Anabolic steroid misuse and liver tumors

This page is for anyone who has used anabolic steroids, or cares about someone who has, and wants to know the cancer risk. It explains what the National Institute on Drug Abuse (NIDA) reports about liver tumors, testicular cancer, other harms, and when to get help.

Anabolic-androgenic steroids are man-made substances similar to the male sex hormone testosterone. NIDA says they build muscle and drive male traits in both sexes. That is the effect people want when they misuse them.

They are not the same as the steroids given during cancer treatment. Those are corticosteroids, a different type of drug used to reduce swelling, control nausea, or manage reactions. If your oncology team gave you a steroid, this page is not about that medicine.

The clearest answer to the cancer question is in NIDA's account of liver effects. Steroid misuse has been linked to liver damage, tumors, and a rare condition called peliosis hepatis. In peliosis hepatis, blood-filled cysts form in the liver.

Two parts of that finding deserve a closer look.

The word "linked" matters. NIDA reports a documented tie to tumors. It does not call this a proven cause of one named cancer, and we will not stretch the claim further than that.

Peliosis hepatis is not cancer at all, but it may be the more urgent danger. NIDA notes those blood-filled cysts can burst. That can cause bleeding inside the body, and in rare cases death.

NIDA lists liver damage, tumors and peliosis hepatis among the possible harms of steroid misuse.

The liver is not the only site mentioned. NIDA says anabolic steroids may also act on the hormone system to increase the risk of testicular cancer. NIDA says this is especially so when steroids are used together with insulin-like growth factor. Testicular cancer appears on its list of possible health consequences in men.

Again, note the wording. NIDA says "may also act" and describes an increase in risk. It is not saying that anyone who used steroids will develop this.

Knowing how people misuse steroids explains why the exposure is so far beyond any medical dose.

NIDA describes a few common patterns:

• Stacking means taking several steroids at once. People mix pills and shots, and sometimes use drugs meant for animals.
• Cycling means taking steroids for a set stretch of time, then stopping.
• Pyramiding means slowly raising the dose, then lowering it back down.

None of that looks like a doctor-prescribed plan. The doses and mixes are self-chosen and unsupervised.

Heart and blood vessel harm gets real attention in NIDA's report, and it can show up faster than people expect.

Steroid misuse is linked to high blood pressure. It is also linked to a higher risk of heart attacks, artery damage and strokes, even in athletes under 30. Being young and fit does not protect someone from this pattern.

NIDA also stresses that anabolic steroids can cause severe, long-lasting, and sometimes permanent damage. That is strong language from a research agency. It applies across the whole body, not just one organ.

The most dangerous effect NIDA names is not physical. Depression during withdrawal sometimes leads to suicide attempts.

That deserves to be said plainly, because it changes what help should look like. Someone stopping steroids may need support for their mood as much as checks on their liver or heart. Treating it as only a physical problem misses the most serious risk.

If you or someone close to you is going through this, that is a reason to bring in a doctor rather than face it alone.

If you used these substances in the past, the useful step is to make sure a doctor knows. Liver function, blood pressure and heart health are all things a clinician can check. A history of steroid misuse rightly changes what they look for.

There is no standard screening program built around past steroid use. We cannot tell you which tests you personally need. What we can say is that this history belongs in your medical record, not left out of it. It gives whoever treats you a clearer picture to work from.

Be honest about the timeline too. When you started, how long you used them, and when you stopped can all shape what a clinician chooses to check first.

• Call 911 or go to an emergency department if you have sudden severe pain in the upper right of your abdomen with faintness or a racing pulse. NIDA warns that the blood-filled cysts of peliosis hepatis can rupture and cause serious internal bleeding. Do not drive yourself.
• Call 911, or call or text 988, if you are having thoughts of ending your life while coming off steroids. NIDA calls depression the most dangerous withdrawal symptom because it sometimes leads to suicide attempts.
• Call 911 or go to an emergency department if you have chest pain, sudden weakness on one side, or trouble speaking. NIDA links steroid misuse to heart attacks and strokes even in athletes under 30. Being young and fit is not a reason to wait. Do not drive yourself.
• Call your care team within a day or two if your skin or eyes look yellow, or your mood has dropped since stopping.