Diabetes and high blood pressure can both be difficult to manage alone or together. Throw colorectal cancer into the mix and the picture gets more complicated.
Colorectal cancer patients and survivors would do well to treat their high blood pressure and get control of their diabetes. That’s because a bundle of all three of these conditions ups the odds of the cancer returning for one last victory lap.
Having high cholesterol, contrary to what one would think, seems to protect against colon cancer returning.
This large study looked back at the information of more than 36,000 patients with colon cancer. An oncologist and researcher at Temple University School of Medicine and Fox Chase Cancer Center - Nestor Esnaola, MD, MPH, MBA – led the research.
"Our results suggest that patients with early stage colon cancer who also have diabetes or hypertension may need to be followed more closely for recurrence and could potentially benefit from broader use of adjuvant chemotherapy." Dr. Esnaola said in a statement.
Both of these are components of metabolic syndrome, which one out of every five Americans has. Metabolic syndrome conditions include obesity, diabetes, high blood pressure and high cholesterol.
Dr. Esnaola and his team looked at the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program. They compiled information from Medicare records gathered from 1998-2006 relating to 36,079 colon cancer patients.
Previous studies have found no links between metabolic syndrome and colon cancer, according to Dr. Esnaola. “"When we teased out and analyzed the effect of each of its components, however, the data told a different story,” said Dr. Esnaola, who is chief of the Division of Surgical Oncology, and vice-chair of Clinical and Academic Affairs in the Department of Surgery at Temple University School of Medicine.
Cancer patients who had either hypertension (high blood pressure) or diabetes had an 8 percent greater likelihood of seeing their cancer return in five years compared to survivors who did not have either condition.
The scientists also noted a difference in lifespan. Five years after diagnosis, 47.7 percent of survivors who didn’t have hypertension or diabetes were alive vs. 41.3 percent of diabetics.
Interestingly, high amounts of lipids (blood fats) seemed to have a protective effect. Five years after diagnosis, 39 percent of folks with normal lipids were alive, compared to 52.7 percent of survivors with high lipids.
Dr. Esnaola believes this phenomenon can be explained by the fact that statins – cholesterol-lowering drugs – also seem lower the risks of colon cancer.
"The adverse effects of diabetes and hypertension in early stage patients and apparent protective effect of high blood lipids observed in our cohort suggest that when it comes to metabolic syndrome and cancer outcomes, the devil is in the details," Dr. Esnaola said.
These findings were published online December 20 in the journal CANCER. This research was supported in part by the Nanjing Drum Tower Hospital Health, Education, and Research Foundation.