Having prostate cancer at all is a bad thing, but living with the constant fear of prostate cancer recurrence can be worse.
There is no shortage of controversy over our fascination with overdiagnosis of both prostate cancer and breast cancer in medicine today. I have covered this in a previous blog article (that can be read by clicking here) so I won’t go into it the controversy in detail here.
There is also no shortage of lifestyle factors that clearly, strongly play a role in the development of prostate cancer. Dairy intake increases the risk of prostate cancer. Exercise decreases it. Smoking increases risk. A plant-based diet decreases risk.
But there is one thing that absolutely plays a role in the development of most types of cancers, with prostate cancer being no exception.
The diabetic spectrum. Whether we are talking about full-blown diabetes or somewhere along the prediabetic pathway, this absolutely, positively increases your risk of developing prostate cancer.
One of the hallmarks of being prediabetic is abnormalities of lipids like total cholesterol, HDL and LDL cholesterol, VLDL and triglycerides. Lipids are the first thing I like to look at on a patient’s blood work to see if prediabetes is a concern.
It would then make sense that one of the best ways to lower your risk of developing prostate cancer in the first place would be to live an anti-diabetic lifestyle (again—out of the scope of this article, but you can purchase my eBook on diabetes by clicking here).
But what about prediabetes and prostate cancer recurrence?
This is not exactly what researchers called it in this particular article, but that is essentially what they were looking at. They looked at the relationship between lipids abnormalities and the risk of prostate cancer recurrence in 843 radical prostatectomy.
Here’s what they found:
- Elevated triglycerides were associated with a 3% increased risk of prostate cancer recurrence FOR EVERY 10 mg/dl increase. This can add up fast.
- Total cholesterol, LDL and HDL did not affect prostate cancer recurrence risk.
- However, if the men were prediabetic with lipid problems, each 10 mg/dl increase in cholesterol up recurrence risk 9% while the same increase in HDL lowered risk a respectable 39%.
Seems to be in line with expectations. Lipid problems that indicated prediabetes clearly increased the risk of recurrence. But it was after this point in the article abstract that I found myself smacking my forehead against the computer monitor…
The authors concluded that these findings suggest that lipid levels should be explored as a modifiable risk factor for prostate cancer recurrence. In other words, we should use statins to lower the risk of prostate cancer recurrence.
Rather than suggesting that an anti-diabetic lifestyle would be powerful for preventing prostate cancer recurrence, they just completely skirt the prediabetic / lifestyle issue and jump right to using medications to treat the surrogate end marker and hope for the best.