A 14-day, randomized, double-blind crossover trial was carried out comparing an oral glucocorticoid, methylprednisolone (MP), against placebo for the relief of pain and other symptoms in 40 terminally ill cancer patients. After the 14-day, double-blind phase was completed, all patients were given MP for 20 days. The daily dose of MP was 32 mg, and end points of the study were pain, psychiatric status, appetite, nutritional status, daily activity, and performance. Mean intensity of pain (visual analogue, 0-100 +/- SD) was 36.8 +/- 14 after MP treatment and 57.7 +/- 15 after placebo (P less than 0.01). Following the 14-day, double-blind phase, appetite and daily activity increased in 24 of 31 patients (77%) and in 21 of 31 patients (68%) with MP, respectively; depression and analgesic consumption decreased in 22 of 31 patients (71%) and in 16 of 28 patients (57%) with MP, respectively. MP was preferred over placebo by 23 of the 31 patients (74%), and, in 22 of the 31 cases (71%), the investigator chose MP over placebo. No serious toxicity was found at the dose of MP used. It is concluded that MP increases the comfort of terminally ill cancer patients.