{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:48:26Z","timestamp":1777384106265,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2013,4,15]],"date-time":"2013-04-15T00:00:00Z","timestamp":1365984000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:p>Steroids are commonly used for fatigue relief in terminally ill cancer patients. However, steroid-induced adverse effects including depression, myopathy, and hyperglycemia may contribute to fatigue. We report our experiences with aggravation of fatigue with steroid use in three cases. Case 1 was a 65-year-old man with advanced gastric cancer. He was started on betamethasone (2 mg\/d) for fatigue, but the fatigue worsened due to steroid-induced depression. Discontinuation of steroids and initiation of an antidepressant ameliorated the fatigue. Case 2 was a 68-year-old man with advanced lung cancer. He complained of fatigue. Betamethasone (1 mg\/d) was started and alleviated the fatigue. However, when the betamethasone dose was increased to 2 mg\/d, the fatigue, with muscle weakness and myalgia, worsened due to steroid-induced myopathy. We therefore switched from betamethasone (2 mg\/d) to prednisolone (10 mg \/d). The fatigue resolved and the patient returned to his previous condition. Case 3 was a 73-year-old man with recurrent bile duct cancer. He also had diabetes mellitus. He developed fatigue, anorexia and fever. We started betamethasone (1.5 mg\/d) for these symptoms, but the fatigue and anorexia worsened due to steroid-induced hyperglycemia. Blood glucose rose to 532 mg\/dL. Therefore, insulin therapy was started, and the dose of betamethasone was reduced to 0.5 mg\/d. His glucose level decreased to less than 320 mg\/dL and he recovered from the fatigue while achieving moderate oral intake. In conclusion, the possibility of steroid-induced secondary fatigue in terminally ill cancer patients should be taken into consideration.<\/jats:p>","DOI":"10.1177\/1049909113485280","type":"journal-article","created":{"date-parts":[[2013,4,15]],"date-time":"2013-04-15T21:28:02Z","timestamp":1366061282000},"page":"341-344","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Aggravation of Fatigue by Steroid Therapy in Terminally Ill Patients With Cancer"],"prefix":"10.1177","volume":"31","author":[{"given":"Naoki","family":"Matsuo","sequence":"first","affiliation":[{"name":"Hospice, Medical corporation Junkei-kai Sotoasahikawa Hospital, Akita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinomi","family":"Yomiya","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Saitama Cancer Center, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,4,15]]},"reference":[{"key":"bibr1-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1177\/0269216307085183"},{"key":"bibr2-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.12-S1-43"},{"key":"bibr3-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2011.0534"},{"key":"bibr4-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1191\/026921601673324846"},{"key":"bibr5-1049909113485280","first-page":"916","volume-title":"The Oxford Textbook of Palliative Medicine","author":"Yennurajalingam S","year":"2009","edition":"4"},{"key":"bibr6-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.08.013"},{"key":"bibr7-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-8343(02)00241-4"},{"key":"bibr8-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(83)90022-8"},{"key":"bibr9-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-197904000-00006"},{"key":"bibr10-1049909113485280","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v61n0404"},{"issue":"3","key":"bibr11-1049909113485280","first-page":"263","volume":"33","author":"Ros LT","year":"2004","journal-title":"Afr J Med Med Sci"},{"key":"bibr12-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.5.1234"},{"key":"bibr13-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2010.02.025"},{"key":"bibr14-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(93)90161-Q"},{"key":"bibr15-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2011.0002"},{"key":"bibr16-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(01)00043-0"},{"key":"bibr17-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1177\/026921639300700212"},{"key":"bibr18-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(96)00326-0"},{"key":"bibr19-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.03.011"},{"key":"bibr20-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2011.0513"},{"key":"bibr21-1049909113485280","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6860.969"}],"container-title":["American Journal of Hospice and Palliative Medicine\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1049909113485280","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1049909113485280","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1049909113485280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:28:30Z","timestamp":1777368510000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1049909113485280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,15]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,5]]}},"alternative-id":["10.1177\/1049909113485280"],"URL":"https:\/\/doi.org\/10.1177\/1049909113485280","relation":{},"ISSN":["1049-9091","1938-2715"],"issn-type":[{"value":"1049-9091","type":"print"},{"value":"1938-2715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,15]]}}}