local anesthesia makes it more difficult to place IVs, or a belief by healthcare providers that the pain of IV insertion is insignificant."      Research has shown that both the pain and anxiety of IV insertion can be reduced by pretreatment with local anesthetics, but the best method was unclear. Anesthetic creams are often used to reduce pain during IV insertion. However, in a busy ER setting, their usefulness is limited due to their delayed onset of action, the authors note. By contrast, injected anesthetics have a more rapid onset, but require an additional needle stick.      In a randomized, crossover study, Dr. McNaughton's team compared pin and anxiety in 70 medical students or nurses who had IVs placed after pretreatment with injected buffered lidocaine, lidocaine cream, or no analgesia. A 10-point numeric rating scale was used to assess pain, anxiety, and treatment preference immediately following IV insertion.      The median pain scores with lidocaine cream and injected, buffered lidocaine were 3 and 1, respectively. Without analgesia, the pain was much worse with a median score of 7. Similarly, the median anxiety score with both lidocaine treatments was 2 compared with a score of 4 without analgesia. The pretreatment method had no bearing on the likelihood of success, the report indicates, and most of the IV placement attempts were successful.      When surveyed, 70% of the subjects indicated that they would always request injected, buffered lidocaine for themselves and for their patients undergoing IV insertion. Lidocaine cream was the preferred treatment for 26% of subjects and no analgesia for 4%. Ann Emerg Med. 2009;54:214-220. News Author: Anthony J. Brown, MD CME Author: Laurie Barclay, MD

Ketamine May Be Useful for Intubation in Critically Ill Patients

Ketamine is a safe, valuable alternative to conventional etomidate for use as a sedative during intubation in critically ill patients, according to the results of a randomized controlled, single-blind trial reported online in the July 1 issue of The Lancet. "Critically ill patients often require emergency intubation," write Patricia Jabre, MD, and colleagues from the KETASED Collaborative Study Group. "The use of etomidate as the sedative agent in this context has been challenged because it might cause a reversible adrenal insufficiency, potentially associated with increased in-hospital morbidity. We compared early and 28-day morbidity after a single dose of etomidate or ketamine used for emergency endotracheal intubation of critically ill patients." At 12 emergency medical services or emergency departments and 65 intensive care units in France, 655 patients requiring sedation for emergency intubation were prospectively enrolled and randomly assigned by a computerized random-number generator list to receive 0.3 mg/kg of etomidate (n = 328) or 2 mg/kg of ketamine (n = 327) for intubation. Group assignment was known to only the emergency medicine physician enrolling patients. The main outcome measure was the maximal score of the sequential organ failure assessment (SOFA) during the first 3 days in the intensive care unit. Analysis was by modified intent-to-treat, with exclusion from analysis of patients who died before reaching the hospital and those discharged from the intensive care unit earlier than 3 days. Data were analyzed for 234 patients in the etomidate group and 235 in the ketamine group. Both groups had statistically similar mean maximal SOFA scores (10.3 ± 3.7 for etomidate vs 9.6 ± 3.9 for ketamine; mean difference, 0.7; 95% confidence interval [CI], 0.0 - 1.4; P = .056). Both groups had a median intubation difficulty score of 1 (interquartile ratio, 0 - 3; P = .70) suggesting similar intubation conditions. Compared with the ketamine group, the etomidate group had a significantly higher percentage of patients with adrenal insufficiency (odds ratio, 6.7; 95% CI, 3.5 - 12.7). No serious adverse events occurred with either study drug. "Our results show that ketamine is a safe and valuable alternative to etomidate for endotracheal intubation in critically ill patients, and should be considered in those with sepsis," the study authors write. Limitations of this study include possibly insufficient power to show a significant increase in morbidity rates associated with etomidate use in patients with sepsis. In an accompanying comment, Dr. Volker Wenzel and Dr. Karl H. Lindner, from Innsbruck Medical University in Innsbruck, Austria, note that successful emergency intubation of critically ill patients depends on pharmacologic knowledge as well as manual skills and clinical experience. Unfortunately, tightening regulations of the European Union hinder trials of commercially noninteresting pathology such as multiple trauma. "We should be lobbying our parliamentary representatives to help with non-commercial research, otherwise industry lobbyists will continue pushing for rules that only global drug companies can comply with," Drs. Wenzel and Lindner write. "Should that occur, our fate would be similar to physicians in developing countries, who have many questions about optimising health care but cannot do clinical trials to find valid answers." The French Ministry of Health supported this study. The study authors and editorialists have disclosed no relevant financial relationships.  Lancet. Published online July 1, 2009.