Steroids for children

Steroids occur naturally within our bodies, but can also be made in the laboratory for medical purposes. One of their key functions is to reduce inflammation/swelling and ease associated symptoms, such as headaches. They are also used to protect the brain during surgery. In other words, steroids help to manage the symptoms of a brain tumour rather than treating the tumour itself.

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When and why might my child be given steroids?

It is highly likely that your child will be given steroids at some point during their treatment.

After diagnosis

When your child has a tumour in their brain, it is not only the tumour itself that causes some of the symptoms they may have, but also the swelling surrounding the tumour. This swelling puts pressure on surrounding tissues that can cause symptoms such as headaches, sickness and seizures (fits). To help reduce the swelling, your child's doctor may prescribe steroids. As steroids are fast-acting drugs this could mean that some of the effects caused by the tumour reduce quite quickly. This does not mean, however, that the size of tumour itself has been reduced.

Before or after treatment

If your child is having radiotherapy or surgery as part of their treatment, they may be given steroids to help bring down swelling caused by these treatments. Also, if your child is having chemotherapy, a low dosage of steroids may be given if they feel seek (have nausea).

How will my child take steroids?

There are different ways that steroids can be taken, including:

orally (as tablets or liquid medicine)
by injection (to the vein or muscle)

The most common way for children to take steroids is in tablet form. The tablets are small and should not be too difficult for your child to swallow. They could practice by swallowing tic tacs.

How long will my child need to take steroids for?

Generally, your child will only take steroids for a few days or weeks. You will be given instructions from your child's doctor about exactly when and for how long your child will need to take steroids.

If taking steroids for longer than a week, your child is likely to be given a steroid card. It has important information about the type of steroid and the dosage that may be needed in an emergency.

You may also wish to buy your child a medical alert bracelet.

What if I forget to give my child their steroids?

It might help to leave yourself a note or set an alarm to remind you. Getting into a routine of when your child takes their steroids is also helpful. If your child does miss a dose, do NOT try to compensate by giving them a double dose next time. Speak to your child's doctor to see what they advise.

Important points to remember:

Steroids help with symptom management rather than treating the tumour itself

It is important that your child keeps taking steroids for as long as their doctor tells them to. When taking steroids your child's body will start to produce less of its own steroids naturally, so stopping steroids suddenly can make your child unwell.

Your child must always carry their steroid card with them - for up to a year after treatment.

The steroids used for brain tumours are NOT the anabolic steroids that are used by some athletes to build muscle

What are the side-effects of steroids?

Everybody is different and your child is unlikely to have all these side-effects. You should talk to your child's doctor about any side-effects they do experience.

Remember do NOT stop giving your child their steroids without advice from your doctor.

Common side-effects of steroids

Common side-effects of steroids include:

feeling hungrier than usual - if not managed, this can lead to weight gain

difficulty sleeping

indigestion or heartburn

infection in the mouth - known as oral thrush

feeling thirstier or needing to wee more often
(Speak to your child's doctor promptly, as your child's blood sugar levels may have temporarily heightened)

swelling of the hands and feet - because their body is retaining fluid

emotional effects - such as anxiety, irritability, temper tantrums, crying

Side effects with longer term use of steroids (more than a few months)

With longer term use of steroids (more than a few months), other side-effects include:

skin feeling thinner

bruising more easily

legs feeling weaker

increased chance of catching infections and infections being more severe
(as your child's immune system may be lower)

increased pressure in the eyes, which can lead to gradual loss of vision
(take your child to the opticians regularly to be monitored for any signs)
their growth may be affected, if taking a high dose of steroids for a long time

Children on steroids should not be given 'live' vaccines including the MMR (measles, mumps and rubella) injection nor the BCG injection (which protects against tuberculosis). Speak to your child's doctor about this.

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