Corticosteroids for Cancer Pain

Inclusion Criteria:

• Verified malignant disease
• Receiving a scheduled strong or weak opioid
• Insufficient pain control: Average pain last 24 h: ≥ 4 (NRS 0-10)
• Given informed consent according to the ethical guidelines
• Able to complete planned assessment schedules
• ≥ 18 years of age
• Life expectancy > 1 month

Exclusion Criteria:

• Excruciating pain (average pain ≥ 8) (These patients should be considered as emergency patients. Patients may be eligible for the study after stabilization)
• Dose adjustment in scheduled opioid medication last 48 hours
• Concurrent medication with NSAIDs (Patients are eligible for the study one week after NSAIDs are discontinued)
• Receiving radiotherapy within 4 weeks before entering the study or planned within the study period
• Started systemic treatment (chemotherapy, hormone therapy or bisphosphonates) within 4 weeks before entering the study Patients who have received chemotherapy for more than 4 weeks are eligible for the study if it is more than 7 days since receiving the last dose and they are not having the next dose within the study period
• Manifest spinal cord compression or in need of bone surgery
• Severe cognitive impairment
• Previously on steroids during the last 4 weeks
• Diabetes mellitus
• Known peptic ulcer disease
• Systemic fungal disease, patients vaccinated with viable viruses, and patients with known allergies to the study medication (MethylPrednisolone)
• Female patients who are pregnant or lactating.
• Women of reproductive potential not willing or unable to employ an effective method of contraception (be sterilized, using IUD or oral contraception)
• Patients using following medication: cyclosporin, erythromycin, phenobarbital, phenytoin, carbamazepin, ketoconazole, methotrexate, ciclofosfamide, rifampicin, aprepitant and diltiazem.