Practical application of steroids in palliative therapy

Area of Science:

• Palliative Medicine
• Oncology
• Pharmacology

Background:

• Palliative care focuses on enhancing the quality of life for patients and families facing life-limiting illnesses.
• Systemic steroids are administered to 32-80% of palliative patients for symptom relief, yet usage guidelines vary significantly.

Purpose of the Study:

• To review the indications, benefits, and safe administration of systemic glucocorticoids in palliative care.
• To highlight the role of steroids in managing specific oncological emergencies and non-specific symptoms.

Main Methods:

• Review of current literature and clinical practices regarding systemic steroid use in palliative care.
• Analysis of specific indications for glucocorticoid administration, including anti-inflammatory and vascular permeability-reducing effects.

Main Results:

• Systemic glucocorticoids (dexamethasone, betamethasone, prednisolone, methylprednisolone) are crucial for managing symptoms like pain, nausea, and dyspnea.
• Dexamethasone is the preferred agent internationally due to potent anti-inflammatory action and fewer mineralocorticoid side effects.
• Therapeutic benefits of steroids in palliative care generally outweigh risks of late-onset side effects, given patient prognosis.

Conclusions:

• Appropriate use of steroids, with careful monitoring and patient education, is essential for effective palliative symptom control.
• Steroid therapy, when indicated and managed properly, significantly contributes to improving the quality of life for palliative patients.