Having both breast cancer and diabetes greatly increases the chances of dying, new research shows.
Specifically, the studies showed breast cancer patients with diabetes were nearly 50% more likely to die than those who didn’t have diabetes.
“It’s basically a signal that there may be a stronger association between diabetes and breast cancer mortality than we have appreciated,” said lead study author Dr. Kimberly Peairs, an assistant professor of medicine at John Hopkins University School of Medicine in Baltimore.
The reason why breast cancer patients with diabetes are more likely to do poorly isn’t known, but several studies offer some clues. One study found that women with type 2 diabetes tended to have their breast cancer diagnosed later than those without diabetes.
Women with pre-existing diabetes may also be sicker overall than women without diabetes. That may make them less able to handle the harsh chemotherapy drugs, or may prompt doctors to treat their cancer less aggressively because of concerns about their overall health, Peairs said.
One study the team reviewed showed that women with diabetes had more adverse events from chemotherapy, while another demonstrated that women with diabetes tended to receive less aggressive treatment, Peairs said.
There could also be a biological cause for the increased mortality risk. High levels of insulin may stimulate tumor growth, said Dr. Julie Smith, director of the breast cancer screening and prevention program at NYU Cancer Institute.
“Insulin regulation, obesity and diabetes (are) critical in general health,” Smith said. “I can’t conclude that controlling insulin will modify anything about breast cancer, but it tells us we should be looking in those areas and there may be something very important.”
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