Even though both conditions are often present in the same individual, it has not been clear how a diabetes diagnosis affects clinical outcomes for prostate cancer. Research at Fox Chase Cancer Center — Temple Health showed that the answer depends on what type of anti-diabetic drugs, if any, prostate cancer patients are taking. By examining a large database of prostate cancer patients, the researchers found that diabetic individuals who either took insulin or did not take any anti-diabetic medications had lower survival rates and worse adverse effects from radiation therapy compared with non-diabetic patients. Zaorsky, MD, resident physician in radiation oncology at Fox Chase. To examine the link between diabetes and prostate cancer, Zaorsky and his collaborators reviewed their prospectively collected institutional database of 3, men undergoing intensity-modulated radiation therapy IMRT for localized prostate cancer.
So, we conducted a nationwide, population-based study to estimate the relationship between obesity and development of prostate cancer with 10 Prostate cancer diabetes of follow-up. In tandem with the accumulation of adipose tissue, obesity Prostate cancer diabetes linked with low-grade chronic subclinical inflammation with infiltrating macrophages, Prostate cancer diabetes stimulate the production of cytokines and pro-inflammatory factors involved in the pathogenesis of insulin resistance Response to Comments on Inzucchi et al. Association Free jugs mmf gang orgy diabetes with prostate cancer risk in the multiethnic cohort. There are also confounding factors to consider when looking at these results. An additional 39 studies were excluded from this analysis, because they were not mortality studies that evaluated diabetes. Diabetes and hormone therapy One other aspect to consider when thinking about diabetes and prostate cancer is not just diabetes increasing the risk of prostate cancer, but rather, certain prostate cancer treatmentsincreasing the risk of developing diabetes. With evidence of familial history playing a role in risk reduction, some researchers have suggested a genetic component to the apparent connection, while others have proposed that certain signaling pathways characteristic of long-term diabetes could reduce Prostahe amount of androgens made, including testosterone. Background Prostate cancer diabehes the second leading cause of Prostatee death among men in the United States Siegel Pfostate al. The proportion of hypertension, dyslipidemia, and prostate cancer was also significantly higher in those with diabetes.
Prostate cancer diabetes. You are here
Results Of the articles identified, 17 cohort studies that hadmale patients were included in this meta-analysis. The Asia-Pacific perspective: redefining obesity and its treatment. Patients may be canceg on steroids while being treated for prostate cancer, which may increase blood sugar levels. Although studies indicate that people Prostate cancer diabetes diabetes suffer more frequently from cancer, men with diabetes do not increasingly suffer from prostate cancer. Am J Epidemiol.
There are conflicting results as to the association between pre-existing diabetes and the risk of mortality in patients with prostate cancer.
- There are conflicting results as to the association between pre-existing diabetes and the risk of mortality in patients with prostate cancer.
- The link between diabetes and prostate cancer is rarely studied in Asians.
- Men with type 2 diabetes are less likely to develop prostate cancer than patients without diabetes.
There are conflicting results as to the association between pre-existing diabetes and the risk of mortality in patients with prostate cancer. The purpose of this study is to estimate the influence of pre-existing diabetes on prostate cancer-specific mortality and all-cause mortality.
We searched PubMed and Embase to identify studies that investigated the association between pre-existing diabetes and risk of death among men with prostate cancer. Heterogeneity tests were conducted between studies. Of the articles identified, 17 cohort studies that hadmale patients were included in this meta-analysis. Additionally, in a subgroup analysis that was a type specific analysis focusing on type 2 diabetes and was conducted only with three cohort studies, pre-existing type 2 diabetes was associated with all-cause mortality RR 2.
There was significant heterogeneity between studies and no publication bias was found. This meta-analysis suggests diabetes may result in a worse prognosis for men with prostate cancer. Considering heterogeneity between studies, additional studies should be conducted to confirm these findings, and to allow generalization regarding the influence that each type of diabetes has on prostate cancer mortality.
Prostate cancer is the second leading cause of cancer death among men in the United States Siegel et al. Inthe American Cancer Society reported that 1 in 7 men will be diagnosed with prostate cancer during his lifetime Jemal et al. The known risk factors for prostate cancer include Sexy dom wife, ethnicity, and family history Jemal et al. Diabetes mellitus influences the risk of various cancers, including colon, pancreas, and thyroid cancer Giovannucci et al.
Prostate cancer appears to be an exception, whereby a diagnosis of diabetes is associated with a reduced incidence in most studies. However, whether a previous history of diabetes influences the prognosis of prostate cancer is not clear Batty et al. Diabetes is primarily divided into type 1 and type 2 diabetes. Recently, the prevalence of type 2 diabetes has rapidly escalated owing to the increase in obesity, which also increases the risk Vintage porcelain place settings for baby various cancers Baba et al.
Although hyperinsulinemia was hypothesized as the link between type 2 diabetes and the risk of various cancers Barone et al. Pre-existing diabetes is defined as having a diagnosis of diabetes before the prostate cancer was diagnosed. Since here is a controversy whether pre-existing diabetes would affect prognosis of prostate cancer, a meta-analysis would be necessary. There was two prior meta-analyses have studied association between pre-existing diabetes and prognosis of prostate cancer.
These two studies indicated that pre-existing diabetes was associated with increased risk of prostate cancer death Cai et al.
However, the meta-analysis by Snyder et al. Since these meta-analyses, there are six additional cohort studies, which further examine the association between pre-existing diabetes and prognosis of prostate cancer. By including more studies, it is now possible to further examine subgroup analyses such as types of diabetes, Prostate cancer diabetes of adiposity and country where study was conducted. Therefore, we have included 17 cohort studies, which met our inclusion criteria to examine association between pre-existing diabetes and prognosis of prostate cancer.
The studies selected for inclusion needed to evaluate the effects of diabetes mellitus on the risk of death in patients with prostate cancer and they should have been published in the English language and in peer-reviewed journals. After a study was considered relevant on the basis of the search terms, its references were manually examined to find additional relevant studies.
This study selected articles that reported finding in two categories: 1 the association of diabetes with prostate cancer-specific mortality in Eat pussy morning cancer patients, and 2 the association of diabetes with all-cause mortality in prostate cancer patients.
We then separately pooled the results from these two categories, to determine the relationship between type 2 diabetes and both prostate cancer-specific mortality and all-cause mortality, exclusively among prostate cancer patients. The authors evaluated the quality of the selected studies using the Newcastle-Ottawa Scale for the following factors: clarification as to diabetes status, adjustment for intermediate factors e.
This meta-analysis study combined the risk estimates with CI or SE to estimate prostate cancer-specific mortality and all-cause mortality. The statistical heterogeneity between studies was estimated using Q statistic, and inconsistency was quantified using the I 2 statistic Borenstein et al. Fixed-effect models with forest plots were used to pool the results of homogeneous studies whereas random-effect models with forest plots were used for heterogeneous studies.
Publication bias was evaluated using the Egger test Egger et al. To further assess the potential effects of publication bias, the Duval and Tweedie nonparametric trim and fill method was used Duval and Tweedie This method considers the possibility of hypothetically missing studies, imputes their RRs, and then recalculates a pooled estimate Borenstein et al. All statistical analyses were performed using the Comprehensive Meta-Analysis software version 1. This meta-analysis study followed the selection processes shown in Prostate cancer diabetes.
Of the searched studies initially identified, were excluded for the following reasons: presented duplicate information, did not report prostate cancer-specific mortality or all-cause mortality, were reviews or Granny s getting fucked, or did not evaluate diabetes mellitus. An additional 39 studies were excluded from this analysis, because they were not mortality studies that evaluated diabetes.
The total number of patients with prostate cancer wasThis meta-analysis pooled directly the relative risk of prostate cancer-specific mortality and all-cause mortality from the Antonella barba naughty pics selected studies and then calculated the overall prostate cancer-specific Pro and cons of pornography all-cause mortality, respectively.
This study included only prior studies that had prospective and retrospective cohort designs, in order to understand the association between pre-existing diabetes and the prospect of prostate cancer mortality. The majority of the studies selected for this meta-analysis were conducted in the United States Best et al. The remaining studies were conducted in the Republic of Korea Park et al.
The methods used for determining the existence of diabetes were: 1 medical records; 2 documented use of diabetes medicine; 3 the International Classification of Diseases ninth revision diagnosis codes for surveillance, epidemiology, and end results Medicare ; or 4 fasting glucose level.
Seventeen studies examined the association between pre-existing diabetes, prostate cancer-specific mortality, and all-cause mortality in patients with prostate cancer Fig. There was significant heterogeneity between studies. In addition, there was no influence of unpublished data in any analysis using the trim and fill method. Relative risk for the association between pre-existing diabetes, prostate cancer-specific mortality, and all-cause mortality.
To further examine whether pre-existing type 2 diabetes, separately from type 1 diabetes, was associated with the prognosis of prostate cancer, five studies, which evaluated only type 2 diabetes, were included in this ancillary analysis Fig. This analysis showed that pre-existing type 2 diabetes was significantly associated with all-cause mortality RR 2. Significant heterogeneity was found between studies. Relative risk for the association between pre-existing type 2 diabetes, prostate cancer-specific mortality, and all-cause mortality.
This meta-analysis study evaluated the association of pre-existing diabetes on prostate cancer-specific mortality and all-cause mortality.
In our ancillary analysis, which only included results from patients with pre-existing type 2 diabetes, we found that patients with prostate cancer with type 2 diabetes had a doubling in all-cause mortality. Although Fetish catalog mail are cautious in asserting that pre-existing diabetes is a key causal factor for worse prognosis of prostate cancer, taking preventative measures towards precluding diabetes is appropriate for patients with prostate cancer.
This meta-analysis included 17 studies. Of these, 11 studies addressed prostate cancer-specific mortality and 10 addressed all-cause mortality. Two previous meta-analyses reported the association between pre-existing diabetes and prognosis of prostate cancer Begg and Mazumdar ; Liu et al. The meta-analysis by Snyder et al. Current meta-analysis found six additional studies that have reported the impact of pre-existing diabetes on prognosis of prostate cancer Chamie et al.
The results from our and other meta-analyses clearly showed that pre-existing diabetes, whether type 2 diabetes alone or both type 1 and 2 diabetes, increased the risk of all-cause mortality in patients with prostate cancer.
The association between type 2 diabetes and prostate cancer mortality was not significant compared to the significant association seen for total diabetes mellitus, but it might be related to the sub-group analysis between type 2 diabetes and prostate cancer mortality was conducted only with 3 studies. There have been controversies about whether pre-existing diabetes Prostate cancer diabetes associated with the incidence and prognosis of prostate cancer Bensimon et al.
Some studies Batty et al. These studies argued that lower androgen levels in patients with type 2 diabetes contributed to the better prognosis of prostate cancer. However, other studies showed significantly worse prognosis in patients with prostate cancer with diabetes. It is not clear as to why some studies found an inverse association whereas others found a direct association between diabetes and prognosis of prostate cancer. Our meta-analyses demonstrated that pre-existing diabetes is associated with worse prognosis of prostate cancer.
Worse prognosis in patients with prostate cancer with diabetes may be related to several mechanisms. First, patients with prostate cancer with diabetes are more likely to have progressive prostate cancer due to the adverse interaction between diabetes mellitus and prostate cancer Lubik et al.
Patients with diabetes present with hyperglycemia, and these factors are associated with tumor development and progression de Beer and Liebenberg ; Lai et al. Second, diabetes can diminish the effects of radiotherapy on prostate cancer. Accordingly, patients with prostate cancer with diabetes are more likely to experience a higher failure rate of radiotherapy treatment and worse gastrointestinal and genitourinary complications compared to patients with prostate cancer without diabetes Chan et al.
These complications can be explained by possible alterations in insulin-like growth factor 1, which may decrease the effectiveness of the treatments Casa et al.
Third, changes in certain hormones, including testosterone, sex hormone-binding globulin, and leptin, may affect the risk of prostate cancer Baradaran et al.
Additionally, previous studies Basaria et al. In this respect, long-term androgen deprivation therapy, which is commonly used to treat patients with prostate cancer, increases insulin resistance and hyperglycemia, which in turn induces cardiovascular diseases Basaria et al.
There are several limitations of this study. First, the duration of diabetes in the selected studies was not consistent.
The duration of diabetes is crucial because recent findings Prostate cancer diabetes that longer durations of diabetes were associated with a higher risk of prostate cancer mortality and all-cause mortality Bensimon et al.
Second, the selected studies used different adjustment factors, such as tumor stage, treatment methods, and varying durations of diabetes, and these different adjustment factors may influence the RRs found in this study. Third, this meta-analysis study did not have adjustment for immortal time bias.
This meta-analysis study was unable to address this issue as the prospective studies contained no information regarding follow up status for those men free of diabetes till time of diabetes diagnosis, and then till prostate cancer death occurred.
Finally, the selected studies in this meta-analysis did not provide the Gleason scoring content, and therefore, we cannot rule out the possibility that only the high grade tumors are positively associated with diabetes, while the majority of prostate cancer tumors with low histologic grading may not be associated with diabetes co-morbidity.
This study suggested that pre-existing diabetes is clearly associated with total mortality and possibly prostate cancer-specific mortality in men diagnosed with prostate cancer. Future studies are necessary to select adequate treatments for patients with prostate cancer with diabetes in order to improve prognosis and reduce complications. In addition, these studies should examine the differences between type 1 and type 2 diabetes and determine how factors such as the duration of diabetes, radiotherapy treatments, and tumor stages can affect prostate cancer mortality.
All authors read and approved the final manuscript. We would like to thank Dr. John Brobst for comments on a previous draft of this manuscript. The authors declare that they have no competing interests. The authors have full control of all primary data and we agree to allow the journal to review the data if required. Junga Lee, Email: moc. Edward Giovannucci, Email: ude. Justin Y. Jeon, Email: rk.
Jan 31, · Prostate cancer and type 2 diabetes are among the most common diseases in men. Although studies indicate that people with diabetes suffer . Sep 13, · Worse prognosis in patients with prostate cancer with diabetes may be related to several mechanisms. First, patients with prostate cancer with diabetes are more likely to have progressive prostate cancer due to the adverse interaction between diabetes mellitus and prostate cancer (Lubik et al. ; Ma et al. ).Cited by: Feb 17, · A positive link between diabetes and prostate cancer is observed, which is more remarkable in the youngest age of 40–64 years. The association between prostate cancer and comorbidities commonly seen in diabetic patients suggests a more complicated scenario in the link between prostate cancer and diabetes at different disease yourbakingstory.com by:
Prostate cancer diabetes. Background
Type 2 diabetes and the risk of mortality among patients with prostate cancer. Danker R, Boffetta P, et al. Osteoporos Int. This could lead to under-diagnosis of the condition in diabetic men, falsely contributing to the decreased risk. Annu Rev Med. After a study was considered relevant on the basis of the search terms, its references were manually examined to find additional relevant studies. The remaining studies were conducted in the Republic of Korea Park et al. Prostatic Diseases. National Center for Biotechnology Information , U. Among a total of , participants, 16, Finally, the selected studies in this meta-analysis did not provide the Gleason scoring content, and therefore, we cannot rule out the possibility that only the high grade tumors are positively associated with diabetes, while the majority of prostate cancer tumors with low histologic grading may not be associated with diabetes co-morbidity.
Use of diabetes drugs, especially metformin, prior to surgery for prostate cancer is associated with an increased risk of high-grade tumors, investigators reported. Preoperative use of metformin was associated with 3-fold greater odds of high-grade PCa compared with preoperative use of other diabetes drugs.
When Michelle Hall was diagnosed with breast cancer two years ago, she was shocked. As diseases, cancer and diabetes seem a world away from each other. Yet, numerous studies suggest the conditions are linked. People with diabetes are more likely to be diagnosed with cancer than those without diabetes, but why remains unclear. Scientists are still trying to answer even the most basic questions: Does diabetes cause cancer?