Friday, January 21, 2011

The breast cancer patients with diabetes are worse

Having both breast cancer and diabetes significantly increases the chances of dying, new research shows. The researchers conducted a meta-analysis or pooled analysis of previously published studies that looked at how breast cancer patients with diabetes was. Six of the seven studies found pre-existing diabetes was significantly associated with greater long-term all-cause mortality.

In particular, studies showed that breast cancer patients with diabetes were almost 50 percent more likely to die than those without diabetes. But much remains unknown, the study's authors said it was premature to conclude that prevention of diabetes and improved blood glucose control would lead to a better prognosis.

The data do not look at specific causes of death, nor whether the diabetes research actually caused more deaths from breast cancer. "It's basically a sign that there may be a stronger association between diabetes and breast cancer mortality have been appreciated," said study author Dr. Kimberly Peairs, assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.

"The next step is to determine whether there is a causal link between diabetes and breast cancer mortality." The study, supported by grants from the National Institutes of Health, USA. UU., The American Cancer Society and the National Institute of Diabetes and Digestive and Kidney Diseases, is published in the January issue of the Journal of Clinical Oncology.

The reason why breast cancer patients with diabetes are more likely to do harm is not known, but several studies in meta-analysis offer some clues. One study, for example, found that women with type 2 diabetes tend to have their breast cancer diagnosed before age without diabetes. Women with preexisting diabetes patients may be more general than women without diabetes.

That may be less able to handle the harsh chemotherapy drugs, or it can encourage doctors to treat their cancer less aggressive because of concerns about their health in general, Peairs said. A study of the review team found that women with diabetes had more adverse effects of chemotherapy, while others have shown that women with diabetes tend to receive less aggressive treatment, Peairs said.

There could also be a biological cause for the increased risk of mortality. High insulin levels can stimulate tumor growth, said Dr. Julia Smith, director of breast cancer detection and prevention of NYU Cancer Institute. In people with type 2 diabetes, cells become resistant to insulin, leading to increased levels of blood sugar and insulin than that circulates throughout the body.

"Regulation of insulin, obesity and diabetes [are] critical to overall health," said Smith. "We can not conclude that the control of insulin change anything about breast cancer, but we are told that we should be looking at these areas and can be something very important." About 24 million U.S.

residents. UU., Or 8 percent of the adult population, had diabetes in 2007, according to background information in the article. Prior research also shows that diabetics have an increased risk of developing breast cancer. Women should try to maintain a body mass index of 25, limit intake of animal fats, and exercise to prevent diabetes and reduce the risk of cancer, said Smith.

And women who already have diabetes should ensure that controls, while the oncologists and physicians who treat patients with diabetes should ensure that they are coordinating care, Peairs said.

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