Steroids for brain tumours

PDF download is not available for Arabic and Urdu languages at this time. Please use the browser print function instead

Learn about steroid treatment for brain tumours, including why your child may need this treatment and the possible side effects.

Key points

  • Steroids are given to manage symptoms of brain tumours by reducing swelling in normal tissues.
  • It is very important that your child takes dexamethasone exactly as the treatment team has told you.
  • Dexamethasone can cause unpleasant side effects such as heartburn and stomach irritation, sleep problems, water retention, skin problems, weakness, and changes in mood.

Your child may be given a type of medicine called a steroid. Steroids are given to manage some of the symptoms of the brain tumour. The steroid that is most commonly used with brain tumours is dexamethasone. It may also be called dex.

Dexamethasone falls into the group of steroids known as glucocorticoids. These are different from anabolic steroids, which some athletes use to build muscle. They are also different from sex steroids (or sex hormones) such as estrogen and testosterone. Glucocorticoids are used to manage many medical conditions.

Why does my child need dexamethasone?

Brain tumours cause swelling (edema) in the normal tissues near the tumour, leading to symptoms such as headache, nausea and vomiting. Dexamethasone may be prescribed to treat swelling and may be taken one or more times a day a tablet or as a liquid.

Dexamethasone may be given:

  • at the time of diagnosis to ease symptoms
  • with surgery, to reduce swelling after an operation
  • with radiation therapy, to reduce the swelling that may occur during treatment
  • for long-term use to reduce symptoms

Dexamethasone does not have an effect on the tumour. The benefit of symptom relief is only temporary.

Important information about dexamethasone

Your child needs to take dexamethasone exactly as the treatment team has told you. It can be dangerous for your child to stop taking it suddenly. This is because your child’s body stops making its own steroids when they are taking dexamethasone. Steroids are involved in many important functions in the body, such as helping the body respond to stress. If your child suddenly stops taking dexamethasone, they may become unwell.

Your child’s treatment team will talk to you about how you can gradually reduce the dose of dexamethasone when it is appropriate, or "wean" your child, so that it is safe.

What are the side effects of dexamethasone?

Even though dexamethasone may make your child feel much better, it may produce some unpleasant side effects. Most of these will end once treatment is over. However, in some cases dexamethasone may need to be used for months, and then certain effects will last longer.

Side effects

  • Stomach irritation: Dexamethasone can cause stomach irritation that feels like heartburn. Make sure your child takes dexamethasone with food. Your child may be given antacids that reduce acid production.
  • Stomach problems: If your child has problems with bowel movements, they may be given a stool softener. It makes bowel movements easier.
  • Mood changes, such as irritability: This is sometimes seen in children taking dexamethasone. It can be mild symptoms such as mood swings or crying easily, or more serious such as bizarre behaviour. This side effect will go away when the dexamethasone use is stopped, or the dose is reduced.
  • Sleeping problems: Mild exercise before bed, such as a walk around the block, may help. If your child has several daily doses of dexamethasone, give the last dose no later than 6 pm.
  • Increased appetite: Your child may develop a huge appetite when they are given high doses of dexamethasone. As a result, they may gain weight. Most of the extra weight is from fluids that the body retains while on dexamethasone.
    • Make sure your child is eating healthy, well-balanced meals while their appetite is good. Avoid foods with high amounts of salt, as they can add to the water retention. Keep lots of low-calorie snacks on hand, such as fruits and vegetables, or popcorn without salt or butter.
    • Your child’s appetite should return to normal and the weight will drop once they stop taking dexamethasone. If they continue to gain weight, talk to the treatment team.
  • Increase in thirst and more peeing: This may indicate an increase in blood sugar levels. Talk to your child’s treatment team. In some cases, the dietitian may recommend a low concentrated carbohydrate diet for your child.
  • Water retention: Your child may have swelling in their hands, feet, or around their face. Raise your child’s feet when they are sitting. Avoid tight fitting clothing. Avoid adding extra salt (sodium) to foods or serving foods with lots of salt, such as processed foods.
  • Skin problems: Some of the problems that may develop are acne or hair on the shoulders or back. The acne usually goes away when the dose of the dexamethasone is reduced. Stretch marks may occur due to rapid weight gain and they are not reversible. Talk to the treatment team about how to deal with these effects.
  • Weakness: Your child may feel weak when walking up stairs or standing up from a sitting position. This side effect should go away when dexamethasone use stops.
  • Increased risk of infection: Dexamethasone can lower your child’s resistance to infections such as measles or chicken pox.

Side effects from long-term use

  • Bone loss (osteoporosis): There are certain measures you can take to prevent bone loss while your child is taking dexamethasone. Make sure your child stays physically active as much as possible. They should consume the daily recommended amounts of calcium, an important mineral found in bones, and vitamin D to help the bones absorb calcium. Talk to your child’s treatment team for further information.
  • High blood pressure: Avoid adding extra salt to food or giving your child foods with lots of salt, such as processed foods.
  • Muscle wasting: The muscles involved in standing, walking, and moving the arms (proximal muscles) may become weak. Make sure your child stays physically active as much as possible. Muscle weakness may be improved by reducing the dose of dexamethasone. Rehabilitation, such as physical or occupational therapy, may also help.
Last updated: July 20th 2022