HER2 Support Group Forums - View Single Post - Confused steroids/anti-inflammatories

Lani · 04-24-2006, 08:46 AM

As if your medical problems themselves weren't enough!

Ibuprofen (and naprosyn and clinoril and a host of others) are NSAIDS (nonsteroidal antiinflammatories) they make your body make less prostaglandins (chemicals which are involved in inflammation) by decreasing the enzymes needed for their synthesis (cox enzymes). One of these cox2 is involved in many her2 positive breast cancers, so NSAIDS may help prevent it (and perhaps treat it, but the relevant studies are not performed, conclusive yet--I found one on herceptin and an NSAID in metastatic breast cancer where it didn't perform as well as expected)

Those that are both cox1 and cox2 inhibitors (ibuprofen, naprosyn, aspirin, indocin, etc) also thin your blood, those that are cox2 speciific (eg celebrex)
generally do not (or much less) as it is the cox1 which prevents the blood cells called platelets responsible for stopping bleeding from joining together.

Steroids are, by definition, NOT non-steroidal antiinflammatories. They are STEROIDAL antiinflammatories as they work in a different way to fight inflammation. They do not thin the blood, but they make your white blood cells not work quite as well, which is not a good thing IF you had an infection--I take it you do not.

In some studies (head and neck cancer for one) taking cox2 inhibitors
radiosensitizes the tumor so that a given amount of radiation is more effective--you get more bang for the buck. But they must be discontinued 5-14 days before surgery if they decrease both cox1 and 2 to avoid excess bleeding

I wish we could find you a thoughtful radiation therapist or surgeon to discuss all this with you. Oncologists generally only want to discuss their potions and are less well versed at the particulars of surgery and radiation.

Steroids can cause a false sense of well-being (and a sort of let-down when you stop them) so be aware of how they and the morphine are altering your mood and perhaps not letting you fully be your spirited self!

Be sure to keep asking questions of your doctors --

In case they continue to keep dropping the ball we will keep trying to answer your questions as best we can and you can be sure that lots of prayers are going your way!

04-24-2006, 08:46 AM	#4
Lani Senior Member Join Date: Mar 2006 Posts: 4,783	Lyn, sorry about your ongoing troubles with doctors As if your medical problems themselves weren't enough! Ibuprofen (and naprosyn and clinoril and a host of others) are NSAIDS (nonsteroidal antiinflammatories) they make your body make less prostaglandins (chemicals which are involved in inflammation) by decreasing the enzymes needed for their synthesis (cox enzymes). One of these cox2 is involved in many her2 positive breast cancers, so NSAIDS may help prevent it (and perhaps treat it, but the relevant studies are not performed, conclusive yet--I found one on herceptin and an NSAID in metastatic breast cancer where it didn't perform as well as expected) Those that are both cox1 and cox2 inhibitors (ibuprofen, naprosyn, aspirin, indocin, etc) also thin your blood, those that are cox2 speciific (eg celebrex) generally do not (or much less) as it is the cox1 which prevents the blood cells called platelets responsible for stopping bleeding from joining together. Steroids are, by definition, NOT non-steroidal antiinflammatories. They are STEROIDAL antiinflammatories as they work in a different way to fight inflammation. They do not thin the blood, but they make your white blood cells not work quite as well, which is not a good thing IF you had an infection--I take it you do not. In some studies (head and neck cancer for one) taking cox2 inhibitors radiosensitizes the tumor so that a given amount of radiation is more effective--you get more bang for the buck. But they must be discontinued 5-14 days before surgery if they decrease both cox1 and 2 to avoid excess bleeding I wish we could find you a thoughtful radiation therapist or surgeon to discuss all this with you. Oncologists generally only want to discuss their potions and are less well versed at the particulars of surgery and radiation. Steroids can cause a false sense of well-being (and a sort of let-down when you stop them) so be aware of how they and the morphine are altering your mood and perhaps not letting you fully be your spirited self! Be sure to keep asking questions of your doctors -- In case they continue to keep dropping the ball we will keep trying to answer your questions as best we can and you can be sure that lots of prayers are going your way!