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Corticosteroid Appetite — SCE Medical Oncology MCQ

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EasySupportive & Palliative OncologyCorticosteroid AppetiteSCE Medical Oncology

A 68-year-old man with cancer cachexia is started on dexamethasone 4 mg daily for appetite stimulation. After 3 weeks, his appetite improves. What is the expected duration of corticosteroid-induced appetite benefit?

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Correct answer: B — Short-term benefit only (typically 2-4 weeks) — corticosteroid appetite-stimulant effect wanes with prolonged use, while side effects (proximal myopathy, hyperglycaemia, immunosuppression, skin fragility) accumulate

Corticosteroids (dexamethasone 2-4 mg daily) are the most commonly used appetite stimulants in cancer cachexia, providing rapid improvement in appetite and well-being. However, the benefit is typically short-lived (2-4 weeks), while cumulative side effects (proximal myopathy worsening sarcopenia, hyperglycaemia, immunosuppression, mood disturbance, skin fragility, adrenal suppression) limit prolonged use. ESMO guidelines recommend short courses (2-4 weeks) for appetite stimulation, with reassessment and planned taper.

Reference: ESMO 2024 Cachexia/Supportive Care; NICE palliative care; Yennurajalingam et al JCO 2013