Type II diabetes and breast cancer - prognosis poor??
Hi there. In March I was diagnosed with DCIS. The doctor told me it was the "best" breast cancer I could have and I was scheduled for a lumpectomy. Unfortunately, after an MRI to make sure that was it, they found another DCIS in the same breast, different quadrant, so I had to switch plans to a mastectomy. After someone else looked at the second dcis slide, they saw it was really invasive so now I have what the doctor calls a Stage 1 cancer. The tumor size is small she says, about 2.5 mm. Anyway, in reading around the net (a no no I realize, especially for a neurotic, frightened worrywort like myself), I found more than 1 article (one in USA Today even) stating that those who are diabetic have a poorer prognosis, even with beginning stage breast cancer. That is so alarming to me as I've been a diabetic for at least 15 years, some of that time controlled, some not. I am 62, overweight. I also have COPD and have had a stent put in a coronary artery. The PS would not do diep or any other flap recon. because of the diabetes so I am getting Te's and implants. Even with that, I realize healing problems can occur. I have been my own worst enemy throughout my life (diabetes due to weight, COPD due to smoking which I don't do anymore but still, the damage was done). Can anyone tell me if my prognosis is indeed really poor. Does it mean I will not do well with any treatment (hormone or chemo if indicated?) Is the chance of recurrence much greater. The articles threw me for a loop.
Comments
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Hi Bevg,
I know what article you are referring to but keep in mind that diabetics that have poorly controlled diabetes, generally speaking, are at higher risk fo an all cause mortality and not just breast cancer. The main point of that article was that diabetics are not treated as aggressively as their counterparts who do not have diabetes, hence diabetics have a higher chance of a rucurrence from an early stage BC.
However, the following article contradicts the above stated findings by supporting the fact that Diabetics taking metformin have a higher response rate to systemic therapies and thus have a lower chance of a recurrence compared to diabetics not taking Metformin or NON-DIABETICS not on metformin. The point is that having diabetes is not a poor prognostic marker, if anything it may turn out to be a blessing in disguise.
For some reason I can't copy paste the link but here is the URL: www.cancer.gov/ncicancerbulletin/053111/page6
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Just remember...Type 2 diabetes get lumped together often. As you know...your T2 is different than say your neighbor's down the street. Also studies look for trends. You might not fit that trend. Best I think you can do is to tell yourself..."I'm me and I'm going to do the best and get the best for me." Studies can't tell how things will be for you.
I'm diabetic - no cancer, but at risk. All I know is with my personal merry-go-round with doctors is to make sure everyone is on the same page. Have copies of all your records - I remember when I was sick with newly diagnosed diabetes & my mom (retired oncology RN) made up file folders with each doctor's name and keep all my records this way. Also she had me keep a copy of the medications I was on or was on (dates on it or started it and quantity). This came in handy since I didn't have to remember that with each doctor I saw...I could just take it out of my purse.
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Thanks for your responses, ladies. It was just so depressing to read something saying PROGNOSIS POOR...... This has been a roller coaster that started in late March and feels like it's just been spinning out of control - from one DCIS to 2, then no, sorry, the 2nd dcis is really invasive.... so I have to have the nodes checked (I think she said sentinel node biopsy) and the mascetomy on 6/7. I pray I'll heal well and the diabetes won't make it harder. Hell, I pray for good health for me and for all of you too.
Good thing is I do take metformin already so hopefully it'll do some good. I am going to try to stop looking things up on google right now. You get good information but a lot that's terribly scary and might not really apply...Kat, I just printed out lists of all my meds (many!) so thanks for that suggestion. Hope, thanks for that link. It made me feel a lot better. It's not a consensus that diabetis=poor prognosis.
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Bev -
Very sorry you are having to go through this. One thing I can add...keeping track/records of things will give you a sense of control. You know how it feels when you are in charge of your diabetes...it's a great feeling to be dealing with it head-on.
Attitude plays a big part in health and that T2 study isn't taking that into account!
Hugs to you!!
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Forgot...another thing my mom was doing with the folders. In the inside of each have a piece of paper stapled to the folder or write on the inside of the folder itself. Keep a record of when you had an appointment with that doctor. Also if weight, blood pressure, heart rate, or other? were taken record the numbers there. That way it's easy to see.
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I have Type II diabetes which I was not controlling at the time of my IDC diagnosis. That inattention ended when the surgery scheduler refused to okay my lumpectomy w/snb and I had to fall on my sword to get the surgeon to overrule the tech's denial. Long story short, I am now exercising (well, doing better anyway), eating "clean" (just began the pre-plan phase of Dr. Hyman's Blood Sugar Solution) and taking Glucophage again. I do not believe I have a poor prognosis...but I would if my A1c remained high and I went back to my previously sedentary lifestyle. I look at this as an opportunity to really start taking care of myself and controlling the things I truly have control over -- food, movement, vitamins & supplements, etc. The stuff I can't control I try not to stress about.
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I'm with you Jo.... I have not been controlling my blood sugar for a long time. Why? Because it's easier not to than to work at doing the right thing. This has put a scare into me however. Since my diagnosis at the end of March, I've been very careful with what I eat, have my sugars down, not to where they should be but the 130's is a lot better than the 190's. Because of my habits, I'm not able to have the reconstruction I might have chosen unfortunately. I'm 62 and stuff is certainly getting serious lol. What do they say? Getting old ain't for sissies!! i do concur
... I will do all I can to keep my blood sugars controlled, A) for my health and
so I can get my endo to stop lecturing me
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Kat - I wish I were as organized as you and your mom.... I am totally disorganized but along with the medication lists I just printed up for all my doctors, I will try to keep track of what happens at each appt.
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