Metformin - not looking so good.... - Advanced Prostate...

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Metformin - not looking so good....

Blackpatch profile image
16 Replies

When someone posts about metformin and PCa, the general consensus seems to be that a lot of guys are on it and have seen significant improvements in their weight and bloodwork - but there is usually a fair bit of to- and fro- as regards evidence that it actually helps.

This recent paper claims metformin is of no value in treating PCa, based on both historic patient data and cellular studies:

onlinelibrary.wiley.com/doi...

I'm on metformin as part of CareOncology's protocol, yet my blood sugar levels have always been fine - so now I guess I can start thinking about dropping those four big white tablets from the daily dose....

Stuart

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Blackpatch
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16 Replies
whatsinaname profile image
whatsinaname

I take Metformin to keep my blood sugar down. Despite all the blood sugar raising steroids that I am currently taking as part of my PC treatment, my blood sugar levels have not risen much, thanks to Metformin.

tango65 profile image
tango65

It seems metformin does not work for castration resistant cancer being treated with docetaxel, according to the Taxomet trial:

urotoday.com/conference-hig...

these studies are too contradictory...

LearnAll profile image
LearnAll in reply to

The reason these studies are contradictory is because they have a very narrow sample and try to generalize the results to all PCAs. Its sampling error. In this current article ,they are talking about patients who are on radiation therapy but people are getting impression that Metformin is not helpful in ALL pCa cases. Faulty conclusion.

puxi profile image
puxi

Nothing but another evidence that oncologie is pseudo-science.

kaptank profile image
kaptank

I think the point of taking metformin is to control insulin, which when in excess encourages PCa growth. There may be other reasons to take it but that one is sufficient. Insulin control is vital for us.

Shanti1 profile image
Shanti1

The theory behind "metabolic treatment" of cancer is that you block multiple pathways the cancer might use for growth and metabolism. So, while metformin and statins may not show benefit on their own, per the theory, when you combine them with other meds, you now have synergy. If you are going to use this approach I would suggest keeping all 4 meds. The main (but not only) mechanisms of each are as follows:

Metformin- mitochondrial inhibition and lowers IGF-1 and insulin

Doxycycline- mitochondrial inhibition

Mebendazol- Induces abnormal mitotic spindal formation (interferes with cell replication)

Statin- blocks cholesterol synthesis

The Care Oncology has published their retrospective data on glioblastoma, showing a doubling of lifespan and hopefully we will see more data from them in the months and years to come. Since prostate cancer has a relatively long survival time, I doubt we will see any data on prostate cancer for many years. If you ask them, perhaps they will share what they are seeing so far with prostate cancer. Please share if you find out. - Shanti

LearnAll profile image
LearnAll

this article only pertains to people undergoing radiation therapy. can not be generalized.

GP24 profile image
GP24

The title of the study is:

"Metformin may offer no protective effect in men undergoing external beam radiation therapy for prostate cancer"

I understand that very few patients take Metformin to improve the effectiveness of radiation. You take it to fight the metabolic effects of ADT and in the hope it will help a bit against the tumor as well.

tom67inMA profile image
tom67inMA

The problem with studies like this (including statin studies) is that they don't randomly assign who gets the drug and who doesn't. Effectively, they're comparing patients with a comorbid condition (diabetes, high cholesterol) with "healthy" controls. No duh when patents with diabetes and high cholesterol don't do better than patients without these complications.

pjoshea13 profile image
pjoshea13

Here was the objective:

"To assess whether metformin reduces radio-resistance and increases survival in men undergoing external beam radiation therapy (EBRT) for prostate cancer (PCa), and to determine its effect on hypoxia inducible factor 1-a (HIF1a)."

Two specific questions relating to radioresistance & HIF1a.

One of the ways in which PCa cells resist radiation therapy is via HIF. Studies have shown the genistein might be useful [1]. & curcumin? [2].

From a 2018 Canadian study [3]:

"We investigated the importance of metformin in patients treated with radiotherapy or brachytherapy."

"... diabetics had worse overall survival (OS) than non-diabetics (HR 1.5 ...), but diabetics on metformin fared better than diabetics not taking metformin (HR 0.5 ...)."

The distinction isn't made in the Australian study Abstract:

"No association was found between the use of metformin and time to metastasis detection, time to BF or OS in patients undergoing radiation therapy with or without ADT for PCa."

I am not diabetic but have been using Metformin for ~10(?) years - currently at 2,000 mg. This would not be the case for newly diagnosed men. i.e. it seems safe to assume that Metformin users are diabetic in that study.

Metformin is the standard drug for the newly diabetic. A year after becoming diabetic, many men need another drug, but also remain on Metformin. Of course, some diabetics cannot tolerate Metformin & are on something else virtually from the start. But when a study compares two populations: Metformin users & non-users, it is basically also comparing diabetics to non-diabetics. That is a flaw.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/191...

[2] ncbi.nlm.nih.gov/pmc/articl...

[3] ncbi.nlm.nih.gov/pubmed/302...

NPfisherman profile image
NPfisherman

There are a couple of issues with this study:

1) When you have only 19% with 2 or more co-morbidities in the non-metformin group vs 35% in the metformin group, then you can expect the metformin group to do worse. Also, the non-metformin group had 32% with no co-morbidities vs 2% in the metformin group. It is a known fact that elderly individuals with higher co-morbidities do not last as long.

2) The Gleason scores--the metformin group had 22% that were G8-10 vs 16% in the non-metformin group...while 6% is not a huge advantage, it is another factor in favor of the non-metformin group. Also, 44% of the non-metformin group were G2-6 vs. 36% in the metformin group.. A disadvantage for the metformin group with higher severity of disease...

3) ADT--the metformin group had a higher percentage of people that had no ADT--51% vs non-metformin of 43%. Does ADT increase life expectancy??

4) The French study that tango65 listed showed no benefit with chemotherapy...There are chemosensitizers and radiation sensitizers that can help out these therapies, but overall, there are few things additive with these kind of therapies. I am waiting for the STAMPEDE trial, Arm K to see whether Metformin is benefiting or not....

Just my 2 cents....

Don Pescado

j-o-h-n profile image
j-o-h-n in reply to NPfisherman

Sorry Bud but it's up to a nickel now....👀 IRS

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 08/30/219 4:20 PM DST - Pinnes

NPfisherman profile image
NPfisherman in reply to j-o-h-n

That much??Let's get some gumballs or some bazooka gum--maybe a couple of lick and stick tattoos inside.... Remember that??

Fish

j-o-h-n profile image
j-o-h-n in reply to NPfisherman

Do I? Still got the tattoos.... Those were the days....no worries..........✔✔✔

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/31/2019 11:55 AM DST - Pinnes

cesces profile image
cesces

I wouldn't be so quick to drop the stations and metformin.

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