diabetestalk.net

Chemotherapy Diabetes Complications

Complications Of Systemic Chemotherapy As Treatment Of Retinoblastoma

Complications Of Systemic Chemotherapy As Treatment Of Retinoblastoma

Complications of Systemic Chemotherapy as Treatment of Retinoblastoma Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2000 Arch Ophthalmol. 2000;118(4):572-575. doi: Retinoblastoma is the most common intraocular tumor in children. 1 Historically, the treatment of retinoblastoma was enucleation. 1 However, improvements in diagnosis and treatment of retinoblastoma have led not only to a survival rate well over 90%, 1 but also to an increasing ability to offer globe conservation as a secondary goal of therapy. Globe-conserving therapies include cryotherapy, laser photoablation, hyperthermia, and plaque radiotherapy for smaller tumors, and external beam radiation and systemic chemotherapy for larger tumors not amenable to local control. 2 Recently, multiple-agent chemotherapy with etoposide phosphate, carboplatin, and vincristine sulfate combined with transpupillary hyperthermia has been demonstrated to achieve excellent local control of retinoblastoma. 3 Further, systemic chemotherapy spares the patient the risk of craniofacial abnormalities and may eliminate or decrease the risk of secondary tumors that have been associated with external beam radiation. 4 However, systemic chemotherapy employed for retinoblastoma has been associated with adverse events such as myelosuppression and subsequent infections and need for transfusion of blood products. 5 To our knowledge, the incidence of such complications and their effect on treatment remain unknown. This study evaluates the adverse events and resultant alterations in treatment protocol during the treatment of retinoblastoma with systemic chemotherapy. The study protocol was approved by the Institutional Review Board of the University of Miami School Continue reading >>

Why Does Diabetes Raise Cancer Risk?

Why Does Diabetes Raise Cancer Risk?

More Questions Than Answers From Expert Panel on Diabetes, Cancer Link June 16, 2010 -- People with diabetes are at increased risk of certain cancers -- but why? Could it be that some diabetes treatments trigger or promote cancer ? Or do the underlying causes of diabetes also underlie cancer ? These are the questions put before an expert panel from the American Diabetes Association and the American Cancer Society (ACS). Even so, lifestyle changes that prevent or reverse diabetes will certainly cut cancer risk, says panel member Susan M. Gapstur, PhD, ACS vice president of epidemiology. "The full biologic link between diabetes and cancer has not been completely defined," Gapstur tells WebMD. "But first of all we should prevent diabetes. Then we can prevent some cancers. And for those who do have diabetes, it should be controlled as much as possible through a healthy lifestyle." Diabetes doubles the risk of liver , pancreas , and endometrial cancer . It increases the risk of colorectal, breast , and bladder cancer by 20% to 50%. But it cuts men's risk of prostate cancer . People with diabetes tend to have some known risk factors for cancer: older age, obesity , poor diet, and physical inactivity. And problems common in diabetes -- too-high insulin levels, too-high blood sugar levels , and inflammation -- increase cancer risk. "No matter what science ultimately reveals ... we already know what we need to do to lower risk for both cancer and diabetes," Alice Bender, RD, of the American Institute for Cancer Research, says in a news release. "Eat a healthy, varied, predominantly plant-based diet, be physically active every day, and maintain a healthy body weight ." Do Diabetes Treatments Raise Cancer Risk? There is evidence, but not definitive proof, that diabetes treatments Continue reading >>

10 Nutrition Tips For Managing Cancer And Diabetes

10 Nutrition Tips For Managing Cancer And Diabetes

November is National Diabetes Awareness Month, and of the more than 13 million Americans who have or have had cancer, eight to 18 percent also have diabetes. It’s an eye-opening statistic and a reminder about why it’s important to be proactive about our overall health and well-being during and after cancer treatment. “Because of the huge link between insulin resistance and cancer, it is critically important for people who have diabetes to manage their blood glucose during cancer treatment,” adds Brooke McIntyre, a clinical oncology dietitian and diabetes program coordinator at CTCA in Tulsa. McIntyre recommends the following tips to help manage cancer and diabetes: Never eat a “naked” carbohydrate. Funny statement, but people remember it! Rather than eating only an apple, eat a handful of nuts or one to two tablespoons of nut butter too. This helps decrease the rise in blood sugar and makes you feel more satisfied. Eat fewer carbohydrates. Decreasing carbohydrate intake not only lowers blood sugar, but can also help lower blood pressure. Eat more veggies, fruits and whole grains. Eating cancer-fighting foods high in fiber can help regulate blood sugar. Foods to add to your diet include: Asian pears, raspberries, blackberries, bananas, blueberries, beans, broccoli, spinach, lentils, peas, corn, flax seeds and whole-grain breads or crackers. Exercise regularly. The American Institute for Cancer Research and the American Diabetes Association recommend 30 minutes of physical activity five days a week to lower risk of cancer recurrence. Add healthy fats to your diet. Say “no” to doughnuts and fried chicken and “hello” to healthy fats such as avocado, salmon and walnuts. Good fats contain antioxidants, help you maintain a steady blood sugar level and feel Continue reading >>

How Does Having Diabetes Affect My Cancer Treatment?

How Does Having Diabetes Affect My Cancer Treatment?

More than 25 million people in the United States have been diagnosed with diabetes, according to the Centers for Disease Control and Prevention. Among people 65 and older, nearly 27 percent have diabetes. The vast majority of diabetes cases are type 2 diabetes, which is associated largely with older age and being overweight as well as family history. Older age and obesity also are risk factors for developing cancer, which means that people with type 2 diabetes are diagnosed with cancer more often than those in the general population. Having diabetes can complicate cancer treatment due to a number of factors. At the same time, some treatments for cancer, including certain newer targeted therapy drugs, can spur the development of diabetes, especially in patients who already had a propensity toward developing the disease, although this effect is usually reversible. Azeez Farooki is a Memorial Sloan Kettering endocrinologist who specializes in treating cancer patients who also have diabetes. We spoke with Dr. Farooki about what special considerations are taken into account when treating this group of patients. A Disease of Blood Sugar “Diabetes is a disease in which a person has increased levels of glucose, or sugar, in the blood,” Dr. Farooki explains. “It can occur because the pancreas does not produce enough insulin — the hormone that allows glucose to be absorbed — or because cells do not respond to the insulin that is produced. Cells should normally take in sugar from the blood; if they don’t, then high blood sugar or ‘hyperglycemia’ results.” The majority of people with type 2 diabetes are overweight, which often causes the body to become resistant to the effects of insulin. Type 2 disease may be treated with insulin injections, other hormonal inject Continue reading >>

Diabetes And Cancer: What's The Connection?

Diabetes And Cancer: What's The Connection?

When Michelle Hall was diagnosed with breast cancer two years ago, she was shocked. "The standing joke in the family was that I came from a long line of stocky French women who lived forever," says Hall, 62, of Salem, N.H. "We had no breast cancer in the family." Hall had been diagnosed with type 2 diabetes in 2001, so she would have special challenges while facing down cancer. 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? If so, what kinds of cancer and how? As the interplay between diabetes and cancer becomes clearer, researchers hope to gain an edge against both diseases. The link between diabetes and cancer may be partially explained by risk factors that underlie and raise the risk of both diseases. Sex: Overall, men are more likely to develop both cancer and type 2 diabetes than women. Weight: Overweight and obese people are more likely to develop cancer than lean people. The association between type 2 diabetes and weight is also well established. While it's clear that losing weight reduces the risk for type 2 diabetes, less is known about whether weight loss combats cancer. Diet: Eating patterns that are thought to help prevent and treat type 2 diabeteslimited red and processed meats and abundant vegetables, fruits, and whole grainsare also associated with a lower risk for many types of cancer. Exercise: Studies show that regular physical activity lowers the risk of developing several types of cancer. Likewise, 30 minutes of moderate-intensity exercise per day can reduce th Continue reading >>

Diabetes And Indigestion While Undergoing Chemotherapy And Radiation Therapy

Diabetes And Indigestion While Undergoing Chemotherapy And Radiation Therapy

Diabetes and Indigestion while Undergoing Chemotherapy and Radiation Therapy Diabetes and Indigestion while Undergoing Chemotherapy and Radiation Therapy My 87-year-old Dad was just diagnosed with bladder cancer. He has indigestion every day now, even though he is on a low fat diet. He is also a recovering stroke patient, with hypertension and insulin diabetes. He starts chemotherapy and radiation soon. How will side effects of chemotherapy and radiation therapy affect his diabetes problems? How do I manage the food intake and blood sugar levels? I am afraid that the side effects will keep him from eating and blood sugar levels will drop too low. Ellen Sweeney, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: Depending on the type of chemotherapy drugs along with the radiation he receives, he could experience several side effects. These side effects may include nausea, loss of appetite, change in the taste of foods, constipation and/or diarrhea. Any side effects that end up affecting the amount he eats can obviously affect his blood sugar levels. If he does not have a loss of appetite and is able to eat normally, then he would continue to treat his diabetes with his current insulin regimen. If his appetite is poor through treatment, then it becomes more important for him to get his calorie and protein needs met for weight and protein store maintenance than to follow a diabetic diet. Diabetic patients' diets are liberalized during cancer treatment and those patients are allowed to eat differently during treatment, especially if their appetite is poor. It becomes more important to maintain weight in order to prevent nutritional compromise during treatment. Typically, physicians will adjust oral blood sugar medication or Continue reading >>

Diabetes Management In Cancer Patients

Diabetes Management In Cancer Patients

Hyperglycemia is a common challenge during cancer treatment and palliation. In addition, many patients with pre-existing type 1 or type 2 diabetes undergoing cancer treatment develop iatrogenic hyperglycemia with unique features. The most common example is steroid-induced hyperglycemia,[1] but several other scenarios are common and clinically important (Table 1). Special considerations are often necessary regarding standard lifestyle recommendations, optimal choice of antidiabetic drug (Table 2), and goals of therapy.[2] In patients with active cancer, the focus of hyperglycemia management shifts from preventing long-term complications toward avoiding acute and subacute outcomes, such as dehydration from polyuria, infection, catabolic weight loss, hyperosmolar nonketotic states (HNK), and diabetic ketoacidosis (DKA; Table 3).[3,4] It should be noted that the truly emergent conditions HNK and DKA are rare. The more common scenario of an asymptomatic severe elevation in blood glucose level (> 400 mg/dL, for example), although requiring a treatment plan with good hydration and close follow-up, does not typically require an emergency room visit or admission. Two representative clinical cases are presented here. Clinical Vignette #1 Corticosteroid-induced hyperglycemia A 53-year-old woman with a history of pre-diabetes and peripheral blood stem cell transplant for acute myelogenous leukemia (AML) presented with asymptomatic elevated random blood glucose levels. After transplant she developed graft-versus-host disease (GVHD) with liver injury, which was treated with 60 mg of prednisone daily, tapered gradually to 20 mg daily at the time of presentation 2 months later. Random serum glucose level was 396 mg/dL. Previously, all serum glucose levels had been less than 160 mg/dL u Continue reading >>

What Is The Relationship Between Breast Cancer And Diabetes?

What Is The Relationship Between Breast Cancer And Diabetes?

What is the relationship between breast cancer and diabetes? Survivors of breast cancer, who are post-menopausal, have a higher chance of developing diabetes. Scientists are becoming increasingly aware of an association between diabetes and cancer. In this article, we discuss the link. A study, published in Diabetologia, is the largest to observe the link between surviving breast cancer and eventually developing diabetes; it also showed that whether the patient went on to develop diabetes was closely associated with having undergone chemotherapy . The opposite interaction has also been observed: females with diabetes have a 20 percent chance of developing postmenopausal breast cancer. A study from last year demonstrated that people with diabetes over the age of 60 are more likely to develop breast cancer, compared with their counterparts without diabetes. Fast facts on breast cancer and diabetes: It has been observed that having diabetes increases the likelihood of breast cancer, and that having breast cancer increases the likelihood of developing diabetes. Lifestyle changes can help reduce risk long-term. How has the connection between breast cancer and diabetes been established? There has been increased study into the correlation of breast cancer and diabetes. The connection has been made as a result of improvements in diagnosis and treatment of breast cancer. As more women survive breast cancer, it is becoming increasingly important to understand the long-term outcomes for survivors as they grow older. However, few studies have tried to determine what the risk of developing diabetes is for a breast cancer survivor. The study in Diabetalogia is an example of the new research that has established the connection between breast cancer and diabetes more firmly. The team, Continue reading >>

Chemotherapy And Glycemic Control In Patients With Type 2 Diabetes And Cancer: A Comparative Case Analysis

Chemotherapy And Glycemic Control In Patients With Type 2 Diabetes And Cancer: A Comparative Case Analysis

Chemotherapy and Glycemic Control in Patients with Type 2 Diabetes and Cancer: A Comparative Case Analysis Denise Soltow Hershey , PhD, RN, FNP-BC1 and Sarah Hession 2 1College of Nursing, Michigan State University, MI, USA 2Center for Statistical Training and Consulting, Michigan State University, MI, USA Corresponding author: Denise Soltow Hershey, College of Nursing, Michigan State University, MI, USA Tel: (517) 432-8294 E-mail: [email protected] Received 2017 Feb 24; Accepted 2017 Mar 26. Copyright : 2017 Ann & Joshua Medical Publishing Co. Ltd This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. This article has been cited by other articles in PMC. Individuals with diabetes who develop cancer have a worse 5-year overall survival rate and are more likely to develop an infection and/or be hospitalized when compared to those without diabetes. Patients with diabetes and cancer receiving chemotherapy have an increased risk for developing glycemic issues. The relationship between chemotherapy and glycemic control is not completely understood. The aim of this study was to explore the relationship between glycemic control, symptoms, physical and mental function, development of adverse events, and chemotherapy reductions or stoppages in adults with Type 2 diabetes (T2D) and cancer. A prospective 12-week longitudinal cohort study recruited 24 adults with T2D, solid tumor cancer, or lymphoma receiving outpatient intravenous chemotherapy. Eighteen individuals completed baseline data and were included in the analysis. Continue reading >>

How To Balance Diabetes And Cancer Treatment

How To Balance Diabetes And Cancer Treatment

How to Balance Diabetes and Cancer Treatment Managing your type 2 diabetes during cancer treatment can be challenging but it can be done. Being treated for cancer when you have type 2 diabetes requires working with a multidisciplinary team of caregivers. Type 2 diabetes can raise your risk for several types of cancer, and it can also affect your cancer treatment if you are diagnosed with cancer. The critical issue is to treat the cancer with whatever works best for the patient and not to avoid any treatment just because of the diabetes, says Derek LeRoith, MD , director of research in the division of endocrinology, diabetes and bone disease at the Icahn School of Medicine at Mount Sinai in New York City. It is vital, though, to take the diabetes into consideration as part of the treatment, says Marilou Terpenning, MD , a physician at Santa Monica Hematology-Oncology Consultants in Santa Monica, California. And that means assembling a multidisciplinary team of caregivers that may include an endocrinologist , internist, surgeon, medical oncologist , and radiation therapist, and a dietitian for nutritional education and counseling,Dr. Terpenning says. Treatment for cancer can affect glucose metabolism and affect the need for monitoring blood sugar and adjustment of medications, she says. The cancer treatment team needs to prepare the joint cancer treatment plan and work with the endocrinologist or internist overseeing diabetes management. The good news is that experts can generally predict how certain treatments such as surgery and chemotherapy will affect diabetes management and advise accordingly, Terpenning says. Many people with diabetes have a form of nerve damage known as diabetic peripheral neuropathy. Peripheral neuropathy can cause tingling, burning, pain, or num Continue reading >>

Diabetes And Cancer

Diabetes And Cancer

Tweet Studies have shown that diabetes carries an increased risk for a number of different forms of cancer. Having cancer with diabetes can make achieving good diabetes control much more difficult but this can be relieved to some extent. How is type 2 diabetes linked with cancer? One theory for why a link may exist is that high levels of circulating insulin (known as hyperinsulinemia) can promote the growth of tumours. In type 2 diabetes, insulin resistance commonly causes the body to produce more insulin than normal. Another reason why a link may be present is where a harmful lifestyle may lead to obesity and therefore higher risks of both type 2 diabetes and cancer. Cancer and type 2 diabetes The risks of contracting the following cancers are shown to be doubled by the presence of type 2 diabetes: Pancreatic cancer Endometrial cancer (also known as womb cancer) A smaller increased risk, of 20% to 50% is seen for the following forms of cancer. Colorectal cancer Bladder cancer Blood cancers (non-Hodgkin’s lymphoma) The one positive is that incidences of prostate cancer are actually lower for people with type 2 diabetes. Cancer and type 1 diabetes Links between type 1 diabetes and cancer are not so well recorded but it appears there is also an increase in risk of cancers for people with type 1 diabetes. The cancers with the highest increase in risk tended to be different to those noted in type 2 diabetes. The cancers with increased risk in type 1 diabetes include: Stomach cancer Cervical cancer What are the symptoms of cancer? The symptoms of cancer vary widely depending on which part of the body the cancer strikes. What treatment options are open for cancer? The main treatment options for cancer are surgery to remove the cancers or radiotherapy (also known as radiatio Continue reading >>

Clinical Challenges In Caring For Patients With Diabetes And Cancer

Clinical Challenges In Caring For Patients With Diabetes And Cancer

Abstract In Brief Diabetes and cancer are two diagnoses that individually overwhelm both patients and clinicians. Approximately 8–18% of people with cancer have diabetes. Together, these two diseases can pose formidable challenges to clinicians caring for this difficult patient population. Unfortunately, our knowledge of this topic is limited by insufficient evidence to determine how best to manage diabetes while simultaneously treating cancer. This article seeks to review some of the most common problems encountered by clinicians caring for these patients. Diabetes and cancer are two diagnoses that individually overwhelm both patients and clinicians. Approximately 8–18% of people with cancer have diabetes.1 Together, these two diseases can pose formidable challenges to clinicians caring for this difficult patient population. Unfortunately, our knowledge of this topic is limited by insufficient evidence to determine how best to manage diabetes while simultaneously treating cancer. This article seeks to review some of the most common problems encountered by clinicians caring for these patients. Cancer Screening and Prevention Several studies published within the past decade demonstrate that patients with a chronic disease are less likely to receive preventive services, such as cancer screenings, than their counterparts without diabetes.2–5 A recent retrospective study addressed cancer screening in patients with diabetes.6 After examining the mammography rates of 69,168 Canadian women with diabetes and 663,519 Canadian women without diabetes, the authors concluded that patients with complex chronic diseases are 32% less likely to receive this routine cancer screening, even though they see primary care and specialty physicians more frequently than their counterparts Continue reading >>

Management Of Diabetes In Patients With Cancer

Management Of Diabetes In Patients With Cancer

Introduction Fuelled by rapid urbanization leading to changes in obesity, diet and physical activity on the background of genetic predisposition, rising levels of type 2 diabetes worldwide appear to show no sign of abating.1,2 Although it is widely recognized that diabetes is associated with vascular complications, it is less well known that the condition is also associated with an increased risk of cancer, independent of its association with obesity.3–6 Cancer and diabetes are both common conditions, but their co-diagnosis in the same individual occurs more commonly than might be expected. Consensus statements from the American and European Diabetes and Oncology Associations report that observational data suggest a strong link between diabetes and breast, colorectal, endometrial, liver and pancreatic cancers.7 They suggest that the likely pathogenesis of this association is through hyperinsulinaemia, hyperglycaemia, inflammation and possibly some diabetes therapies. This article aims to review the management of diabetes in patients with cancer, discussing the challenges of anti-cancer therapies in patients with diabetes, the relative importance of glucose control in such patients, and the management of diabetes at the end of life. Many cancer chemotherapeutic regimes include glucocorticoids which may induce diabetes or exacerbate pre-existing diabetes. Other therapies, such as androgen-deprivation therapy (ADT) with luteinizing hormone-releasing hormone agonists for prostate cancer, are linked with increased risk of the development of type 2 diabetes, possibly due to loss of insulin sensitivity.8 Use of ADT in patients with pre-existing type 2 diabetes and prostate cancer leads to worsening glycaemic control over 2 years, along with increased insulin requirements.9 C Continue reading >>

Diabetes And Chemotherapy

Diabetes And Chemotherapy

If you have diabetes, your blood sugar may need closer monitoring while you are having treatment. Chemotherapy can make you feel sick or be sick. You might not want to eat and this can be a problem. If you can't eat, your blood sugar could drop too low causing: faintness sweating coma This is called a hypoglycaemic attack. You and your doctor might need to plan chemotherapy a bit more carefully than would be necessary if you weren’t diabetic. Some chemotherapy combinations include steroids and these might upset your sugar balance. It might be a good idea for you and your cancer doctor to talk to your diabetes specialist. Types of diabetes There are 2 different types of diabetes. How you manage it depends on the type you have: type 1 – you need to have regular insulin injections or an insulin pump type 2 – you may be able to control it with either diet or with a combination of diet and tablets. There are some people with type 2 diabetes who also need to have insulin injections Type 1 diabetes If you are dependent on insulin, your doctor may suggest that you have the first course of chemotherapy in hospital so that the nurses can keep an eye on you. Then, if you need sugar quickly, you can have it through a drip rather than by mouth. It's possible for you to have insulin and a sugar solution (dextrose) given together through a drip in hospital. The insulin dose is based on hourly or 2 hourly blood sugar tests. But most people don't need this. If you are unable to eat your normal diet when you are at home, you may find you need to check your blood sugar a bit more often than you usually would. Type 2 diabetes If you control your diabetes with diet or tablets it should be possible to manage it during chemotherapy without too many problems. Discuss the options with you Continue reading >>

My Life With Cancer & Diabetes

My Life With Cancer & Diabetes

We're sorry, an error occurred. We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later. This upcoming Sunday is National Cancer Survivors Day , a worldwide observance the first Sunday in June, dedicated to "showing the world that life after a cancer diagnosis can be meaningful and productive." We almost hate to mention it, but there is some question about a possible link between cancer and diabetes and there are many people out there dealing with both. There's no real proof that one causes the other, yet there are a lot of studies linking the two . Results suggest that anywhere from 8 to 18% of people with cancer also have diabetes. One recent study published in Diabetes Care showed that 16 out of every 100 men with diabetes and 17 out of every 100 women with diabetes said they had cancer, compared to just 7 out of 100 men and 10 out of 100 women without diabetes. So maybe there is some connection...? We're not pointing this out to scare anybody, but rather to pay homage to the folks who are dealing with both illnesses. Despite the stats cited, there's hardly any available literature on treating this combination. One of the few things we found was a 2006 Diabetes Spectrum article by Helen Psarakis, a diabetes nurse practitioner at Yale New Haven Hospital. She states that cancer patients who are on glucocorticoids a steroid used in short term, high-dose chemo treatments often suffer with high blood sugar. In fact, patients at risk for diabetes who begin taking glucocorticoids during cancer treatment are often quickly diagnosed with diabetes too. Insulin is recommended to treat steroid-induced blood sugar, as patients "may require two to three times their usual dose(s) of insulin." Woah. Helen points out a f Continue reading >>

More in diabetes