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Type 1 and cancer treatment?

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frenchkittie

Well-Known Member
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96
Location
South West France
Just wondering if anyone has any experience of cancer, radiotherapy and/or chemotherapy in combination with type 1 diabetes?

I have recently been diagnosed with cancer, and (amongst the hundreds of other questions that I have) am wondering if a pump might be the best way to control my diabetes during treatment?
 
Hi FK.
I am really sorry to hear about your diagnosis. I understand totally how you must be feeling. I too am another who drew the 'short straw' and was diagnosed with Cancer in October 2009. This was documented here in this thread:

viewtopic.php?f=26&t=13373&start=0&hilit=cancer

Now I am not a Type 1, but a Type 2 who injects Byetta. Who almost had to go onto Insulin during the treatment. However, it makes little difference really what type you are, Cancer knows no difference.

Now it may be that a pump may make it easier to control your levels. It may also make no difference at all. MDI may be difficult but not insurmountable. You need to discuss it with your HCP's.

The one thing that my Endocrinologist said to me before I embarked on the treatment regime was this, "Ken......sometimes Diabetes has to take a back seat. You have to run with whatever gets thrown at you. Cancer is your number one priority, that, is what you have to concentrate on. Once you have got through this, that is the time to worry about your Diabetes......" My HbA1c levels soared up to 7% but that was a lot less than I thought it would be, now they are steadily dropping with each subsequent test. 6.6% at last test, another due in Feb which I believe will be better.

He was so right, I was stressed out enough as it was without having the additional stress worrying too much about some raised levels (24+ at times) or hypo's (2's). Getting to grips with a pump at this point of time is probably not a good idea, maybe after you have beaten this thing ?

So, my advice to you is do everything that you need to to beat the Cancer, do the best you can to control your Diabetes, but remember that you may need to do things slightly differently because of the Cancer......that is what your priority needs to be......everything has to be taken into consideration at this point in time.

I beat the Cancer, I am in remission. I managed the Diabetes in the best way I could.....that is now back to the control that I had prior to the Cancer. It took some months, but it was a challenge.....a challenge I was determined to win, and did. Life is so much better now.

Good luck to you with your own challenge........my thoughts are with you and you will find much support and help here. Keep us updated with your progress.......when you have the time. During treatment sometimes you will find that you don't have a great deal of time......tiredness, nausea, pains etc dictate what you can and will do. Some days you will be full of energy......other days, will be a blur......whatever happens, deal with it and never ever give in to this insidious thing....Cancer.

Best wishes to you.
Ken.

Edit:
We are moving this to the Diabetes Discussion area for now as we think it deserves a wider audience than it will get in the Type 1 area alone. There is a 'shadow topic' in the Type 1 area, so in effect it is in 2 places at once.
 
Sorry to why you'll asking the question...

I think that when considering insulin pumping under these types of circumstances, it's not so much about the pumps ability to control blood glucose (on that score it would be an advantage) but you need to be thinking about the impact of the particular treatment on the patient and whether the patient is going to be able to cope with running the pump..

Pumps have an high learning curve at the start, and a lot of blood glucose testing even when you got up and running... When the treatment and the side effects involved is the patient going to be able to handle the regiem, both mentally and physically..

Mentally can the patient cope with all whats needed to make adjustments required to use the pump, when they are feeling very poorly from treatment?

Physically, cancer treatment as a major impact on the body and it's immune system, pumping means having a forgien body (the canualar) under the skin 24/7, even in a healthy diabetic this does have a risk factor of infection that comes with it.. What are the risk factor for the patient under going cancer treatment, and if an infection happens what impact could it have above the norm of the healthy diabetic?

The extra blood glucose testing that comes with pumping, is the patient body physically able to take this, chemo tends to make the skin very thin and delicate, harder to heal more open to infection what are the effects of extra BG taking with this aspect?

It's this side of pumping that will probably determin whether pumping is the way forward during cancer treatment than the pumps actual ability to control the BG..

Sorry that I couldn't be more helpful, but I do hope that your treatments go very well indeed take care..
 
Just a couple of things to add to Jo and Ken's advice. The first is that you would have to take a pump off for radiotherapy, not a problem in the short term, but it would mean being without any insulin for that time. However, bearing in mind the points made by the others which are valid, I still think that it is worth discussing with your doctor. I assume that like me that if you went on the pump, the pump start would involve far more help than they seem to get in the UK. I had several visits from the prestataire before, had to stay in hospital for the pump start and there was quite a lot of follow up help available. We were given direct telephone numbers for both hospital doctors so we could always contact them if necessary. It is also possible that you might be able to have a CGM which could help you spot unexpected changes in your levels.
Whatever you decide, I'll be thinking about you, Best wishes
H
 
Thanks for your comments and good wishes.

There is certainly a lot of food for thought to be chewed over.

I've only been diabetic for just over a year, and I was doing so well. My last Hba1c was 5.9, so I am well controlled, and used to testing 6 or 7 times a day. I calculate my insulin doses based on what I will be eating, and know my correction factors, so would not be coming to a pump totally ignorant of that side of things.

But... as I understand it, my radiotherapy sessions will be every day for 5 to 6 weeks, so having to remove and reattach the cannula/pump every day (with the inherent risk of infection due to suppressed immune system) doesn't sound like such a great idea for that period.

Phoenix has hit on one of the things I will be asking for, a continuous glucose monitor. Even if this is only available as a short term loan, I feel it would be most helpful for surgery and the immediate recovery period.

To be honest, diabetes really hasn't changed my life a great deal, it's just a bit of a pain. Cancer is a bit more scary, but I feel really well and am keen to take the most aggressive stance possible to kick its bum to kingdom come. I just hope that my diabetes isn't seen as a reason to temper the treatment to a less aggressive one.

Obviously I will be discussing all of this with my diabetes consultant, and also my oncologist (sadly they are not at the same hospital) it is just that there seems to be so very little info out there on the combination of insulin dependant diabetes and cancer that I thought I'd try to see if anyone had experience of it themselves.
 
frenchkittie said:
I just hope that my diabetes isn't seen as a reason to temper the treatment to a less aggressive one.
Click to expand...

You can bet your life the only thing that will be adjusted is your diet and doses etc......the Oncologist was very keen that nothing should get in the way of the anti-Cancer treatments. His view was do what you need to control it, as best you can, but........do not interfere with the planned treatment ! The Endocrinologist agreed with that 100% !

Depending on the drugs and treatment, there could be massive effects on Bg levels and how you feel each day. Take each day as it comes. There will probably be days you will wonder how you managed to get up, let alone worry about Bg levels....... :(
 
Small point, it's only the pump you'd have to take off as it can damage the workings. I would think that the cannula should be OK to remain in place.
 
Just hope all goes well for you frenchkittie!

Best wishes

Nigel
 
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