possible use of prednisone

[DianeSH]

I have inflamed sinuses and have taken short term prednisone before. If I were to do this again would it complicate or damage things? I was just diagnosed with the pre-cursor to CLL and do not have CLL yet. I want to do all I can to prevent it from developing further. I also have been getting cortisone shots in my hip for bursitis.

My question is ..is it advisable to get the prednisone or cortisone when I need it or should I avoid it completely....

Thank you

75 year old 9 year survivor of both kidney and uterine cancers, surgery only

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[SofiaDeo]

Since steroids can suppress your immune system a bit, anyone with immune system issues is generally recommended to be judicious in their use. But this is because of an increased risk of infection, not because they can either make or allow the blood cancer to grow. I am unaware of steroids contributing to the growth of blood cancer, or blood cancer precursors. This question might best be asked to your hematologist/oncologist, whether or not steroids have aggravated blood cancers in their patients. Mostly I have seen articles regarding steroids affecting certain hormones, and cancers that are sensitive to those hormones may be affected. Things like breast or prostate cancer. Some lymphoma and other cancer treatments actually use steroids in the treatments.

If you had immunotherapy treatment coming up soon, they probably should be discontinued if possible.

[Big_Dee in reply to SofiaDeo]

Hello SofiaDeo

Great reply. I have had sinus issues for ever and had severe bout from end of May to Sept. Did a lot of nasal sprays and over the counter meds, final nasal discharge back to normal. Actually, more concerned about my CLL relapse rather than sinus infection.

[cllady01 Former Volunteer]

Check out this possible way to go by Harvard Health Publishing

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[Davidcara]

From my layperson and personal experience point of view: Most MDs will tell you there is minimal systemic absorption and side effects from bursitis steroid injection. It can and may happen but, no where to the extent of oral steroids.

Did the oral steroids help your sinuses? If yes, was that relief long lasting. If no, then probably a bad idea to repeat the therapy, and subject yourself to all of the possible side effects. From a CLL point of view, my providers never worried to much about oral short term steroids. They were hesitant because, of possible side effects and further suppressing my immune system.

How do you know you have inflammatories sinuses? Have you seen a specialist. Not that seeing a specialist is always warranted.

Before repeating oral steroids, have you tried steroid and antihistamine nasal sprays?

I am recovering from a secondary sinus infection due to covid infection. Had Augmentin antibiotics, and after completion my CT Scan still showed infection and inflammation. Followed that up with doxycycline antibiotics and bactrim antibiotics. ENT scoped my sinuses and prescribe Neli Med Sinus Wash ( you can look it up ) with the addition of a prescribed steroid that I add to the wash, twice a day for two weeks, and then once a day for four weeks.

Try googling budesonide steroid sinus irrigation. Actually, let me see if I can find you a link

Can’t seem to figure out a link but, you could google it

[BeckyLUSA]

Has your doctor(s) checked your IgG levels? I was having 5-6 sinus infections a year before my CLL diagnosis. All of my immunoglobulins were very low and I was started on IVIG, which I still get every six weeks. Since starting IVIG, 6 years ago, I have only had 3 sinus infections. Just a thought.

[Gretsch6120]

I have had both medications and no side effects or issues. In fact prednisone actually has the effect of lowering your white cell blood count it did in me for a short time. However it is not a treatment for cll because steroids are bad long term and can harm you.

[DianeSH in reply to Gretsch6120]

Thank you for your response. I am newly diagnosed with the precursor to CLL and I cant seem to get control of myself., I know in my mind that people can stay in this stage for years but I just keep thinking about when or what it turns into. I have already had and survived two cancers., I dont need another one....but at 75 I guess I should expect things to start going wrong

[Gretsch6120 in reply to DianeSH]

Iam 75 also. Had pre no treatment for six years prior. Just started treatment one year ago. The meds are amazing and work really well. Don’t worry you may not need treatment for many years. When and IF you do, at this age you will well out live the Cll issue. Stay well.

[DianeSH in reply to Gretsch6120]

thank you again...I have to stop letting this stupid thing ruin my days. As I told you I am a double cancer survivor and also have kidney disease,,,it will be a crap shoot to see what takes me. Why I am so concerned about this instead of my other issues is beyond me. I will soon have this elephant off my back. I guessd what I ws more afraid of was the treatments.,.,,,I need to stop surfing the net., Thank you again for your supporting words. May I be such a help to someone else someday

[lankisterguy Volunteer in reply to DianeSH]

Hi DianeSH,

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While it may not be what you want to hear, there are no things you can do to "prevent" your MBL (Monoclonal B cell Lymphocytosis - en.wikipedia.org/wiki/Monoc... ) from becoming fully CLL or SLL. As you say many people stay in MBL for years or their entire life. Only 1% of folks with low count MBL ever show full CLL / SLL.

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So your past history of cancers may indicate that your immune system is weak, and steroids might provide some short term relief, but they have side effects. As others suggested you may want to explore with your doctor (Hematologist) whether boosting your immune system with IVIG infusions of antibodies from other blood donors could reduce your infection rates webmd.com/a-to-z-guides/imm... . It's expensive and time consuming but if you get regular sinus infections it may be the best way to treat them.

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Also please be alert to getting your vaccinations up to date to prevent pneumonia and other infections that plague us with weak immune systems. There is a new Pneumonia vaccine PCV-20 that recently became available without a prescription at most pharmacies, that may be helpful along with the seasonal flu shot and the bivalent COVID-19 booster.

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Len

[mrsjsmith]

Diane,

When I was first diagnosed with sinus problems ( not much fun ) my Haematology ( prior to me seeing ENT ) started me on monthly IVIG and Azithromycin. My lovely ENT surgeon said operating could actually make things worse and cause scar tissue and more infections. The IVIG and antibiotics with saline spray and a nasal spray keep my problems at bay.

Good luck

Colette