Type 2 Diabetes & Breast Cancer

After Speaking to my BC nurse the other day there was something she said that did not sit right with my long term diagnosis’. If someone says something that doesn’t add up. I will investigate especially when I feel they are talking for talking sake. My treatment is being based on breast cancer not diabetes and breast cancer. Within the NHS I have noted that my type two diabetes is not brought into conversation. It is seen as a hindrance, not a trigger of the breast cancer.

On more than one occasion when speaking about my diabetes I was told I am sorry I am an oncologist not a diabetic consultant. You must speak with your diabetes consultant, but I do not see your diabetes to be a issue on treatment.

My BC nurse told me about a condition called Diabetic mastopathy. My BC nurse explained how tumours can develop in the breast tissue that are benign. It seems my last meeting and me mentioning how I was high risk where breast cancer was concerned, into her doing her own investigations on my condition. I had heard of various conditions with diabetes, but this flumped me into a false sense of what is she talking about. Her attempts at trying to reassure me were valid, but I felt she actually really knew nothing, or at least did not have the right info in front of her. I typed up benign breast tumours and diabetes in the task bar, and up came the condition and a small paragraph explaining.

Diabetic mastopathy (lymphocytic mastitis, sclerosing lymphocytic lobulitis/ductitis)

Diabetic mastopathy (also called lymphocytic mastitis and sclerosing lymphocytic lobulitis/ductitis) are small, hard masses that appear in the breast. This rare condition most often occurs in premenopausal women with insulin-dependent (type 1) diabetes. It may appear as a breast lump or an abnormal finding on a mammogram. A biopsy may be needed to confirm the diagnosis. Diabetic mastopathy does not need treatment.
Although still under study, diabetic mastopathy may be due to an autoimmune reaction. It does not appear to increase the risk of breast cancer.

Now anyone else who had not read my medical records would look at this piece of information and say, well yes that is it, but I am not a Type 1 diabetic and I am not insulin dependent. The differences between the two diagnosis is considerable with treatment. This is why I truly believe there should be a consultant that knows about these two conditions together rather than two departments that never speak. To me whilst the two departments are not communicating as in my blood results etc then there is a loop hole for error. Diabetes type 2 increases the risks of breast cancer and no-one actually knows why. Thankfully I have sense to sit up and say something and not shy away from a good debate.

My nurse had reminded me about the patient cancer advocate group committee she wanted me to attend. The invitation was due to the self help group that I am still juggling with, and a committee member inviting me along. Personally I will gather the facts together and put it in front of this committee asking why this is not happening considering type 2 diabetes is on the increase within the western world. And more should be done in treatment instead of treating diabetes as a headache. The probability of me developing a reoccurrence is increased because the two condition can thrive off each other. This in turn leaves a big question mark to how they treat me. My BC nurse also informed me I am on a ten year observation list instead of five. To me that makes me think they are aware that my issues have just begun rather than solved. I have not met anyone who is being observed for ten years with breast cancer not unless they are high risk. Being a part of this committee puts me in a place where I can debate with those that are treating me. And develop a better understanding of the treatments involved with diabetes and breast cancer at this current time.      

Type 2 Diabetes Worsens Breast Cancer Prognosis

By Aaron Tabor, MD                                                                                    

Type 2 diabetes and breast cancer are two health conditions that share some of the same risk factors and pathways including obesity, changes in insulin-like growth factors, steroid hormone changes, and changes in inflammatory chemicals produced by fat cells. In fact some research studies suggest that type 2 diabetes is linked to a 20-30% increased risk for developing breast cancer.

The impact of type 2 diabetes on breast cancer outcomes is of particular interest because it has been reported that about 15-20% of breast cancer patients have type 2 diabetes, while more likely go undiagnosed. A new breast cancer research study used data collected from 3,003 women with a history of early stage breast cancer who took part in a larger breast cancer study. For this new study, glycated hemoglobin (HbA1c) levels were used to determine diabetes status with levels between 6.5-6.9% indicating high risk for diabetes and levels of 7.0% and above indicating type 2 diabetes. Analysis of the relationships between type 2 diabetes and breast cancer outcomes in this population of women with a history of breast cancer showed that:

Hb1Ac levels higher than 6.5% (high risk for type 2 diabetes) were associated with obesity and more advanced breast cancer upon diagnosis.

Women with type 2 diabetes were about 2.4 times more likely to die from any cause.

Breast cancer-free survival was reduced with increasing levels of Hb1Ac

These study results show the negative impact that type 2 diabetes can have on breast cancer. Breast cancer patients who also had type 2 diabetes or were at high risk for developing type 2 diabetes generally had more advanced breast cancer and were at slightly greater risk for breast cancer recurrence. The interaction between type 2 diabetes and breast cancer risk appears to be very complex. Interestingly, it has been reported that breast cancer treatment drugs can effect glucose metabolism, while some type 2 diabetes drugs like metformin have been reported to decrease breast cancer risk. More well-designed human studies will need to be done to clarify this potentially important interaction between type 2 diabetes and breast cancer.

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Concentrating On The Here & Now

This next month is going to be an excellent month with only positives. I have cupcakes to bake and sell to raise money for  Race 4 Life. The cupcake sleeve designed by me have been agreed and is based on the ‘Hungry Caterpillar’ children’s story book.

This will be taking place on the 9^th and 10^th of May at my youngest daughters primary school. The children in her class will be helping to design/make their own sleeves with pieces already cut out and put together. All the children have to do is stick them on where they want to put the pieces. 

Other people are helping me with getting sponsors on Sophia’s sponsor web page. I have designed a small poster to pass round with the link printed on it. I just need to tread the streets and get people to sign our sponsor sheets also.

http://www.raceforlifesponsorme.org/sarahmendoza0770

In between that I have around twenty costumes for three different productions to design and sew. The first production is being performed at her Majesty’s Theatre very soon.

 I have had to design wing like attachments for nine black leotard bases. These have to be detachable so the leotard can be used again. I have already started on the design and they are looking good. The second production I have to design and sew several fishnet type crop tops with only one sleeve. The over locker will come in handy for that particular job because of the neat seams required. The third production is five simple black cloaks. All these I will photograph and add to my portfolio. Something I did not keep track of before which is my bad.

I have also been told I have a part in a movie only small, but this gives me a chance to see what ticks on a film set. After doing the extra roll on the music video it has given me new found confidence to pursue rather than sit back. The director of the movie asked me to do a couple of auditions and he was pleased with both. I can honestly say my three years at my previous theatre position has not gone to waste. It proves I was learning new skills without even realising it. Never say a old dog cannot learn new tricks I say. The director will be moulding a speaking part for me and if I perform well in the film who knows what other projects I can be involved with. It still could end up on the editor’s floor, but at least I can use the experience as a positive.
The script is interesting and I can see how it is written and how they put it together with an end result. My curiosity to this side of the process of film making is very strong because I have tried to write several scripts for stage. To me it is all a learning curve with valuable skills and networking to be used to the max.

The medication Metformin I have been taking for two weeks with no side effects. This is excellent news because I can be awkward with medication. I have made my next appointment with my diabetic nurse to see where we go from here.
So that leaves me with my plastic surgeon appointment on the 16^th May with my fingers firmly crossed that all goes well.  Even though they would sooner I had a silicone nipple. I am determined to get the surgery to complete my reconstructed breast. Hopefully I will continue to move forward without further occurrences of BC, but who knows. All I can do is concentrate on the here and now.

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