A recent retrospective observational study in diabetic men with prostate cancer suggests that poor glycemic control before radical prostatectomy increases the risk of later progression, including metastasis.
The study evaluated data from more than 1,400 men who underwent radical prostatectomy between 2000 and 2017. The researchers were particularly interested in a possible connection between existing diabetes mellitus type 2 and the risk of later metastases and/or progression of prostate cancer.
The patients median were observed for 6.8 years after the radical prostatectomy. After evaluation of all data, 51% of the participants had an HbA1c value of > 6.5%. However, this increased HbA1c value, as a sign of insufficient glycemic control, was not associated with a higher risk of biochemical recurrence.
However, the higher HbA1c correlated with the risk of metastases (HR: 1.21; p = 0.031) and a progression into a Castration-resistant prostate cancer (CRPC) (HR: 1.27; p = 0.023). In addition, prostate cancer-specific mortality (HR: 1.24; p = 0.067) and total mortality (HR: 1.09; p = 0.058) increased slightly with elevated blood glucose.
However, the findings from the work could not be statistically verified. One possible reason for this is to be found in the retrospective design of the observational study.
To the extent that these results can also be confirmed statistically in further studies, this already suggests that consistent glycaemic control could slow down the progression of prostate cancer.
Nik‐Ahd BS et al. “Poorly controlled diabetes increases the risk of metastases and castration‐resistant prostate cancer in men undergoing radical prostatectomy: Results from the SEARCH database” in Cancer, May 2019. doi: 10.1002/cncr.32141