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Advanced Prostate Cancer
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Any benefit from metformin is proved

Dx 2015 APC with iliac lymph node involvement. Had RT, on lupron for 20 months, turned to CRPC seven months ago. Now on zytiga and Prednisone (5mg) for the last seven months. Had orchiectomy two months back. With zytiga, practically no side effects. I use to read all the posts in this forum for the last six months. I learn from the posts of many that they take metformin along with their other medicines even though they are not diabetic. My MO didn't prescribe metformin for me so far. I asked my GP's opinion. He told that post-orchiectomy patients may develop insulin resistance due to the defficiency of testosteron. I am not diabetic and my blood sugar is normal now. Should I take metformin? Is there any proven studies that metformin is beneficial for patients like me. If it is beneficial what is the ideal dosage for for a non diabetic person. I expect a good advice from my fellow-members who got very wise opinions regarding all the treatment regimes.

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Do not need much from us---you can ask for papers on Metformin--and some will direct you---but for a fast read---Google Metformin and Prostate Cancer.

Nalakrats

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Thank you Nalakrats for the information.

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I'm afraid that nothing is really proven. There are some studies that suggest some benefit, and some studies that suggest no benefit. nothing definitive either way. In most people, there are no major side effects, and it is relatively inexpensive, so why not? Metformin, statins, and aspirin are in this category - perhaps some minor benefit, perhaps no, but not much harm in trying them.

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Thank you Tall Allen for your reply.

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I am chagrinned on this site by the lack of balance. You'll find below many lower-level-of-evidence studies put forward as if anything were proven by them. Just for a little balance (but still no proof), you may also want to look at studies like these:

• Metformin use was not associated with a risk reduction in biochemical recurrence, systemic progression, or all cause mortality in men who'd had treatment for prostate cancer:

ncbi.nlm.nih.gov/pmc/articl...

link.springer.com/article/1...

ncbi.nlm.nih.gov/pmc/articl...

• Metformin use had no effect on incidence of prostate cancer

care.diabetesjournals.org/c...

journals.lww.com/amjclinica...

academic.oup.com/jnci/artic...

ncbi.nlm.nih.gov/pmc/articl...

If you decide to try it in spite of these, take the lowest dose possible.

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Thanks Tall Allen for your wise reply

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Most of what we know about Metformin relates to diabetics, of course. What might be the benefit to non-diabetics? The study that impressed Dr. Myers, myself & others is this:

ncbi.nlm.nih.gov/pubmed/244...

"Metformin in chemotherapy-naive castration-resistant prostate cancer"

"Thirty-six percent of patients were progression-free at 12 wk, 9.1% were progression-free at 24 wk, and in two patients a confirmed ≥ 50% prostate-specific antigen (PSA) decline was demonstrated. In 23 patients (52.3%) we observed a prolongation of PSA DT after starting metformin. The homeostatic model assessment index fell by 26% from baseline to 12 wk, indicating an improvement in insulin sensitivity. There was a significant change in insulin-like growth factor-1 and insulin-like growth factor binding protein 3 from baseline to 12 wk."

IMO, reason enough to try it at the 2,000 mg dose.

-Patrick

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Thank you for the reply.

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Last week after pestering our doctors, we finally got one to prescribe Metformin. Our MO is a fellow who graduates this year and goes to Minneapolis to work. He was an ND who became an MD. He had heard of using metformin. I printed out the papers... he was very agreeable... but he wants my husband to ease up to the 2000mg dose.

The complaint the other doctors had made was that Metformin was not a big player and my husband was/is doing so well.

Print out the papers and be persistent.. eventually you will find someone who will listen.. and prescribe it to you.

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Thank you for your reply.

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800 million diabetics may not be sufficient proof for some folks, but it is more than enough more me.

There are a lot of diabetics, and metformin is an old drug. That means there are tens of millions of people who have been taking metformin for decades.

Diabetics are pretty sick people. It is a terrible disease that affects the entire body. They tend to die younger from a variety of illnesses as well as from the direct effects of diabetes.

But several studies found that diabetics on metformin had lower rates of cancer, and lower mortality from cancer, than healthy people. That got a lot of attention.

Since then there has been a lot of research. We know understand a lot more about how metformin helps with cancer.

It is an inexpensive drug, and most people don't experience any side effects. Many doctors, like Snuffy Myers, prescribed it to all of his cancer patients. His own clinical experience convinced him that it helped, and that the benefit grew the longer you take it.

So low cost, low chance of it harming you, huge amount of epidemiological evidence that it helps prevent and control cancer, and now a steady stream of research learning how it works. What's not to like? Why not take it?

cancer.gov/about-cancer/cau...

ncbi.nlm.nih.gov/pmc/articl...

mdanderson.org/publications...

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Thank you for the reply.

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Taking metformin with xtandi target resistance of cells, thru enzyme TGF. Lengthens time to progression.

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dress2544, I've been on metformin for the past 15 years due to my type 2 diabetes. I was diagnosed with stage 4 PCa on March 2017. I wouldn't bet that metformin would help with PCa. I still take it of course to control my blood sugar. I've been on lupron for 14 months and thank God no hot flashes as a side effect, did 6 rounds of chemo and my PSA is still very low. I feel great.

Nick

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Thank you Nicnanto

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dress2544,

Metformin has a natural molecular equivalent in the berberine molecule. A professor of nutrition at Cal said it was the most powerful natural molecule he had studied. There is research on berberine and prostate cancer which can be found through the pubmed database. I use berberine as I have a creeping blood sugar issue to manage. Berberine reduced my A1c from 5.7 to 5.1. I am a 76 yr old stage IV, PCa patient diagnosed in 2012 with 2 pelvic bone mets, G8. My therapy consists of Lupron. For approximately the first 3 years in AZ I also took Casodex. My FL urologist uses only a 6 month Lupron shot. My PSA has been trending lower in 2017 until my last checkup two weeks ago. It was 0.06, the same as last September.

No side effects from berberine. I take a 1,000 mg before each meal.

Hope this gives you a new perspective on Metformin. Please understand I take many other natural supplements. Sorting out causality would be impossible.

Your happy vegan, CalBear74

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Thank you CalBear for your informative re

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