Interference of glucocorticoids with apoptosis signaling and host-tumor interactions

The cure of cancer is compromised by a variety of factors and mechanisms, which include tissue origin of the malignant cells, tumor load and hypoxia, impediment of drug access, and cellular resistance to treatment. Treatment resistance may be intrinsic, acquired, or induced, and it may occur to either radiation or a single drug alone, or simultaneously to multiple agents. Although the problem of corticosteroid-induced and hence, iatrogenic resistance to the treatment of cancer has continuously gained some interest over the past several years, no measures have been taken yet to diligently examine this problem in the clinical situation. In this review, we address several additional mechanisms through which glucocorticoids may influence the result of cytotoxic therapy of cancer, like: inducible interference with apoptosis signaling; interference with immune response against malignant cells; issues relating to their impact on glucose metabolism in cancer patients.