Diabetes and Breast Cancer

LuvRVing

I thought I'd try this topic here, hoping to get people to talk about their treatment plans if they also have diabetes (any type). I suspect it's trickier if you are T1 or T2 with insulin.

I am worried about long term organ damage from chemo.  Also during chemo, steroids are administered to ward off side effects.  But as you know, diabetes and steroids are not a good mix.

There is one study published that I could find.  Data taken from the Medicare information for 12000 diabetics (so everyone is over 65) indicated that more diabetics end up in the hospital with complications than other BC patients.  And I think it indicated that diabetics lived about the same number of years with or without chemo.

Did you have chemo?  Did the onco reduce the steroids?  If so, how did you manage SEs?

If you didn't have chemo, how did you get to that decision?  Oncotype score?  Fear of SEs? Not recommended by onco or primary physician?

If you are on hormone therapy, is it having an impact on your glucose levels? 

What about neuropathy?  Did you already have it and it made it worse?  Or if you didn't already have it, are you suffering now either from chemo effects or hormonal therapy?

 Let's talk!  We have some unique situations to deal with.

Michelle

LuvRVing

Here is a link to a published article in the Journal of Clinical Oncology discussing diabetes, breast cancer and chemotherapy.

^{http://jco.ascopubs.org/cgi/content/full/27/13/2170}

Some excerpts:

Patients with diabetes were also more likely to as a resultof breast cancer than were nondiabetic patients, although theabsolute differences were small. Survival curves are shown inFigure 2. In the multivariable analysis, we found that therewas a significant interaction between diabetes and chemotherapyuse for BCS mortality. When we stratified patients by chemotherapyuse, the BCS mortality of diabetic patients who did not receivechemotherapy was similar to that of nondiabetic patients whodid not receive chemotherapy (HR, 0.95, 95% CI, 0.88 to 1.03);however, diabetics who did receive chemotherapy had higher BCSmortality than nondiabetic patients who received chemotherapy(HR, 1.20, 95% CI, 1.07 to 1.35).

and then...

Among patients who receive chemotherapy, patients with diabetesare at an increased risk of developing chemotherapy-relatedtoxicities, despite receipt of less-toxic regimens. We alsohave demonstrated that diabetes is associated with a significantlyhigher risk of all-cause mortality in elderly patients who havebreast cancer. Breast cancer patients with diabetes who receiveadjuvant chemotherapy have a higher risk of BCS mortality thanpatients without diabetes who receive chemotherapy. Despitethese findings, patients with diabetes should continue to beoffered standard chemotherapy regimens, because this study cannotdefinitely answer which chemotherapy offers the best risk-benefitratio for patients with diabetes. Future studies are necessaryto define the optimal management of breast cancer patients whohave diabetes.

Michelle