Metabolic Syndromes and P Ca

• 23 Jul 2021 11:11:48 AM
• |Onco Urology

Dear All,

Recently number of studies are addressing the Role of Metabolic Syndromes in P Ca.

P Ca is a hormone dependent Cancer and as such we treat many a patient with ADT in its advanced stage. Recently there are studies indicating the usefulness of Neoadjuvant ADT prior to RP in high risk P Ca. The newer ADT’s now being considered for treatment of P Ca claiming Longer Progression free survival, is not devoid of developing Metabolic Syndromes during Tt. These drugs are also known to develop Early Resistance but this has been attributed to other factors.

Most of these studies have emanated from affluent countries, but how much these can be of importance in a country like India has not been understood yet. India is considered as the Diabetic capital of the world. Hence in most Metabolic syndromes coexist even if they develop P Ca. Do this have an effect on the outcome of Treatment for P Ca remains elusive? As early as 2013, in the NCCN Asian Consensus statement, it has been said that the side effects of prolonged ADT use are much less among Orientals. Even prolonged use of over 3 to 4 years do not manifest with side effects. But as mentioned with high incidence of diabetes in India, do we see this as a factor of importance.

Metabolic Syndrome can affect in two ways. Pts with P Ca having inherent Metabolic Syndrome, will they have lesser survival and will this aggravate with the use of ADT. The other aspect is whether Pts with P Ca on ADT develop higher CV complications leading poor survival. We in India still do not have an answer for these queries but continue to use ADT unabated.

I am providing some articles which when read together will enrich our knowledge as regards Metabolic Syndromes and P Ca.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551937/pdf/fon-12-1947.pdf  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444769/pdf/oncotarget-08-30606.pdf

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068793/pdf/cancers-13-01827.pdf

I am also providing the PDF of an article on ‘Role of Metabolic Syndrome in Prostate Cancer Development’ from the latest issue of European Urology Focus.

I am afraid that such write ups may not be of interest for many in our group. Many of us have a view that why know regarding aspects not yet well established. WE go with the premise of crossing the river when we come to the bridge’ and hence why think about these before they have been established. But science have a way of thrusting many unknown things on us with the blink of an eye and then we may have to struggle hard to keep pace with the current understandings.

With warm regards,

Venu

 

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