Saturday, 28 April 2012

Type 2 Diabetes & Breast Cancer

After Speaking to my BC nurse the other day there was something she said that did not sit right with my long term diagnosis’. If someone says something that doesn’t add up. I will investigate especially when I feel they are talking for talking sake. My treatment is being based on breast cancer not diabetes and breast cancer. Within the NHS I have noted that my type two diabetes is not brought into conversation. It is seen as a hindrance, not a trigger of the breast cancer.
On more than one occasion when speaking about my diabetes I was told I am sorry I am an oncologist not a diabetic consultant. You must speak with your diabetes consultant, but I do not see your diabetes to be a issue on treatment.

My BC nurse told me about a condition called Diabetic mastopathy. My BC nurse explained how tumours can develop in the breast tissue that are benign. It seems my last meeting and me mentioning how I was high risk where breast cancer was concerned, into her doing her own investigations on my condition. I had heard of various conditions with diabetes, but this flumped me into a false sense of what is she talking about. Her attempts at trying to reassure me were valid, but I felt she actually really knew nothing, or at least did not have the right info in front of her. I typed up benign breast tumours and diabetes in the task bar, and up came the condition and a small paragraph explaining.
Diabetic mastopathy (lymphocytic mastitis, sclerosing lymphocytic lobulitis/ductitis)
Diabetic mastopathy (also called lymphocytic mastitis and sclerosing lymphocytic lobulitis/ductitis) are small, hard masses that appear in the breast. This rare condition most often occurs in premenopausal women with insulin-dependent (type 1) diabetes. It may appear as a breast lump or an abnormal finding on a mammogram. A biopsy may be needed to confirm the diagnosis. Diabetic mastopathy does not need treatment.
Although still under study, diabetic mastopathy may be due to an autoimmune reaction. It does not appear to increase the risk of breast cancer.

Now anyone else who had not read my medical records would look at this piece of information and say, well yes that is it, but I am not a Type 1 diabetic and I am not insulin dependent. The differences between the two diagnosis is considerable with treatment. This is why I truly believe there should be a consultant that knows about these two conditions together rather than two departments that never speak. To me whilst the two departments are not communicating as in my blood results etc then there is a loop hole for error. Diabetes type 2 increases the risks of breast cancer and no-one actually knows why. Thankfully I have sense to sit up and say something and not shy away from a good debate.
My nurse had reminded me about the patient cancer advocate group committee she wanted me to attend. The invitation was due to the self help group that I am still juggling with, and a committee member inviting me along. Personally I will gather the facts together and put it in front of this committee asking why this is not happening considering type 2 diabetes is on the increase within the western world. And more should be done in treatment instead of treating diabetes as a headache. The probability of me developing a reoccurrence is increased because the two condition can thrive off each other. This in turn leaves a big question mark to how they treat me. My BC nurse also informed me I am on a ten year observation list instead of five. To me that makes me think they are aware that my issues have just begun rather than solved. I have not met anyone who is being observed for ten years with breast cancer not unless they are high risk. Being a part of this committee puts me in a place where I can debate with those that are treating me. And develop a better understanding of the treatments involved with diabetes and breast cancer at this current time.      

Type 2 Diabetes Worsens Breast Cancer Prognosis

By Aaron Tabor, MD                                                                                    
Type 2 diabetes and breast cancer are two health conditions that share some of the same risk factors and pathways including obesity, changes in insulin-like growth factors, steroid hormone changes, and changes in inflammatory chemicals produced by fat cells. In fact some research studies suggest that type 2 diabetes is linked to a 20-30% increased risk for developing breast cancer.

The impact of type 2 diabetes on breast cancer outcomes is of particular interest because it has been reported that about 15-20% of breast cancer patients have type 2 diabetes, while more likely go undiagnosed. A new
breast cancer research study used data collected from 3,003 women with a history of early stage breast cancer who took part in a larger breast cancer study. For this new study, glycated hemoglobin (HbA1c) levels were used to determine diabetes status with levels between 6.5-6.9% indicating high risk for diabetes and levels of 7.0% and above indicating type 2 diabetes. Analysis of the relationships between type 2 diabetes and breast cancer outcomes in this population of women with a history of breast cancer showed that:
Hb1Ac levels higher than 6.5% (high risk for type 2 diabetes) were associated with obesity and more advanced breast cancer upon diagnosis.

Women with type 2 diabetes were about 2.4 times more likely to die from any cause.

Breast cancer-free survival was reduced with increasing levels of Hb1Ac

These study results show the negative impact that type 2 diabetes can have on breast cancer. Breast cancer patients who also had type 2 diabetes or were at high risk for developing type 2 diabetes generally had more advanced breast cancer and were at slightly greater risk for breast cancer recurrence. The interaction between type 2 diabetes and breast cancer risk appears to be very complex. Interestingly, it has been reported that breast cancer treatment drugs can effect glucose metabolism, while some type 2 diabetes drugs like metformin have been reported to decrease breast cancer risk. More well-designed human studies will need to be done to clarify this potentially important interaction between type 2 diabetes and breast cancer.

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