Cortisone drugs have a bad rap.
Pharmaceuticals like prednisone, prednisolone, dexamethasone, budesonide, and triamcinolone are drugs in the cortisone family. And over the years these medications have achieved much attention as bad chemicals.
This is very likely due to what could be described as overuse. These drugs of have historically been prescribed for a wide variety of medical conditions in medicine. Since these meds provide symptomatic relief for many problems, a large number of people–as well as pets–have received them. And the truth is that we have likely used them excessively in our patients in the past.
As time went on, the medical community began to realize that cortisone drugs have side effects that warrant other meds being tried first. In other words, using higher doses of cortisone drugs when milder treatments could have been effective has been shown to be the wrong strategy. We have witnessed this phenomenon in allergies and arthritis in particular.
However, when one is coping with a cancer diagnosis, the realization must be made that cancer is extremely aggressive. In spite of all of our medical advances, it still resists treatment. Thus, in order to get an edge on cancer to promote longevity and life quality, we need to use a broad range of tools to attack this disease.
Cortisone drugs have their place in cancer medicine. The side effects that are seen with cortisone use are rarely life threatening, while systemic cancer is always life threatening. Therefore if the drug can increase a patient’s lifespan and the disease will proceed relentlessly without it, it is sensible wisdom to at least consider its use.
Here are guidelines for the use of the most common drug in this class, prednisone, taken from Plumb’s Veterinary Handbook, the gold standard of veterinary drug texts:
1. Glucocorticoids can mask disease! Try not to use them until you have a diagnosis.
2. Make a specific diagnosis!
3. Determine course from outset
4. Determine endpoint before you starting treating
5. Use the least potent form for the minimal time
6. Know where glucocorticoids inappropriate. (Behrend 2007)
Prednisone and prednisolone are central players in cancer chemotherapy protocols, most commonly for lymphosarcoma. And the good news is that they really make a difference in both life quality and life span. Oncologists are achieving median survival times of 10-14 months using these chemo protocols. This is most definitely worth considering.
The bottom line is that in some cases we have swung too far in being anti-drug. We need a balanced approach to cancer treatment.
We should always consider diet, apoptogens, anti-metastatics, pain control as needed, and efforts to convert our patients to a cancer-fighting brain state. We must consider surgery, radiation, and chemotherapy (all of these are discussed in the Guide).
Don’t forget, when using cortisone drugs, decrease the dose of Apocaps to ¼-1/2 the labeled dose if your dog is receiving cortisone drugs, give with a full meal, and use this combination under veterinary supervision only.