Glucose metabolism & PCa treatment

New study below [1].

In 1998, Walsh, et al (Johns Hopkins), published:

"Influence of radical prostatectomy on serum hormone levels." [2]

Basically, RP caused testosterone [T] to rise - therefore the cancer had caused T to fall. This ties into my recent posts on low T in PCa cases - specifically the association between lower T & more serious disease.

In 2002, a similar Austrian study [3]:

"Although 12 months after RP no changes in testosterone were observed in the low Gleason score group, the testosterone levels more than doubled in those with high-grade tumors."

In 2007, a Greek study also replicated the Walsh study [4]:

"... it may be that the prostate neoplasm before RP may have secreted a substance that induced a negative feedback to the pituitary gonadotrophin secretion"

A 2011 Italian study failed to observe such an effect [5].

A 2016 Spanish study [6] that looked at recovery following radiation [EBRT] & RP, reported that:

"Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP."

So, 4 out of 5 studies agreed.

...

I suggest that hormone recovery following primary treatment might have an effect on markers of the metabolic syndrome.

In the new paper:

"At baseline patients with aggressive prostate cancer demonstrated impaired glucose tolerance compared with men of similar age and body size. Following treatment, glucose tolerance improved in the absence of changes in expected modifiers of glucose metabolism."

i.e. treatment alone somehow affected glucose (& presumably insulin sensitivity).

These were aggressive cases. In study [3], the T increase was strong in those with aggressive PCa.

(Note that testosterone supplementation in hypogonadal men increases insulin sensitivity. [7])

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/279...

Clin Nutr. 2016 Dec 2. pii: S0261-5614(16)31341-3. doi: 10.1016/j.clnu.2016.11.024. [Epub ahead of print]

Glucose metabolism during the acute prostate cancer treatment trajectory: The influence of age and obesity.

Di Sebastiano KM1, Bell KE2, Mitchell AS1, Quadrilatero J1, Dubin JA3, Mourtzakis M4.

Author information

Abstract

BACKGROUND & AIMS:

Obesity and age, key risk factors for aggressive prostate cancer, are associated with insulin resistance. Glucose-related parameters in patients with aggressive prostate cancer were compared with 2 reference groups: men of similar age and body mass index (BMI) without cancer, and healthy young men. Acute changes in these parameters following radiation treatment were also evaluated.

METHODS:

Nine patients with aggressive prostate cancer underwent metabolic assessments prior to treatment (baseline), 7 and 33 weeks post-baseline (post-treatment initiation). Baseline measures were compared with the 2 reference groups. Evaluations included: 1) fasting and oral glucose tolerance test (OGTT) blood samples for glucose, C-peptide, and insulin, 2) fasting blood samples for triglycerides, cholesterols, leptin, adiponectin, IL-6, and TNF-α, 3) body composition, 4) nutrition, and 5) physical activity.

RESULTS:

At baseline, patients had normal fasting glucose concentrations (<5.6 mM; 4.9 ± 1.2 mM) but impaired 2-h OGTT glucose concentrations (>7.8 mM; 8.7 ± 2.9 mM). Both reference groups had normal fasting (matched males: 4.2 ± 0.5 mM; young males: 3.7 ± 0.4 mM) and 2-h OGTT glucose concentrations (matched males: 5.6 ± 1.8 mM; young males: 3.1 ± 0.1 mM) that were significantly lower than patient values. During the OGTT, patients had higher insulin (120 min) and C-peptide (45, 60, 90, 120 min) concentrations compared to the matched males. At 7 weeks, 2-h OGTT glucose concentrations in patients improved to healthy ranges without changes in insulin, C-peptide, IGF-1, IGFBP-3 or other metabolic parameters.

CONCLUSIONS:

At baseline patients with aggressive prostate cancer demonstrated impaired glucose tolerance compared with men of similar age and body size. Following treatment, glucose tolerance improved in the absence of changes in expected modifiers of glucose metabolism. These improvements may be related to treatment.

Copyright © 2016. Published by Elsevier Ltd.

KEYWORDS:

Body composition; C-peptide; IGF-1; Insulin

PMID: 27998647 DOI: 10.1016/j.clnu.2016.11.024

[PubMed - as supplied by publisher]

[2] ncbi.nlm.nih.gov/pubmed/967...

[3] ncbi.nlm.nih.gov/pubmed/124...

[4] ncbi.nlm.nih.gov/pubmed/174...

[5] ncbi.nlm.nih.gov/pubmed/212...

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

[7] ncbi.nlm.nih.gov/pubmed/266...

1 Reply

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  • Patrick,

    As you know, casodex increases testosterone.

    Rich

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