prostate cancer
Research
Treatment
Source: Oncotarget
Does metformin improve survival rates in patients with prostate cancer?
In a nutshell
This study investigated if the use of metformin for anti-diabetic therapy improved survival rates in men also treated for prostate cancer.
They found that patients taking metformin may have a greater chance of survival from prostate cancer.
Some background
Metformin is a medication that is commonly used to lower blood sugar levels in patients with diabetes. Some studies suggest it can suppress the growth of cancerous tumors by blocking a cellular pathway.
In the treatment of prostate cancer, patients will typically receive chemotherapy. This works by targeting cells that are growing and multiplying rapidly (such as tumor cells. Studies have shown that patients undergoing treatment for prostate cancer and also taking metformin have greater survival rates.
Methods & findings
This study analyzed the findings of recent clinical reports investigating the association between metformin use and survival rates in prostate cancer patients.
This study included data from 13 clinical reports including 177,490 patients. In these studies, some patients were receiving metformin and were undergoing or had undergone treatment for prostate cancer.
Patients taking metformin had a 21% more likely to have a longer overall survival (time from treatment until death from any cause) compared to non-metformin patients. Chances of cancer-specific survival were also increased in metformin patients (by 24%). The risk of cancer recurrence was also lower in metformin patients (decrease of 26%).
The bottom line
This study concluded that patients taking metformin may have a greater chance of survival from prostate cancer.
The fine print
The number of studies included in this study was relatively small for certain analyses. Some information could not be included in the analysis as it was not available (tumor size, disease stage). These factors could also influence the prognosis and survival rates. Future studies should include this to fully understand the benefits (if any) of metformin use in prostate cancer.
What's next?
If you have any questions regarding prostate cancer treatment, please discuss this with your physician.
Disclaimer:
This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided by Medivizor solely at your own risk. Medivizor makes no warranties or representations as to the accuracy of information provided herein. If you have any concerns about your health, please consult a physician.
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Thank you for your advices. I am 82 yrs old and have had Prostate Cancer for some 20 years now and have a good Doctor. Reply
Please share with me your protocol. I have had
prostate cancer since age 62 and would like to do everything possible to survive.
Reply
Steve:
I have had Stage 4 Prostate cancer since Jan. 2013. I have had very aggressive treatment for this and also have been on Metformin for the past 23 years to help treat my diabetes. Currently I have no evidence of disease. As you have seen there are several studies showing survival benefit to those who also take metformin for prostate cancer. You should discuss this with your Urologist/Oncologist team for their advice.
As an aside, I am a Urologist myself. Reply
Thank You Reply
Hi, May I ask what very aggressive is? I also have metastasized prostate cancer and there is a bit of a debate as to how aggressive to be. Thanks, Joe Reply
Joe-
I started with ADT for 15months followed by a robotic prostatectomy. After another 4 months I had 6 months of Docetaxel, then 3 months of Enzalutamide, and finally Radium 223 for the extensive bone mets. This is not yet the standard of care but hopefully will be shortly. What is important to remember however, is everyone's tumor is genetically different, therefore the treatment should be tailored to your own tumor. Reply
Thank you . I am currently on Abiraterone and Lupron. This was started when the cancer was discovered about a year ago so I an not resistant yet (PSA .2 at last test). The cancer is in my lymph nodes outside of the pelvis. My doctor basically says wait and see what happens before doing anything. She also states that a prostatectomy will not change the statistical outcome. Did the prostatectomy result in a measurable difference in your PSA?
I think the Radium 223 is very interesting and I am glad to hear that it worked well for you. I have quite a bit of experience with genetics and it is so true that each cancer is its own animal. Unfortunately we are still not that good at understanding these genetic differences and the opportunities and challenges they present. Making progress though. Reply
Joe, your doctor is like most in not appreciating the value of a prostatectomy in men with metastatic disease . The European literature shows there is a 50-70% improvement in survival in men with metastatic prostate cancer. I have spoken at national meetings on this topic and the audiences are astounded by this figure. Get this reference and read it. It prompted me to have the surgery.
Europen Urology vol. 65 1058-1066 2014 Reply
Hi,
In reviewing the paper it certainly makes a case that surgery is a good idea. I forwarded the paper to my doctor. Her response was:
"
There are a few papers like this- all retrospective, so interesting and hypothesis generating to serve as a foundation for prospective trials, but not enough to base treatment decisions on at this point.
"
I guess I am going to have to decide what to do.
Joe Reply
In Europe they have been doing it for fifteen years or more. My colleagues here in the US will be slow to adopt this as we were taught once the horse is out of the barn why close the door? Old ways die hard. If we wait for the prospective studies, many men will lose their lives. Unfortunately the insurance industry calls the shots. Reply
I find it abhorrent that patients have very little influence in "treatment" [coverage] decisions in general, but particularly in clinical situations such as these. How is it rational to define that the gold standard for local PCa is prostatectomy, yet negate the benefit of the primary tumor removal -- at any later stage of the disease? Simple rational thought tells us that PCA returns to zero following prostatectomy for a reason. And if it doesn't, there is a reason for that as well -- clinically unidentified metastasis. Research validation of clinical guidelines has its place. But, in this situation, it's like treating a whole house for mold, without removing the original source of the infestation. As you note, CaPDoc, the practice is widely deployed in Europe; though even there it still remains technically outside of the EU Guidelines. You, or others, may find these updates of use in your battles, for which I wish you God's speed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770575/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849176/# Reply
Thank you Reply
I just gave a talk at another international PCa symposium 2 days ago. The information I posted previously is now more accepted as more and more preliminary studies using sequential multi modal therapies are being published. The radical surgery issue is very simple to understand. The primary tumor is basically the mother ship of the metastatic lesions. It sends out more and communicates with the mets when they are established. Removing the primary helps both aspects of this mechanism.
What I also stated previously about the individual genetics of each tumor is crucial in deciding which agents to employ in your treatment. Genetic analysis is easily obtainable in today’s world.
Wishing you all a good new year. Reply