Chemo caused diabetes??

LeeandShirley

My husband has cholyangiocarcenoma,(primary liver cancer of the bile tract). After his third treatment with Gemzar/Cisplatin, his sugar levels went up dramatically. I have read of Chemotherapy induced diabetes as a possibility. Has anyone else had this happen? Is there such a thing? Is the high sugar levels an indication of pancreatic involvement? A nurse friend told me it could indicate spread to the pancreas. Any comments?

northa914

Increased Blood Sugar Levels
I've also experienced an increase in my blood sugar levels, though I'm not sure how dramatic the change is. My oncologist told me it was due to the use of Decadron, a glucocorticosteroid that I'm given before my treatments (Gemzar/Cisplatin for stage IV cholangiocarcinoma). So far it hasn't caused any problems for me. Have you discussed this with your husband's oncologist? I was told that the increase is temporary, and that my levels read high as I had a blood test two days after a treatment. I've been on this therapy since July 7th of 2010.

Hope it's something temporary for your husband also. Take Care.

LeeandShirley

northa914 said:

Increased Blood Sugar Levels
I've also experienced an increase in my blood sugar levels, though I'm not sure how dramatic the change is. My oncologist told me it was due to the use of Decadron, a glucocorticosteroid that I'm given before my treatments (Gemzar/Cisplatin for stage IV cholangiocarcinoma). So far it hasn't caused any problems for me. Have you discussed this with your husband's oncologist? I was told that the increase is temporary, and that my levels read high as I had a blood test two days after a treatment. I've been on this therapy since July 7th of 2010.

Hope it's something temporary for your husband also. Take Care.

Thanks for reply
I appreciated the reply about the high sugar levels. Others, too, have told me that steroids are the culprit. The thing that burns my A - -, is,... his oncologist was totally unconcerned about his sugar and told me he needed to be treated by our family physician, because diabetes is not his speciality. I've read soooo much about how sugar is a tumor feeder. Dr. Shah, is only concerned with his chemo and it's effect on Lee. I try to talk to him about some of my concerns and he treats me like I'm being silly and uneducated, (with all my talk about things I've read on the internet, supplements, sugar affecting tumors, etc). As a matter of fact last time we were there, I attempted to help with my husband's belly band that he wears for an inscision hernia, that he commented, "I've been doing this for 30 years", and THEN realized it would have to be removed BEFORE he could examine his abdomen. Then to re-establish his control over the situation, he said, "well, we don't really need to do that, (examine his swollen abdomen). ???? Does anyone else think we need a new doctor? Since he has stressed to us that the chemo is just palliative, he acts like he's just trying chemo, because insurance will justify payment till he decides it will no longer help. No matter what questions I ask, he comments, "well, if you want another opinion, you are welcome to do so." Why must I go from Oncologist to oncologist to find one who listens and in the meantime , my husband may be losing ground. Any comments out there? Does this sound like a problem? I have been nothing but polite to Dr. Shah, and wait till he asks if there are any questions. Most times I can see he hates saying that, because , yes, I always have questions. And he really didn't want to answer. Thanks again and thanks all for letting me vent. Thank God you guys are out there. I have learned so much about how to handle other situations. Bless you all suffering with or along with this dreadful disease.

LeeandShirley

northa914 said:

Increased Blood Sugar Levels
I've also experienced an increase in my blood sugar levels, though I'm not sure how dramatic the change is. My oncologist told me it was due to the use of Decadron, a glucocorticosteroid that I'm given before my treatments (Gemzar/Cisplatin for stage IV cholangiocarcinoma). So far it hasn't caused any problems for me. Have you discussed this with your husband's oncologist? I was told that the increase is temporary, and that my levels read high as I had a blood test two days after a treatment. I've been on this therapy since July 7th of 2010.

Hope it's something temporary for your husband also. Take Care.

NorthA914
My husband has the exact type of cancer as you do. Have you been on Cisplatin/Gemzar the whole time, (one year)? Lee has onlt had two full rounds of this combinstion and had to forego the last one because of low platelets. What kind of side effects have you experienced? Dr. Hoover , the surgeon, said 12 to 18 months from DX and Lee is 9 mo out now. He had DX in late August of 2010 and had surgery to remove tumor. Then in April it came back stage 4. Started chemo May1. What other treatments have you had? How are you doing? Hope you are faring well.

northa914

LeeandShirley said:

Thanks for reply
I appreciated the reply about the high sugar levels. Others, too, have told me that steroids are the culprit. The thing that burns my A - -, is,... his oncologist was totally unconcerned about his sugar and told me he needed to be treated by our family physician, because diabetes is not his speciality. I've read soooo much about how sugar is a tumor feeder. Dr. Shah, is only concerned with his chemo and it's effect on Lee. I try to talk to him about some of my concerns and he treats me like I'm being silly and uneducated, (with all my talk about things I've read on the internet, supplements, sugar affecting tumors, etc). As a matter of fact last time we were there, I attempted to help with my husband's belly band that he wears for an inscision hernia, that he commented, "I've been doing this for 30 years", and THEN realized it would have to be removed BEFORE he could examine his abdomen. Then to re-establish his control over the situation, he said, "well, we don't really need to do that, (examine his swollen abdomen). ???? Does anyone else think we need a new doctor? Since he has stressed to us that the chemo is just palliative, he acts like he's just trying chemo, because insurance will justify payment till he decides it will no longer help. No matter what questions I ask, he comments, "well, if you want another opinion, you are welcome to do so." Why must I go from Oncologist to oncologist to find one who listens and in the meantime , my husband may be losing ground. Any comments out there? Does this sound like a problem? I have been nothing but polite to Dr. Shah, and wait till he asks if there are any questions. Most times I can see he hates saying that, because , yes, I always have questions. And he really didn't want to answer. Thanks again and thanks all for letting me vent. Thank God you guys are out there. I have learned so much about how to handle other situations. Bless you all suffering with or along with this dreadful disease.

New Doctor
I absolutely think you need a new doctor! You and your husband need a positive and receptive medical team no matter what stage, type of care, etc. I too am under palliative care, but never once has my oncologist made me feel like he is God and has all of the answers. He's all for complementary therapies, telling me at the start of my chemo that he knows what doesn't work and what is counterproductive to traditional therapies and to ask him before I start on any supplements. Can you call your husbands insurance company and see if there is someone else they recommend and/or that you can get a second opinion from? It's so important for the two of you to be confident and at ease with those who are providing medical care. There is no such thing as a silly question when it comes to a life-threatening illness! And I'm amazed that your husband's oncologist didn't ask any questions to discern if he was pre-disposed to diabetes (ie family history, pre-existing conditions, instances of raised blood sugar levels in the past). I asked my oncologist about the link between sugar and cancer. In his opinion, since all foods are turned into sugars (glucose) before they are utilized by the body, the concern is to eat a balanced diet and excercise to the best of ones ability to keep the body running efficiently. If you can accomplish that, then your body will better be able to maintain normal levels. Certain foods do cause blood sugar spikes that you want to avoid, but until there is an elevation of blood sugar levels that can't be explained by the chemo and other drugs being administered then regular monitoring is the best bet. As I have a hard time putting and keeping weight on, I eat whatever whenever, consuming both healthy and not so healthy stuff. Consult with your family physician about this. As annoying as it is that the oncologist dismisses the importance of your concern and won't address the issue, your FP may be able to alleviate some of your concerns or recommend what can be done if he feels the glucose levels are too high or need to be controlled.

I hope this helps. I actually feel like I've vented to you because it really angers me that you're not getting the answers you need from your husband's oncologist! Hang in there and don't let him or anyone else push you around! Take care, and please keep us posted...and vent anytime!

northa914

LeeandShirley said:

NorthA914
My husband has the exact type of cancer as you do. Have you been on Cisplatin/Gemzar the whole time, (one year)? Lee has onlt had two full rounds of this combinstion and had to forego the last one because of low platelets. What kind of side effects have you experienced? Dr. Hoover , the surgeon, said 12 to 18 months from DX and Lee is 9 mo out now. He had DX in late August of 2010 and had surgery to remove tumor. Then in April it came back stage 4. Started chemo May1. What other treatments have you had? How are you doing? Hope you are faring well.

Treatments
Since July 7th through the middle of May this year, I've had Gemzar/cisplatin administered. The side affects were minimal, some fatigue (I require a bit more sleep and am not able to exert myself physically like I used to) and chemo brain, but nothing insurmountable. I now am only given Gemzar as the cisplatin was causing improper kidney function. I also have a low platelet count, but this is something I've suffered from since I was a child so I take an iron supplement. The past month I've developed peripheral neuropathy (also from the cisplatin), just a slight numbness in my fingers, hands, toes, and feet that sometimes spreads to my elbows and knees. This will hopefully improve over time. I have undergone two TACE procedures at which time I was given cisplatin, mitomycin, and adriamycin. The adriamycin caused me to lose my hair, a small price to pay as the TACEs helped shrink the liver lesions treated. I take a lot of supplements for my liver and to boost my immune system and a good multivitamin.

May I ask why Dr. Hoover gave your husband a timeframe of 12 - 18 months after DX? I truly believe that information like that can become a self-fulfilling prophecy unless one is views it as a goal to beat. We're all individuals, and from a statistical standpoint zero percent survival after X amount of years could include 4,900 survivors out of 1,000,000. Right after my DX last year, I ended up in the hospital as my pancreas freaked because I was trying to eat a lot of food and gain weight before my chemo treatments began (pancreatitis, my first and hopefully only bout with this). The emergency room doctor told my sister to take me home and call hospice because I wouldn't make it through the summer...I'm still here and feel better than I did prior to my DX. I live my life like I don't have cancer and treat my body like it does. Please hang in there, both you and your husband keep fighting the good fight! I'm so thankful to have a really strong and positive network of people around me. With the help of my family, friends, and medical team I know I'll beat this! I'll be sending good wishes and strength your way!

LeeandShirley

northa914 said:

Treatments
Since July 7th through the middle of May this year, I've had Gemzar/cisplatin administered. The side affects were minimal, some fatigue (I require a bit more sleep and am not able to exert myself physically like I used to) and chemo brain, but nothing insurmountable. I now am only given Gemzar as the cisplatin was causing improper kidney function. I also have a low platelet count, but this is something I've suffered from since I was a child so I take an iron supplement. The past month I've developed peripheral neuropathy (also from the cisplatin), just a slight numbness in my fingers, hands, toes, and feet that sometimes spreads to my elbows and knees. This will hopefully improve over time. I have undergone two TACE procedures at which time I was given cisplatin, mitomycin, and adriamycin. The adriamycin caused me to lose my hair, a small price to pay as the TACEs helped shrink the liver lesions treated. I take a lot of supplements for my liver and to boost my immune system and a good multivitamin.

May I ask why Dr. Hoover gave your husband a timeframe of 12 - 18 months after DX? I truly believe that information like that can become a self-fulfilling prophecy unless one is views it as a goal to beat. We're all individuals, and from a statistical standpoint zero percent survival after X amount of years could include 4,900 survivors out of 1,000,000. Right after my DX last year, I ended up in the hospital as my pancreas freaked because I was trying to eat a lot of food and gain weight before my chemo treatments began (pancreatitis, my first and hopefully only bout with this). The emergency room doctor told my sister to take me home and call hospice because I wouldn't make it through the summer...I'm still here and feel better than I did prior to my DX. I live my life like I don't have cancer and treat my body like it does. Please hang in there, both you and your husband keep fighting the good fight! I'm so thankful to have a really strong and positive network of people around me. With the help of my family, friends, and medical team I know I'll beat this! I'll be sending good wishes and strength your way!

northa914
Your words have been very uplifting to me, because Lee's doctors have been rather dismal about his cancer. Sometimes it's hard to believe he even has cancer. He is not in any kind of distress , at least not on the outside. Even though the blood tests sometimes say things are changing. And the CAT scan in April was a total shock, I just can't believe it's for real. I am seriously considering changing Oncologists, because he has no confidence in my husband's recovery and that leads me to believe he deserves no confidence, either. We are just waiting for this full treatment with Cisplatin/Gemzar, since most other oncologists would treat him the same. I have contacted a hospital in our state, that has a liver team, and is into targeted therapy like the embolization. But, they ONLY do targeted therapy. So, we will continue the chemo for now. I am anxiously waiting for the next CAT scan. Then we will make new plans. For now I continue to supplement my husband with whatever he needs at the time. He just had an issue with platelets and for a week I dosed him with VitaminD3, Colostrum, Zinc, Echineachea, and an immune booster called Beta Glucan. His platelets went from 66K to normal which is at least 150K in one week. So, I'm hanging in there, and with positive people like you to communicate with, we will be fine. Bless you and I will pray for your health to be restored.
Shirley