Cancer and diabetes: often more than just a chance encounter

As familiar faces in the crowd, cancer and diabetes often seem to collide. At first glance, the two diseases seem strange, but scientists have found that they have multiple connections and often co-exist in the same patients. The results of a new study conducted at the University of Toronto and published this summer in the American Cancer Society ‘s Cancer journal, conclude that people with diabetes are more likely to develop cancer after just a few months.

Although most research supports a link between cancer and diabetes, it has proven difficult to find the root of this association. The Toronto study does not provide a direct physiological link between the two diseases, but does suggest that the dual diagnosis may be explained by “increased healthcare visits and screenings after a diabetes diagnosis,” co-author Dr. Eliana Lega says in an interview. with medicalexpress.com.

How common is diabetes?

Cancer and diabetes are among the most harmful and prevalent diseases in the United States and the world. According to the Centers for Disease Control and Prevention (CDC), nearly 30 million Americans, more than 9 percent of the population, have diabetes. The CDC also estimates that 86 million Americans have prediabetes. According to the American Cancer Society (ACS), approximately 14 million Americans have a history of cancer, and 1.6 million new cases will be diagnosed each year.

The numbers alone suggest that some patients inevitably develop both diseases. But research shows that the relationship is more than just a coincidence. In 2010, the American Diabetes Association (ADA) published a report exploring the relationship between the two diseases, concluding: “Cancer and diabetes are diagnosed in the same individual more than might be expected by chance.”

The direct link between the two diseases is lifestyle. Diet, obesity, smoking, and alcohol are risk factors for both cancer and type 2 diabetes, also known as adult-onset diabetes, which accounts for more than 90 percent of all cases. People with type 2 diabetes may be more likely to develop breast cancer, endometrial cancer, pancreatic cancer, liver cancer, kidney cancer, and colon cancer. “Diet and activity can have direct effects on cancer and diabetes risks and also play an important role in the energy balance equation that helps people achieve and maintain a healthy body weight,” says Caroline Lammersfield, MBA, MS, RD. CSO, LD, Vice President of Integrative Medicine, American Cancer ^Centers®(CTCA). “A plant-based diet that includes fish along with regular physical activity can help people achieve and maintain a healthy weight to reduce the risk of both diseases.”

What causes diabetes?

Diabetes occurs when the pancreas does not produce enough insulin to convert glucose into energy. The disease can also develop if the body cannot process the insulin that is produced. Certainly, diabetes is linked to heart disease, stroke, blindness, kidney damage, and an increased chance of amputation due to circulatory damage. But the direct clinical link between cancer and diabetes has troubled researchers for years. “Potential biological links between the two diseases are not fully understood,” the ADA report says.

However, many clinicians and patients face the fact of having to treat both conditions at the same time, which can be a difficult balancing act. Steroids used as part of chemotherapy regimens can increase blood glucose levels, making it difficult to control blood sugar during cancer treatment. This can lead to worse outcomes, delayed wound healing, and increased risk of infection. High blood sugar levels can also exacerbate cancer-related fatigue, and the loss of appetite caused by some cancer treatments makes it difficult for some people with diabetes to eat well and maintain blood sugar levels.

“This requires communication between health care team members and the patient to adjust goals and balance diabetes management during drug therapy and diet,” says Lammersfeld. “During cancer treatment, eating good food in the right amounts can be a challenge in managing both diseases. If you eat and feel healthy, follow healthy eating guidelines. If you have difficulty eating, work with your team. Your health care provider edits their diet to make sure of meeting their nutritional needs while controlling blood sugar.”

Tips for managing diabetes and cancer

Lammersfeld offers these additional tips for those battling both diseases:

• Eat a constant amount of carbohydrates in meals and snacks. Examples of recommended carbohydrates include fruits, legumes, whole grains, and low-fat dairy products such as yogurt and kefir.
• Don’t miss meals. Work with your health care team to determine options for days when you don’t eat well.
• Participate in physical activity as permitted.
• If you are overweight, talk with your health care team about whether weight loss is appropriate and, if so, how you can achieve optimal weight.