Yesterday’s post was about the increased risks of developing diabetes faced by men who are on hormone therapy. This study, as well as most others about this topic has looked at the first levels of hormone therapy (ADT) using the traditional drugs like Zoladex, Trelstar, Firmagon, and Lupron.

We know very little about the influence on survival that the newer hormone manipulations like abiraterone (Zytiga), which has become one of the standard of care drugs for men who also have castrate resistant metastatic prostate cancer (mCRPC), has on men with diabetes or metabolic syndrome (a precursor to diabetes).

A recent study was designed to begin the process of evaluating the effects on survival that diabetes or metabolic syndrome might have on men using abiraterone post chemotherapy.   The researchers found that the presence of MS is a significant risk factor for shorter progression free survival (PFS) (having positive or increased signs of cancer on scans as well as increasing PSA) in men with mCRPC. However, their research did not show that MS posed a significant impact on overall survival (OS).

The study authors have suggested that there is a need for a larger prospective evaluation.

What this means to us today: Men with MS might be at an increased risk of having their cancer progress while on abiraterone. This doesn’t seem to have a direct result on how long we will live, but it might mean that our quality of life (QoL) will suffer. Therefore, while we wait for more information it is probably a good idea for us to work hard not to develop diabetes or metabolic syndrome. If we do we should work with an endocrinologist to bring these diseases under control.

Reference: Prostate. 2015 May 15. Epub ahead of print.
doi: 10.1002/pros.23014; Conteduca V, Caffo O, Derosa L, Veccia A, Petracci E, Chiuri VE, Santoni M, Santini D, Fratino L, Maines F, Testoni S, De Giorgi U.

PMID: 25982919