The use of corticosteroids in reducing cancer-related fatigue: assessing the evidence for clinical practice

Fatigue is a significant issue for people with advanced cancer, impacting on quality of life. Strategies to address fatigue encompass non-pharmacological and pharmacological approaches and thus require a multidisciplinary approach to manage the physical and psychological impacts on the individual. A widely used strategy to treat fatigue in palliative care is the use of corticosteroids but, despite being frequently prescribed, evidence of their effectiveness is ambiguous. This paper used a systematic approach to explore literature to determine evidence about whether the use of corticosteroids improves levels of cancer-related fatigue in people with advanced cancer. Some 12 relevant papers were found, of which all but 4 were excluded because of age, or because the population group was receiving active treatment. All studies reported improvements in patient-reported fatigue as a result of taking corticosteroids, although the quality of results varied and only a few were deemed to have statistically significant results. While there is some evidence that corticosteroids can improve cancer-related fatigue, more rigorous research is required.