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Steroids around your cancer operation | CION Cancer Clinics
If you have taken steroid tablets, injections or repeated courses with chemotherapy, you may need extra steroid around your operation, often called a stress dose. Your body may not make enough of its own under the strain of surgery. Your anaesthetist decides whether you need it. This page explains which medicines count, what usually happens, and the warning signs to act on at home. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Do you need extra steroids around surgery?
- Which medicines count as steroids?
- How are steroids usually handled before, during and after surgery?
- What do people get wrong about steroids and surgery?
- What should you take to your pre-surgery appointment?
- How else can steroids affect your operation and recovery?
- Common questions about steroids around surgery
The short answer
Do you need extra steroids around surgery?
If you have been taking steroid tablets or injections for a while, you may need extra steroid around your operation, often called a stress dose. Whether you need it, and how much, is decided by your anaesthetist, so the most important thing you can do is tell them about every steroid you have used.
Why steroids change the plan
Your body makes its own steroid hormone, cortisol, in two small glands above the kidneys. During an illness or an operation it makes much more, which helps keep your blood pressure and sugar steady. When you take steroid medicines for a long time, those glands can slow down. They may not be able to produce the extra amount your body needs under the stress of surgery.
What can happen if it is missed
Without enough steroid, blood pressure can fall and stay low despite fluids, and you may feel very weak, sick or confused. This is uncommon, but serious. It is also easy to prevent when the team knows in advance.
What this page cannot tell you
It gives no doses and no timings. Those depend on which steroid you take, for how long, and the size of your operation. It also cannot tell you whether your own glands have slowed down. Only tests or your doctor's judgement can.
Never stop steroid tablets suddenly before surgery. That on its own can cause the problem this page describes.Tell the team about all of these
Which medicines count as steroids?
Many families do not think of these as steroids at all. The anaesthetist would rather hear about one too many than miss one.
Steroid tablets
Prednisolone (Wysolone, Omnacortil), methylprednisolone (Medrol), deflazacort and dexamethasone. Used for asthma, arthritis, skin, kidney and bowel conditions, and after transplants.
Steroids given with cancer treatment
Dexamethasone is often given with chemotherapy to prevent sickness, and for swelling around a brain tumour or a pressed spinal cord. Short courses can still matter, especially if they were repeated.
Mention it if you have had
- Steroid with every chemotherapy cycle
- Steroid for brain or spine symptoms
- Steroid for an immunotherapy side effect
Injections and inhalers
Steroid injections into joints or muscles, and high-dose steroid inhalers such as budesonide or fluticasone. A single joint injection rarely matters, but tell the team anyway.
Creams and unlabelled remedies
Strong steroid creams used over large areas, and some powders or mixtures bought without a label, which are sometimes found to contain steroids. Bring these to your check so they can be looked at.
Not sure whether this applies to you?
Ask an oncologistAround the operation
How are steroids usually handled before, during and after surgery?
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Pre-anaesthetic check
You list every steroid you take or have taken recently, with the name, strength and how long. The anaesthetist decides whether you need extra cover. Occasionally a blood test of your cortisol level is arranged first.
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The morning of surgery
Most people on regular steroid tablets are asked to take their usual morning dose with a sip of water. Do this only if your team tells you to, and say at admission that you took it.
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At the start of the operation
If extra cover is needed, it is usually given as an injection by the anaesthetist. You will not notice it.
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The first days after
Extra steroid may continue for a short time, through a drip or injection, until you are eating and recovering. The dose is then brought back to your usual one.
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Going home
You leave with clear written instructions on which steroid dose to take. Ask whether you should carry a steroid card or note, and what to do if you become unwell.
!
One thing that cannot wait
If someone on long-term steroids becomes very weak, dizzy or faint, is vomiting and cannot keep tablets down, or becomes confused after going home from surgery, go to the nearest emergency department the same day. Say clearly that they take steroids and have just had an operation. Take the steroid strip with you. Do not wait to see if it settles overnight.
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Commonly believed
What do people get wrong about steroids and surgery?
"Steroids slow healing, so stop them before the operation."
Steroids can slow wound healing, but stopping them suddenly is far more dangerous. It can leave your body without the hormone it needs under stress. Any reduction is planned by your doctors, slowly and in advance.
"It was only a short course, so it does not count."
Short courses usually matter less, but repeated short courses can add up. Dexamethasone with each chemotherapy cycle is a common example. Let the anaesthetist decide what counts.
"An inhaler is not a real steroid."
Most inhalers at ordinary doses do not cause a problem. High doses over a long time can, and your inhaler is also important for your breathing under anaesthetic. Bring it with you.
"Extra steroid for surgery means I will stay on a high dose."
Stress cover is usually brief. You go back to your usual dose as you recover.
Bring to the check
What should you take to your pre-surgery appointment?
- Every steroid strip, inhaler, cream and injection record
- Old prescriptions that show how long you have been on steroids
- Your chemotherapy or immunotherapy treatment summary
- Any steroid card or note from a previous hospital
- Recent sugar readings, since steroids raise blood sugar
- Unlabelled powders or remedies, in their packets
Beyond the dose
How else can steroids affect your operation and recovery?
Long-term steroids do more than change the anaesthetic plan. They can affect healing, sugar and infection, and your team keeps an eye on each of these after surgery.
Wounds and infection
Steroids can make wounds heal more slowly and hide the usual signs of infection, such as fever. The ward team checks your wound closely, and you should report any redness, discharge or pain that is getting worse at home, even if you have no fever.
Blood sugar
Steroids raise blood sugar, and extra steroid around surgery can raise it further. People with diabetes may need more insulin for a while, and some people without diabetes need sugar checks too.
Who this does not apply to
If you have never taken steroids, or only used a mild cream on a small patch of skin, none of this changes your plan. People with known adrenal or pituitary gland conditions need a specialist's plan, not a general one, and should raise it well before the surgery date.
Questions we are asked
Common questions about steroids around surgery
What is a steroid stress dose?
It is extra steroid given around an operation to cover the higher amount your body would normally make under stress. It is usually given as an injection by the anaesthetist at the start of surgery, sometimes continued for a short time afterwards. Not everyone on steroids needs it.
Do I take my prednisolone on the morning of surgery?
Many people are asked to take their usual morning dose with a sip of water, but this is your anaesthetist's decision. Ask at your pre-surgery check and get the answer in writing. Do not skip the dose simply because you are fasting.
I had dexamethasone with chemotherapy. Does that matter?
It may. Steroid given with several chemotherapy cycles can add up, especially if the courses were close together or recent. Tell the anaesthetist how many cycles you had and when the last one was. Your chemotherapy summary helps them decide.
Will the extra steroid cause side effects?
Because stress cover is usually short, lasting side effects are uncommon. You may notice higher sugar readings, some restlessness or trouble sleeping for a few nights. Tell the ward team if these bother you. They settle once you are back on your usual dose.
Can I have surgery if I have to stay on steroids?
Yes, many people do. Steroids are one of several things the surgeon and anaesthetist weigh when planning your operation and recovery. They may watch the wound more closely and check your sugar more often. Whether surgery is right for you is a decision for your team.
What is a steroid card, and do I need one?
It is a card or note that says you take steroids and may need extra cover if you are ill or injured. It helps emergency teams who do not know you. Ask your doctor whether you should carry one, and keep a photo of it on your phone.
My mother takes an Ayurvedic powder for joint pain. Should we mention it?
Yes. Bring the packet to the pre-surgery check. Some unlabelled powders sold for pain or breathing have been found to contain steroids, and nobody can plan for what they do not know about. Nobody at the hospital will judge you for it.
Who should I call if I am unwell at home after surgery?
For weakness, fainting, vomiting or confusion, go to an emergency department the same day and say you take steroids. For milder worries, such as high sugar readings or a slow wound, call the team that did your operation and ask.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Sources
- NHS — Steroids
- NICE — Perioperative care in adults (NG180)
- Cancer Research UK — Surgery for cancer
- National Cancer Institute — Surgery to treat cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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