2,7 CME

Risiko Kanker pada Pasien Diabetes: Hal yang Perlu Diketahui

Pembicara: Dr. Priyasha Damodara

Direktur Medis, Oncoclarity, Pendiri Paxa Health, Bengaluru

Masuk untuk Memulai

Keterangan

Diabetes, khususnya Tipe 2, telah dikaitkan dengan peningkatan risiko kanker tertentu, termasuk kanker hati, pankreas, payudara, dan usus besar. Kadar gula darah tinggi, resistensi insulin, dan peradangan kronis yang terkait dengan diabetes dapat menciptakan lingkungan yang mendukung pertumbuhan sel kanker. Selain itu, obat-obatan diabetes dan faktor gaya hidup tertentu dapat memengaruhi risiko kanker. Deteksi dini dan pemeriksaan rutin sangat penting bagi pasien diabetes untuk mengelola risiko ini. Menerapkan gaya hidup sehat, termasuk diet seimbang, aktivitas fisik, dan manajemen berat badan, dapat membantu mengurangi kemungkinan kanker pada penderita diabetes. Bekerja sama dengan penyedia layanan kesehatan memastikan perawatan yang komprehensif dan pemantauan proaktif.

Ringkasan

  • Diabetes is a chronic disease where the pancreas doesn't produce enough insulin or the body can't effectively use the insulin it produces. Type 1 diabetes involves lack of insulin production due to autoimmune destruction of pancreatic beta cells, while type 2 diabetes is characterized by insulin resistance and dysfunctional insulin secretion. Type 2 diabetes is more commonly associated with cancer risk and is influenced by obesity and lifestyle factors.
  • Cancer is defined as a group of diseases where abnormal cells grow uncontrollably and invade adjoining parts of the body or spread to other organs. Hallmarks of cancer include evading growth suppressors, sustaining proliferative signaling, avoiding immune destruction, enabling replicative immortality, tumor-promoting inflammation, activating invasion and metastasis, inducing genomic instability, resisting cell death, and deregulating cellular metabolism.
  • The worldwide instance of diabetes is 830 million and the incidence of cancer is 20 million. In India, 74.9 million people have diabetes and the projected number of cancer cases is 14 lakh. Shared risk factors for both diseases include age, smoking, alcohol, obesity, food habits, lack of exercise, genetic mutations, epigenetic alterations, and chronic inflammation.
  • Diabetes is associated with an increased risk of pancreatic, liver, breast, colorectal, urinary tract, gastric, and female reproductive tract cancers. However, diabetic men have a lower risk of developing prostate cancer. Cancer and diabetes share common pathways due to genetic lesions, abnormal signaling, or metabolic disorders, causing disturbances in cellular proliferation, apoptosis, growth, and differentiation.
  • Diabetes causes hypoglycemia and insulin resistance, elevated insulin levels, increased inflammatory cytokines, and associated dyslipidemia, all contributing to cancer risk. The IGF levels increase through the Ras/MAPK and PI3K pathways, key mechanisms for malignant transformation. Chronic inflammation and microbiome alterations in diabetic patients also contribute to increased cancer risk.
  • Metformin has no increased cancer risk and may have protective benefits, while pyoglitazone has a possible risk of bladder cancer. Insulin at higher doses has a concerned risk of cancer. Diabetes and cancer medications can impact treatment-related toxicities. Diabetic patients have a higher risk of infections and severe non-hematological toxicity during chemotherapy.
  • Factors influencing cancer therapy choices in diabetic patients include potential hypoglycemia from targeted therapies, as well as the need to modify doses due to increased predisposition to renal diseases, cardiovascular diseases, and neuropathies. Hazard risk for death is higher in liver and endometrial cancer in patients with diabetes.
  • Management of diabetes in cancer patients involves pre-treatment assessments, monitoring during therapy, nutritional support, and proper oral hygiene. Cancer screening and counseling on lifestyle changes are crucial for diabetic patients. Lifestyle modifications, proper nutrition management, weight loss, and exercise are equally important in managing cancer, obesity, and diabetes.

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