Colon cancer and diabetes

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pantufla
Posts: 147
Joined: Thu Dec 03, 2015 12:44 pm
Facebook Username: kelleykulina

Colon cancer and diabetes

Postby pantufla » Thu May 25, 2023 4:27 pm

Hello everyone,

My husband had a good-sized bleed in November 2022. He is just now getting around to going to doctors' offices. He has a colonoscopy on June 12. He just got back results from routine blood work which showed a glucose of 350 and an A1C of 12. An umbilical hernia was also found for which he needs to contact the surgeon. How does diabetes effect colon cancer?
Thank you. :)
DH T2 N1b M0. 3/15 positive nodes.
Stage IIIA moderately differentiated adenocarcinoma.
Tumor size 6 cm.
Left hemicolectomy 10/26/15.
FOLFOX 11/30/15 to 5/2/16, full 12 cycles.
10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm.
June 2019: NED.
2020: NED 5 years. 4 mm lung nodule on CT

Rock_Robster
Posts: 780
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Colon cancer and diabetes

Postby Rock_Robster » Thu May 25, 2023 8:36 pm

Hello, I’m sorry I’m not aware of direct links between colon cancer and diabetes, however I understand diabetes and the use of drugs like metformin can make cancer imaging more difficult (CT, PET etc.) due to the contrast and methods used. However there are generally workarounds available for this.

Obviously it’s also important that the diabetes remains well-managed to ensure the patient is fit for other treatments (surgeries, etc.) without a higher risk of complications.

Good luck, Rob
41M Australia
2018 Dx RC 12cm high
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA Nov18: 14>2
Jun22: 5
Dec-Apr23: 17>22
11/18 FOLFOX
3/19 Liver resect
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resect
NED
11/21 Liver met, PALN, tiny lung mets
3/22 PVE, lymphadenectomy, liver SBRT
9/22 Liver met, PALN
10/22 PALN SBRT
11/22 Liver mets, nodes, peri nodules. Xeloda+Avastin
1/23 Stable. Lymph/peri undetectable
4/23 Minor progression. XELIRI+Bev

zephyr
Posts: 339
Joined: Thu Aug 18, 2016 7:31 am

Re: Colon cancer and diabetes

Postby zephyr » Sat May 27, 2023 2:56 pm

It's my understanding that metformin is often prescribed off-label for cancer patients to help block glucose pathways. I'm not a doctor but it seems to me that if glucose levels are important enough to prescribe metformin off-label as part of cancer treatment, anyone with diabetes should be extra vigilant about keeping glucose under control. Maybe someone with more knowledge can chime in here...
Nov-2009 Early stage CRC, routine colonoscopy
2010-2014 F/U colonoscopies, all clear
Jun-2016 CRC during F/U colonoscopy, surgery, Stage 4, KRAS, MSS, inop lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Mar-2021 Forfiri/Avastin
Mar-2022 Ablation & Thoracotomy
Feb-2023 Folfiri

pantufla
Posts: 147
Joined: Thu Dec 03, 2015 12:44 pm
Facebook Username: kelleykulina

Re: Colon cancer and diabetes

Postby pantufla » Sat May 27, 2023 4:29 pm

That's so interesting. I never knew that. I hope the doctor can convince him to take it.
DH T2 N1b M0. 3/15 positive nodes.
Stage IIIA moderately differentiated adenocarcinoma.
Tumor size 6 cm.
Left hemicolectomy 10/26/15.
FOLFOX 11/30/15 to 5/2/16, full 12 cycles.
10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm.
June 2019: NED.
2020: NED 5 years. 4 mm lung nodule on CT

behconsult
Posts: 261
Joined: Fri Jul 04, 2014 4:53 pm

Re: Colon cancer and diabetes

Postby behconsult » Sat Jun 03, 2023 3:15 pm

I am sorry that it is another challenge to deal with. I am a diabetic. The A1C level of 12 is dangerous. There isn't the concern with metformin with imaging and contrast as in the past. They used to have you dc the metformin. Now they don't. It changed about 2-3 years ago. I am sure some hospitals follow the old protocol. They do look at kidney functioning i.e, protein levels and creatinine.

Contrast in CT's and PET scans provide sugar (glucose) that the Cancer gobbles up quickly, that also allows it to be seen on scans There is a boatload of research on diabetes and cancer.

He needs to be aggressive with his blood sugar (BS) management. Being on chemo and a diabetic sometimes makes it more a challenge. If I may, he needs a connection with endocrinology. He also might see if insurance pays for the Libre system of monitoring (no more finger sticks and is accurate; except for 1st and last day before it expires (14 day usage). The unregulated management of his BS makes him feel even worse that becomes a vicious cycle, e.g, "I feel like shit so why care." Comfort eating is understandable when you have CA. All the best. Bob
Stage 4 Age 56 BrafV660E 5/14
spot on perit/ Right side tumor
Resctn 6/9/2014
Folfox strt 7/2014. 6 of 12 tx
Chemo induced DM2
Pet 4 mets to lung (1 cm, 6 mm) Xeloda/Avastin 9/16 to present.
Cryo-ablation to four spots- Collapsed lung/chest tube 2x
Possible local recurrence in a spot or two on PET. Stable CT

pantufla
Posts: 147
Joined: Thu Dec 03, 2015 12:44 pm
Facebook Username: kelleykulina

Re: Colon cancer and diabetes

Postby pantufla » Sun Jun 04, 2023 11:40 pm

Thanks for the response Bob. He won't go on metformin. The doctor wouldn't argue with him. I'm actually not sure the CC is back. He had the rectal bleed in November 2022 and wouldn't go in to the GI doc until recently. His colonoscopy is June 12. Hopefully he'll change his tune if he needs chemo again.
DH T2 N1b M0. 3/15 positive nodes.
Stage IIIA moderately differentiated adenocarcinoma.
Tumor size 6 cm.
Left hemicolectomy 10/26/15.
FOLFOX 11/30/15 to 5/2/16, full 12 cycles.
10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm.
June 2019: NED.
2020: NED 5 years. 4 mm lung nodule on CT


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