Prostate Cancer Therapy: Diabetes Risk

Prostate Cancer Therapy: Diabetes Risk: Common treatments for prostate cancer in men may create an environment in which Type 2 diabetes can develop more easily. More than 37,000 men were involved in the four-year study led by a researcher from Brigham and Women’s Hospital in Boston.

According to TheGlobeAndMail.com, “More than one in five men who undergo androgen deprivation therapy – a form of castration common after prostate cancer treatment – subsequently develop cardiovascular disease and diabetes they otherwise would not have.”

The core finding of the report discovered in the Journal of the National Cancer Institute, “shows that the risk of heart attack, stroke, sudden cardiac death and diabetes in men who underwent ADT was 20 to 30 per cent higher than the risk in men who did not undergo the therapy.”

What Increased the Diabetic Risk?
TheGlobeAndMail.com reported, “The risks were highest in men taking a class of medications called gonadotropin-releasing hormone (GnRH) agonists, which induce chemical castration. These drugs, which are injected by a physician or implanted under the skin every few months, include leuprolide (brand name Lupron) and goserelin (Zoladex).”


A second procedure features a similar risk; “Men who opted for orchiectomy (surgical removal of the testicles) also had elevated rates of heart disease and diabetes.”

Are There Other Options?
The role of therapy for prostate cancer can’t be minimized, but if the therapy increases, other and equally problematic conditions such as heart disease and diabetes often develop. The statistics from this new report suggests that, “men who took oral androgen agonists after prostate surgery did not have higher rates of disease. The drugs, taken in daily pill form, include flutamide (Euflex) and bicalutamide (Casodex).”

Because prostate cancer is generally a slow growth disease it can be easy for doctors to view testosterone deprivation as a positive answer to slow or eliminate this hormonal based cancer. Ironically there appears to be evidence that suggests it has been known for a long time that most approaches to prostate cancer treatment elevates multiple risks. Yet these treatments are being conducted on men at younger ages. TheGlobeAndMail.com report states, “Almost one-quarter of the men under 55 and more than half the men over 75 received ADT, even though there is no firm evidence that treatment reduces mortality.”

The reintroduction of this evidence with new statistics in a fresh study may cause patients and physicians to work together to identify a treatment that takes all aspects of individual health into consideration. There is some evidence to suggest that chemical or medical castration has not proven to directly impact human mortality in connection with prostate cancer. On the other hand there is mounting evidence to suggest that this procedure can ultimately lead to more pronounced health risks.

TheGlobeAndMail.com report states, “An estimated 500,000 men in North America have undergone androgen (testosterone) deprivation therapy, and their ranks are increasing by 40,000 a year.”

While prostate cancer is a troubling condition its effects may be minimized because of its slow growth. Physicians may wonder if it is in the patients best interests to potentially minimize one risk at the expense of multiple new risks. If the physician truly believes in the Hippocratic oath of, “First do no harm” then there must be consideration given to other troubling conditions such as diabetes in men who have been diagnosed with prostate cancer and elect to undergo testosterone reduction therapies.