Corticosteroids, like dexamethasone and prednisone, are staple drugs that pretty much every myeloma warrior takes, has taken, or will take. They are the drugs that patients love to hate. They can give make us hyper crazy with energy, neurotic and quick to anger. It can mess with blood sugar levels and once the dose is complete, it can make us "crash." So why can't we just stop taking dex and move onto something else? It's simple. It works well alone and in combination with other myeloma drugs. So how do they work and why are they used in myeloma? Here's a little more about this important class of drugs:
Dexamethasone is a corticosteroid that prevents the release of substances in the body that cause inflammation. Dexamethasone is used to treat many different inflammatory conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders. And, yes, multiple myeloma. Source: Drugs.com
Corticosteroids, such as dexamethasone and prednisone, are an important part of the treatment of multiple myeloma. They can be used alone or combined with other drugs as a part of treatment. Corticosteroids are also used to help decrease the nausea and vomiting that chemo may cause. Common side effects of these drugs include
When used for a long time, corticosteroids also suppress the immune system. This leads to an increased risk of serious infections. They can also weaken bones. (Source: cancer.org)
- High blood sugar
- Increased appetite and weight gain
- Problems sleeping
- Changes in mood (some people become irritable or “hyper”)
Although the body makes steroids in the adrenal glands, which are small glands located on top of your kidneys, dexamethasone is a synthetic (man-made) product created in the laboratory. Dexamethasone may be used alone or in combination with other drugs at any point in the course of myeloma treatment, including during chemotherapy, before a stem cell transplant, and after myeloma has come back, or in a myeloma that has not responded to other therapies.
Dexamethasone and the other steroids are useful in myeloma treatment because they can stop white blood cells from traveling to areas where cancerous myeloma cells are causing damage. This decreases the amount of swelling or inflammation in those areas and relieves associated pain and pressure. More importantly, in high doses, dexamethasone can actually kill myeloma cells. When combined with other myeloma drugs, it can also make those drugs work even better. Other agents used with dexamethasone include chemotherapeutic drugs, such as vincristine (Oncovin) and doxorubicin, and immunomodulators (drugs that affect the immune system, the body's natural defenses), such as thalidomide and lenalidomide (Revlimid). Dexamethasone and other steroids are sometimes used by themselves to treat the disease. Dexamethasone is the most effective single agent for treatment of multiple myeloma when given in large doses. The risk of side effects is much higher at these doses, however.
So here are some common drug combos used to treat myeloma. Notice how many of then include dex:
The choice and dose of drug therapy depend on many factors, including the stage of the cancer and the age and kidney function of the patient.
Bottom line: You must keep your doctor informed of your health, concerns, and potential side-effects of any drug you're taking. Do not be lax on this one. Yes, it matters! And an ode to Dex via song...
...And now onto something "lighter" and fun (if that can be said with Dex in the same sentence) Jenny Ahlstrom, myeloma survivor, mom, wife, founder of this web site, and so much more, wrote a song about the drug we love to hate. You'll love it! Click here to listen.
The words, so you can sing along, follow:
Don’t be unkind, why be so cruel What did I do to deserve to play the fool? You lift me up, and then let go You’re playing games with me, for all I know And I will get by after all that we’ve been through The real me is trapped inside until I’m free of you And I will say goodbye, when it’s time Waiting for the day that you’re not on my mind After all is said and done, I know I’ll be just fine And I will say goodbye when it’s time I’m in a rage, I want to cry Must think this crazy pain is worth my while I want to go, I always stay I’m running round in circles, can’t go on this way But I will survive after all you put me through Friends wonder why and ask just what I see in you And I will say goodbye, when it’s time Waiting for the day that you’re not on my mind After all is said and done, I know I’ll be just fine And I will say goodbye when it’s time And I will survive after all you put me through The real me is trapped inside until I’m free of you And I will say goodbye, when it’s time Waiting for the day that you’re not on my mind After all is said and done, I know I’ll be just fine And I will say goodbye when it’s time And I will say goodbye, when it’s time Can’t wait for the day that you’re not on my mind After all you put me through, I know I’ll be just fine And I will say goodbye when it’s time
about the author
Lizzy Smith was diagnosed with myeloma in 2012 at age 44. Within days, she left her job, ended her marriage, moved, and entered treatment. "To the extent I'm able, I want to prove that despite life's biggest challenges, it is possible to survive and come out stronger than ever," she says.