Cancer After a Diabetes Diagnosis

(Don't stop reading because you don't have diabetes!)

New Israeli study below.

Once again we find that:

"... diabetes posed an increased risk of cancers of the liver, pancreas, gallbladder, endometrium, stomach, kidney, brain (benign), brain (malignant), colon/rectum, lung (all, adenocarcinoma, and squamous cell carcinoma), ovary, and bladder, as well as leukemia, multiple myeloma, non-Hodgkin lymphoma"

"Diabetes was associated with a reduced risk of prostate cancer."

Everytime I read this result in a new study, I wonder why this hasn't been translated into useful information.

The transition to the diabetic state involves three states:

- insulin resistance, with increased beta cell insulin production

- atrophy of the beta cells

- inability to produce sufficient insulin

Giovannucci reported that protection against PCa took about a year to kick in after the diagnosis of diabetes.

Two things come to mind (others might have additional ideas):

[a] Insulin is a PCa growth factor. A reduction in insulin production might slow the development of PCa. For non-diabetics, restoring insulin sensitivity might be protective. The metabolic syndrom is common in PCa.

The first line of treatment after diagnosis is Metformin. Perhaps Metformin is the reason for reduced risk?

{[c] or both of the above}

But we already have PCa.

Dr. Myers seems to have finally embraced Metformin in his practice.

It seems prudent, regardless of our situation, to restore insulin sensitivity & consider using Metformin.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/272...

10 Replies

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  • I have presented papers on metformin use to my Internist, my Oncologist and my Urologist. All have shrugged and said "you don't have diabetes, you don't need that". But none said they were well aware of the possible benefits! For the record, I have recurrent pca for 15+ yrs, and doing ok on IADT3. Any suggestion on how to break through these gatekeepers besides changing docs?

    herb

  • Hi Herb,

    My solution involved some good luck.

    I was using androstenedione at the time (~8 years ago) to boost testosterone [T] & chrysin to limit the aromatization of T to estradiol [E2]. My stash of andro was legal when I bought it, but it was subsequently banned. (Oddly, having andro without a prescription (in the US) is now a felony, whereas having T is not.) I was running out.

    I saw a reference to a local doctor of Integrative Medicine. I sent him an email asking him, if I became a patient, would he be sympathetic to someone with PCa doing what I was then doing. He said yes. (Why pay for a consultation only to be kicked out the door?)

    My regular doctor had already nixed the idea of Metformin. I could have faked the fasting glucose test, of course. He would have prescribed it if my number was above 100.

    My alternative doctor was useful from the start. Plenty of ideas. Although he favored supplements over drugs, he thought that Arimidex was safer than chrysin, so I switched to that. When my andro ran out, he wrote a script for Androderm patches.

    And he had no problem at all, after my GP refused me, of prescribing Metformin. I currently take 3 x 500 mg daily. It costs pennies!

    Practitioners of integrative medicine end up prescribing various meds off-label. They are not as protocol-bound as GPs. Much more flexible.

    I later discovered that my my urologist would give me anything I wanted too. It's a matter of being perhaps better informed on a topic, but, at the same time, not demanding. My GP says that he doesn't mind discussing drugs with me, but so many patients walk through the door, self-diagnosed, demanding drugs by name (those full-page ads pay off).

    Incidentally, Arimidex is tough to get for some men with PCa. E2 > 30 pg/mL is not safe, but doctors sometimes laugh at men who, quite reasonably, request Arimidex. The common response: "I only give that to female patients."

    Good luck!

    -Patrick

  • Patrick,

    I'll have to try some end run! My fasting glucose is over 100, but no one (docs) is yet concerned. I have all the symptoms of pre-diabetes, but I still can't get any action. I know my GP will be p.o.d if I go around her, but that may be what's needed. I think it's simply that no one wants to mess with what's been working for so long (15 yr). Gotta look for an integrative md...open-minded one!

    Thanks.

    herb

  • I concern myself with my hemoglobin A1C test. Fasting glucose is not definitive on diabetes. Your spleen kills off any red blood cells over 4 months old. When a red blood cell is formed in your bone marrow the amount of glucose in your blood stream determines how much glucose is in the RBC membrane. Glucose counts of 100 are normal, but when the level is say 300 for say 10 to 12 hours (after a big meal) the membrane has 3 times the amount of glucose in the cell wall. These high sugar membrane cells (like M&M's) exist for 4 months and do NOT exchange CO2 and oxygen in the lungs properly. They break open easily in capillaries all over the body and injure all the internal organs by poor oxygen levels. The optic nerve can die due to low oxygen (blindness) and leg sores and infections due to non-aerobic pathogens cause loss of toes, feet, or legs. This why diabetes kills. The hemoglobin A1C test is done every 4 months and the cells are opened up in a test tube, then light is shown through the cells walls and the test tells how much glucose is incorporated in the average RBC wall. A level of 5.5 or 6.5 is ideal.

    When the average person eats a meal the sugar level normally returns to 100 after several hours. When a diabetic eats a meal the sugars level may stay at 350 for hours or all night. So all that time the wrong RBCs are produced. Over four months the HemA1c may be 9 or 10. A doctor can tell if you have diabetes with this test and a glucose tolerance test. Daily sugar levels are for diabetics to control their disease with long or short acting insulin injects and medications like metformin and actose. If you want to hear more let me know, I was a pharmacist for 35 years.

  • Jim and patrick,

    Just for the record. I do not [yet] have diabetes BUT my sugar is slightly raised (125 fast), my AIc is ~5.7 and regrettably I am pear shaped! But most important, I am on intermittent Lupron for 15 yrs; Lupron is known to raise diabetes risk. GP seems to forget these factors--other than my glucose is not astronomical.

    I look at Metformin as another tool in my arsenal to keep my psa down. That's all.

    herb

  • Patrick,

    I am a diabetic; however, I control it with only diet, A1c 5.8 I was wondering if metformin would be any good to consider in the future when I stop Casodex and have a withdrawal PSA decrease for I have insulin sensitivity with diet control.

    Rich

  • Rich,

    Diabetics (for at least a year) get less PCa. Since PCa does not prefer glucose for fuel, I think the reason is due to insulin levels being lower. This has been achieved the hard way - by working the beta cells to death.

    But diabetics who do get PCa have a higher mortality rate - except for diabetics on Metformin. Those guys do better than non-diabetics (who probably mostly have some degree of insulin resistance & overproduction.)

    I use 2,000 mg of Metformin daily & I'm not even diabetic. I think that nondiabetics with PCa should assess their insulin status & respond accordingly.

    But Metformin does more than inhibit glucose production. It is an AMPK activator & is credited with anti-cancer activity.

    -Patrick

  • " should assess their insulin status & respond accordingly." Would you use the A1c test or another test for this purpose?

    Rich

  • Rich,

    A1c should be good enough, but the HDL:triglycerides ratio might be better, since most could dig out a recent lipids panel report. 1:1 excellent, 1:2 not good, 1:3 bad.

    I just switched my statin from Simvastatin to Livalo. The only statin that does not increase A1c.

    -Patrick

  • I will have my lipids checked soon. My last test gave HDL 41and triglycerides 83.

    Rich

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