Breast Cancer and Diabetes
October is breast cancer awareness month in the United States. As my site deals mainly with diabetes and diabetic complications, I will be writing about breast cancer and diabetes. An ounce of prevention is worth a pound of cure, or so the saying goes. This being the case, what can be done to avoid breast cancer, and can we avoid or cure diabetes? Read on, we will be discussing some statistics on diabetes and breast cancer, and some strategies to avoid these diseases.
A quick note about these statistics, the overall statistics on diabetes refer to all cases, but most of the statistics about breast cancer are mainly referring to women with breast cancer. Breast cancer also occurs in men, but at a much lower rate, this makes studying the smaller population much more difficult. So sorry boys, but the cancer numbers are mainly referring to female populations with breast cancer, but please read on there is good information for both men and women below.
Deaths and incidence
In 2016 over 1.5 million deaths were attributed directly to diabetes, and the World Health Organization (WHO) estimated that over 420 million people suffered from diabetes worldwide.
In contrast, breast cancer is responsible for 1.7 million new cases annually. Breast cancer is responsible for about ¼ of all new cancer diagnoses in women, and is the 5th leading cause of death in women. (World Cancer Research Fund Statistics) Incidence of new breast cancer diagnosis is estimated at roughly 125 per 100,000 in the US, which will result in 40 thousand deaths in the US in 2017. (Susan G Komen foundation
Increased risk of breast cancer was noted in type 2 diabetes, but not in type 1 diabetes. (Redaniel 2012) Breast cancer was increased by 23% in US and Europe, but not in Asia. (Liao 2011) It should be noted that in studies such as those mentioned in this article the participants are usually under the care of one or more physicians. This means that the participants being studied sometimes have more access to care than those in the general population. It also means that their diabetes will be better controlled as uncontrolled diabetics will not be allowed into a study. If your diabetes is poorly controlled or uncontrolled, you will likely fare worse with cancer or with any other shock to your system.
Risk factors that can be controlled:
First looking as risk reduction strategies for breast cancer, it is recommended that before menopause women exercise regularly, and that they avoid excessive alcohol consumption, sedentary lifestyle and obesity. Obesity is a risk factor for breast cancer, and many people with diabetes (especially type 2 diabetes) are also obese. Obesity increases risk because of an increase in estrogen, especially after menopause. Not surprisingly, diabetes type 2 would also benefit from the same advice. Diabetes type 2 can often be avoided altogether if weight is controlled, diet is reasonable (balanced), and exercise regularly participated in.
Risk factors that cannot be controlled:
Above we discussed factors that can be controlled to a certain extent. Some breast cancer risk factors cannot be controlled and carry increased risk: being 55 years or older, having the BRCA 1 or BRCA 2 genetic mutation, dense breast tissue, risk is also increased for those who started menstruation at a younger age (usually before 12).
For diabetes type 2 your risk is increased if you have a family history (genetic) of diabetes, if you have increased fatty tissue, or a sedentary lifestyle. Risk is also increased as you age, and for certain races (Black, Hispanic, and Native populations in the US).
Mortality with Diabetes and Cancer:
One study looked at the effect of having diabetes concurrently with several different types of cancer. They found no evidence that supported increased mortality in breast cancer due to diabetes. (Griffiths et al) This simply means that the fact that you have diabetes and breast cancer does not put you at higher risk for death. It should also be noted, however, that 5 year mortality with breast cancer is reported up to 20% while 5 year mortality from an diabetic foot ulcer or amputation due to diabetes hovers between 40-50%. So your risk of death is much higher with ulcer or post amputation than it is with breast cancer.
Diabetes and Breast Cancer
I don’t think anyone would choose to have either diabetes or cancer, I certainly wouldn’t. However, we don’t always get to choose these things. The good news is that there are some things that you can do today to reduce your risk of both diabetes and breast cancer. You’ve heard some of this before, but we’ll say it again: eat a balanced diet, exercise, get off that couch. Have you heard that sitting is the new smoking? It means that our sedentary lifestyles (sitting on the couch, and sitting all day at work for many) are increasing risk for many diseases and overall health they way that smoking used to. Keep your weight down where it is supposed to be. Don’t know where your weight is supposed to be? Ask your PCP. Don’t forget to sign up for the newsletter at the top of the page, and share this article around.
Diabetic Survivor. For the survivors. For the survivors.
Demographic Characteristics, Survival and Prognostic Factors of Early Breast Cancer Patients with Type 2 Diabetes Mellitus: A Hospital-Based Cohort Study. Behrouzi, B, et al. Read here.
Outcomes of preexisting diabetes mellitus in breast, colorectal, and prostate cancer. Griffiths, RI et al. Read here.
Susen G Komen Breast Cancer Foundation. Statistics here.
World cancer research fund. Breast cancer statistics.