This upcoming Sunday is National Cancer Survivors Day, a worldwide observance the first Sunday in June, dedicated to “showing the world that life after a cancer diagnosis can be meaningful and productive.”
We almost hate to mention it, but there is some question about a possible link between cancer and diabetes — and there are many people out there dealing with both. There’s no real proof that one causes the other, yet there are a lot of studies linking the two. Results suggest that anywhere from 8 to 18% of people with cancer also have diabetes. One recent study published in Diabetes Care showed that 16 out of every 100 men with diabetes and 17 out of every 100 women with diabetes said they had cancer, compared to just 7 out of 100 men and 10 out of 100 women without diabetes. So maybe there is some connection…?
We’re not pointing this out to scare anybody, but rather to pay homage to the folks who are dealing with both illnesses. Despite the stats cited, there’s hardly any available literature on treating this combination. One of the few things we found was a 2006 Diabetes Spectrum article by Helen Psarakis, a diabetes nurse practitioner at Yale New Haven Hospital. She states that cancer patients who are on glucocorticoids — a steroid used in short term, high-dose chemo treatments — often suffer with high blood sugar. In fact, patients at risk for diabetes who begin taking glucocorticoids during cancer treatment are often quickly diagnosed with diabetes too. Insulin is recommended to treat steroid-induced blood sugar, as patients “may require two to three times their usual dose(s) of insulin.” Woah.
Helen points out a few key things: For diabetics with cancer, insulin is nearly always more useful than oral meds, because dosing can be based on what a patient is able to eat. Chemo almost always causes nausea and vomiting, which can result in low blood sugar if a patient can’t keep food down. So she suggests giving meal-time doses after eating, matched to the precise amount of carbohydrate the patient took in.
But the truth is that most articles about diabetes and cancer focus on the mutual causes of the two, not necessarily on how to live with both at the same time. So we’re honored today to introduce Barbara Campbell, a 48-year-old woman with LADA, recently also diagnosed with breast cancer, who was willing to share her story with us here at the ‘Mine:
A Guest Post by Barbara Campbell
By the time I arrived at work, I’d already received three voicemails from the imaging center. The previous day, I had presented myself for the annual mammogram. Admittedly, I was six months late, but I hadn’t noticed any changes and thought this would be like every other mammogram. I was wrong.
Each message was the same, “We need you to return to the imaging center as soon as possible this morning. The radiologist is requesting additional views and possibly an ultrasound. There is something suspicious in your mammogram.” I took a deep breath, tried to calm myself and left the office for the afternoon. By the end of the day, I had six additional mammogram films and an ultrasound of my left breast and lymph nodes. The radiologist came in to tell me that I needed to see a surgeon immediately.
I was referred to a surgeon who worked me in to his schedule right away. He examined me, reviewed the reports and the films, and drew a deep breath. “I need you to wrap your head around the fact that you have breast cancer,” he said. It is kind of a punch in the gut when you hear that you have cancer.
More tests were ordered: a biopsy, breast MRI, and BRAC genetic testing. My mother and I were diagnosed the exact same week! The week before, she felt a lump in her breast, while I did not, and she and I just happened to have our mammograms on the same day. That’s why we had the BRAC test, to find out if it was a genetic cancer. However, her cancer is completely different. Hers is responsive to hormone medication, and it’s shrinking just from that so she doesn’t need chemotherapy.
A weight has been lifted knowing she just has to take a pill every day, rather than having to run to her treatment hours and taking care of her, and then having my own treatment.
I didn’t have a big melt-down until about three weeks into it, when I was waiting for the BRAC results. I was afraid that it was genetic, because if it were then I may have passed this on to my own daughters. But thankfully, it isn’t.
Once all the results were gathered, we again met with the surgeon and our worst fears were realized. The surgeon went into great detail, showing me diagrams, photos and charts. I have Invasive Ductile Carcinoma, Stage 2b, Grade 3. It is aggressive and it is spreading.
Oh yeah… and I also have Type 1 (LADA) Diabetes.
We spoke several times with the surgeon about treatment plans and had to make adjustments due to diabetes management. Generally, he would suggest a left mastectomy and remove the lymph nodes, followed by chemotherapy and radiation. This regimen, however, posed issues for me, because people with diabetes sometimes heal slower from surgery. This would then push my chemotherapy program out further than is generally recommended. So we decided to start with chemotherapy, and follow-up with surgery and radiation. I’ve only had a few times when I feel lousy and feel sorry for myself, but I’m mostly high-spirited and in “work mode”, ready to battle it and find out what we need to do “
I am now undergoing chemotherapy and was initially worried about how this treatment would affect my diabetes self-management. My oncologist has made every effort to plan my chemotherapy program without steroids, which is what usually causes blood glucose levels to soar. The regimen we are using is usually administered every three weeks. However, due to the aggressive nature of this cancer, the doctor has ordered my treatment every other week. This has been quite difficult as I am denied the extra week to recover from each treatment.
However, the only issue I’ve had with regard to diabetes is that I have more low blood glucose readings. Chemo hasn’t directly affected my blood sugar numbers, but the nausea and upset stomach from the chemo makes it difficult to eat enough to keep my glucose levels within normal range. On treatment day and for the following few days, I drink Gatorade or Vitamin Water to keep my numbers up and treat lows. I’ve not had to use glucagon… Knock on wood. We’re currently reviewing my basal rates with my endocrinologist to manage these low blood sugar episodes.
I’m happy to report, that after three treatments, the tumor is shrinking. I will have another five treatments, surgery and then radiation. My husband has been a great support and has really stepped in to help manage my diabetes. The day of chemo is the worst for me. The nausea is so awful and the oral meds that I take that day keep me sleeping most of the day. My husband wakes me every two hours, gives me the next dose, makes sure I eat something and checks my blood sugar.
One of the meds I’m taking, Ativan, really knocks me out and keeps me from recognizing a low blood sugar during the night. My husband gets up every two hours to test my blood sugar to make sure I’m not crashing. I have just been approved for a Dexcom CGM, but I’m still working through the paperwork for that. I could never manage all this without my husband and I’m eternally grateful to him!
I know I can get through this. I know I’ll have big cryfest when we get that all-clear signal. I know this year will continue to be a challenge, but when we reach the end of this journey, there will be quite a celebration!
Talk about a “You Can Do This!” attitude, wow. We wish you nothing but the best, Barb. You all can show your support for Barb by visiting her blog or by following her on Twitter at @babssoup.
Thanks for this post! Nice to find some camaraderie in another person living with both diabetes and cancer.
I have been living with T1 for over thirty years, and a little over ten years ago, was diagnosed with chronic myelogenous leukemia (CML). At the time, the standard treatment was a bone marrow transplant, but I was lucky enough to get into a clinical trial for a drug that was soon cleared by the FDA and has been touted as a “miracle drug” ever since. Ironic that a lot of people offhandedly and confidently say, “It turns CML into a chronic disease, just like diabetes,” as if that is a good or easy thing.
I’ve wondered and done literature searches and asked my various docs about any relation or causality between T1 diabetes and CML, but have found no correlations, even though I *feel* that there is a connection – T1 being an autoimmune disease, and CML being a blood cancer of the white blood cells, which are the workhorses of the immune system. As if my body in fact doesn’t really like itself, and has found at least a couple of very strong ways to turn against itself, trying to shut me off and shut me down. Talk about “self-conflicted!”
The two diseases have interracted in my body in various ways, even though the default tendency of the medical community is to treat the two in isolation. Living with diabetes for so many years before the CML came along helped me develop good skills in being my own best health advocate, and I’ve certainly needed those skills in getting the help I need to develop good treatment plans for my WHOLE health, not just the diabetes or the CML.
Long post just to say that yes, treating diabetes PLUS cancer is often tricky bc the medical establishment is not set up to treat the whole person’s health. But, as in Barbara’s case, good people can be found to help.
Good luck, Barbara! Thanks for sharing your story, Sister!
And thanks D’mine for once again for going into the more remote corners of living with diabetes, into which others fear to tread!
What an inspiration you are! Thank you so much for your bravery and wonderful attitude!
Thanks for sharing your story, Babs!
This is such an amazing post. Living with diabetes alone is tough, and I couldn’t imagine trying to deal with cancer as well. It seems like you have a great support system in your life as well as here in the DOC. Thank you for sharing your story and inspiring us all.
Barbara, thank you for sharing your story. Your husband checking you every two hours? A Godsend-bless his heart. You are full of courage and inspiring to all of us. Thank you : )
I continue to be amazed at the strength and resiliency my wife shows on a daily basis. I am proud to be her T3! It is very difficult for us in the caregiver role to see our loved ones suffer and I would encourage those of you who stand side-by-side to keep going, keep steady, give them something and someone to rely on. And those of you who are the recipients; let us help you. Barb and I are a great team because we talk to each other, we tell each other what we need. The other unsolicited advice I would give to T3′s is learn all you can yourself about these maladies, and attend as many of the appointments you can. Having two sets of ears to listen and then ask follow up questions or challenge the answers when they do not make sense is in both of your best interests! And lastly, do not isolate yourselves. There are always people who want to help. It is a natural reaction for us who have introversion tendencies to “hunker down” when faced with struggles, but reach out to someone. And if you have no one, then contact Barb or I. We care. Thanks.
PS Kristin I concur with your conclusion about linkage between the diseases. We had one practitioner actually scoff at us when we suggested that maybe, just maybe there might be a link between autoimmune disorders. We left his office and will not go back. I will not allow someone to practice with a closed mind on me and mine!
HI, Babs. Thanks for sharing your story. You (and that nice yet assertive husband of yours) rock. Sending many thoughts and prayers your way!
Thanks you for an inspirational post Barbara
My mom was diagnosed with Invasive Ductile Carcinoma stage 3 (Her2 positive) a few years ago. While undergoing chemotherapy the steroids lead to her acquiring diabetes.
Your strength, resilience and faith are infectious.
Thank again for sharing, stay blessed.
I have Type II and am a kidney cancer survivor! Double whammy to begin with, then I have to worry about diabetes damaging my remaining kidney. It’s tough but, I am dealing as best I can.
Bravo, and Best of Luck,
P…
Thank you. I am really touched by your story.
We are here for you, cheering for you.
Thank you to all of you! Your kind words and encouragement are appreciated. I am honored to be able to participate in this project and would like to thank Diabetesmine.com for posting my story.
When I was first diagnosed, I had a difficult time finding others who had managed both diabetes and cancer treatments. Having this venue to share my story and hear from others is priceless.
We were never meant to face adversity alone. . we are community creatures. I appreciate everyone who has stepped up beside me, grabbed on to my arms and said, Let’s do this together. From the man who offered to spray my lawn, those offering to provide meals, and those who cheer me on and let me know I’m not alone, I’m loved. . Thank you.
Hi Babs
It was a blessing for me to have the opportunity to read your story, a big thank you. I have been a type 1 diabetic for 4 yrs and just been diagnosed with breast cancer- stage 2, infiltrating ductal, Her2-. I have had 2 surgeries (the 2nd due to margins) with lymph node removal (1 cancerous out of 19).
Now I awaiting results from my 2nd surgery and scheduling Oncology appointment (Chemo & Radiation). Your story has given me some helpful tips for what is coming up. Bless you.
Like yourself I have a husband who is amazing through it all. I am gonna show him your pic of you with Jon (with the same stylist) as my husband plans to do the same for support. Lastly all the best for the future. Lotsa love Joy.
Hi Joy!
Thanks for your comments! I’d love to chat with you on twitter or email. A lot has happened since we posted this story and I’ve learned a lot since last June. If you’re interested, send me a tweet at @babssoup. You can also find more of my story at babscampbell.wordpress.com.
Good luck to you!!! Remember, you’re an Amazon Warrior! Fight like a Girl!!