Corticosteroids for alleviating dyspnea in patients with terminal cancer

Dyspnea is a common symptom in patients with cancer, particularly those with advanced disease. Although corticosteroids can provide effective symptom relief to such patients, the effects of these drugs on dyspnea have not been evaluated. Therefore, we retrospectively evaluated the effect of corticosteroids on dyspnea in patients with terminal cancer through a surrogate third-party evaluation intended to overcome the difficulties of self-evaluation. We investigated the electronic medical records of 693 patients who were hospitalized at Kasugai Municipal Hospital between January and December 2015 and subsequently died. After excluding patients whose deaths were not directly cancer-related and 214 patients remained eligible, 19 of 34 remaining patients with dyspnea were ultimately included in the survey. Eleven patients in the final sample received corticosteroid treatment. Among the 11 patients who received corticosteroids, 9 (81.8%), 1 (9.1%), and 1 (9.1%) received betamethasone, dexamethasone, and prednisolone. The expression of the intended effect was observed in 6 of 11 patients in the steroid group. The median time to effect expression in the steroid group was 2 days. The median durations of effect in the steroid group were 3 days. After eliminating the opioid effect, we confirmed that steroid administration improved patients’ STAS-J scores and possibly alleviated dyspnea.