• Cancer survivor
• Competing risk
• Diabetes
• Physical activity

• Cancer survivor
• cancer care
• cancer survivors
• cancer survivorship
• cancer treatment
• comorbidity
• living with and beyond cancer
• multimorbidity
• quality of life
• quantitative study
• scoping review

• oncology
• cancer

• Humans
• Prediabetic State/epidemiology
• Ethiopia/epidemiology
• Cross-Sectional Studies
• Blood Glucose
• Diabetes Mellitus/epidemiology
• Neoplasms/epidemiology
• Hyperglycemia
• Hospitals

• SF-12
• growth mixture model
• health related quality of life
• prostate cancer

• cancer patients
• cancer survivors
• cohort studies
• diabetes
• meta-analysis
• systematic review

Studies have demonstrated worse health related quality of life (HRQOL) outcomes in gay and bisexual men (GBM) following prostate cancer treatment compared to heterosexual men potentially due to differences in comorbidity burden.

To establish the prevalence of comorbidities and their association with HRQOL metrics in GBM following prostate cancer treatment.

We evaluated HRQOL and prevalence of comorbidities in 193 GBM from the United States and Canada in a cross-sectional, online survey: the Masked for Review. HRQOL was measured with the Expanded Prostate Cancer Index Composite (EPIC) and the 12-Item Short Form Health Survey (SF-12).

Our outcomes included comorbidity prevalence, mean differences for HRQOL scores by comorbidity status, and mean differences for HRQOL by comorbidity count.

GBM were found to have a higher prevalence of blood vessel disease and mental health disorders but lower prevalence of obesity and type 2 diabetes when compared to published data in general prostate cancer populations. Statistically significant reductions in HRQOL metrics were associated with mental health diagnoses, diabetes, and obesity. Increased number of comorbidities was also associated with reductions in HRQOL metrics in nearly all categories.

These results suggest that the worse QOL outcomes in GBM following prostate cancer treatment may be due to differences in comorbidity burden. This study is the first to evaluate the relationship between comorbidities and HRQOL outcomes in GBM. Limitations of this study include a small sample size and cross-sectional study design. If confirmed in larger, longitudinal, clinically confirmed studies, these findings indicate a need to intervene on and consider comorbidities in GBM diagnosed with prostate cancer.

Haggart R, Polter E, Ross M, et al. Comorbidity Prevalence and Impact on Quality of Life in Gay and Bisexual Men Following Prostate Cancer Treatment. Sex Med 2021;9:100439.

• Bisexual Men
• EPIC
• Gay Men
• Health Related Quality of Life
• Homosexual Men
• Prostate Cancer
• SF12

• Longitudinal studies
• Prostate cancer
• Prostatic neoplasms
• Quality of life
• Spouses

• C-peptide
• diabetes
• insulin-like growth factor
• metabolic syndrome

• Disparities
• Hospitalization
• Mortality
• Outcomes
• Prostate cancer
• Race/ethnicity
• Surgery

• Body composition
• C-peptide
• IGF-1
• Insulin

• Colorectal cancer
• Diabetes
• Health-related quality of life
• Lifestyle

This systematic review aims to summarize the current literature regarding potential effects of having both cancer and diabetes on patient-reported outcomes (PROs) and to provide directions for future research.

MEDLINE, The Cochrane Library, CINAHL, and PsycINFO were searched from inception to January 2015. All English peer-reviewed studies that included patients with both cancer and diabetes and assessed PROs were included. All included studies were independently assessed on methodological quality by two investigators.

Of the 3553 identified studies, 10 studies were included and all were considered of high (40 %) or adequate (60 %) methodological quality. Eight of the 10 studies focused on health-related quality of life (HRQoL), functioning, or symptoms and 2 studies assessed diabetes self-management. Overall, HRQoL and functioning was lower, and symptoms were higher among patients with both cancer and diabetes as compared to having cancer or diabetes alone. Furthermore, one study reported that diabetes self-management was impaired after chemotherapy.

Having both cancer and diabetes resulted in worse PROs compared to having either one of the diseases, however, the considerable heterogeneity of the included studies hampered strong conclusions. Future studies are needed as this research area is largely neglected. As the majority of the included studies focused on HRQoL, future research should address the impact of both diseases on other PROs such as depression, patient empowerment and self-management.

Having both cancer and diabetes might result in worse PROs, however, more research is needed as current evidence is scarce.

The online version of this article (doi:10.1007/s11764-015-0486-3) contains supplementary material, which is available to authorized users.

• Cancer
• Diabetes
• Health-related quality of life
• Patient-reported outcomes
• Systematic review

Prostate cancer (PCa) is the most common noncutaneous malignancy and second leading cause of cancer-specific mortality for men in the United States. There is a wide spectrum of aggressiveness ranging from biologically significant to indolent disease, which has led to an interest in the identification of risk factors for its development and progression. Emerging evidence has suggested an association between metabolic syndrome (MetS) and PCa. MetS represents a cluster of metabolic derangements that confer an increased risk of cardiovascular disease and type 2 diabetes mellitus. Its individual components include obesity, dyslipidemias, high blood pressure, and high fasting glucose levels. MetS has become pervasive and is currently associated with a high socioeconomic cost in both industrialized and developing countries throughout the world. The relationship between MetS and PCa is complex and yet to be fully defined. A better understanding of this relationship will facilitate the development of novel therapeutic targets for the prevention of PCa and improvement of outcomes among diagnosed men in the future. In this review, we evaluate the current evidence on the role of MetS in the development and progression of PCa. We also discuss the clinical implications on the management of PCa and consider the future direction of this subject.

• Diabetes mellitus
• Dyslipidemias
• Humans
• Hyperglycemia
• Hypertension
• Insulin resistance
• Male
• Metabolic syndrome X
• Obesity
• Prostatic neoplasms

We developed an algorithm for the identification of patients with type 2 diabetes and ascertainment of the date of diabetes onset for examination of the temporal relationship between diabetes and cancer using data in the electronic medical record (EMR).

The Marshfield Clinic EMR was searched for patients who developed type 2 diabetes between January 1, 1995 and December 31, 2009 using a combination of diagnostic codes and laboratory data. Subjects without diabetes were also identified and matched to subjects with diabetes by age, gender, smoking history, residence, and date of diabetes onset/reference date.

The final cohort consisted of 11,236 subjects with and 54,365 subjects without diabetes. Stringent requirements for laboratory values resulted in a decrease in the number of potential subjects by nearly 70%. Mean observation time in the EMR was similar for both groups with 13—14 years before and 5–7 years after the reference date. The two cohorts were largely similar except that BMI and frequency of healthcare encounters were greater in subjects with diabetes.

The cohort described here will be useful for the examination of the temporal relationship between diabetes and cancer and is unique in that it allows for determination of the date of diabetes onset with reasonable accuracy.

• Cancer
• Cross-sectional survey
• Diabetes, Patient characteristics
• Metformin

• Adolescent
• Adult
• Aged
• Breast Neoplasms/complications
• Cohort Studies
• Comorbidity
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/diagnosis
• Female
• Humans
• Life Style
• Male
• Metformin/therapeutic use
• Middle Aged
• Prostatic Neoplasms/complications
• Quality of Life
• Sex Factors
• Survivors
• Young Adult

• cancer
• guidelines
• multidisciplinary communication
• prostate
• prostatic neoplasm
• therapy

• diabetes
• cancer
• review
• meta-analysis

• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/drug therapy
• Humans
• Hyperinsulinism/blood
• Hyperinsulinism/complications
• Hyperinsulinism/drug therapy
• Hypoglycemic Agents/therapeutic use
• Insulin/blood
• Insulin/therapeutic use
• Metformin/therapeutic use
• Neoplasms/complications
• Neoplasms/prevention & control
• Risk Assessment
• Risk Factors

• UL1 RR025011 NCRR NIH HHS
• UL1 TR000427 NCATS NIH HHS

Objective.To examine gastrointestinal (GI) and genitourinary (GU) toxicity profiles of patients treated in 1999 with external beam radiotherapy (RT), prostate interstitial brachytherapy (PI) or radical prostatectomy (RP). Methods. TThe records of 525 patients treated in 1999 were reviewed to evaluate toxicity. Late GI and GU morbidities were graded according to the RTOG late morbidity criteria. Other factors examined were patient age, BMI, smoking history, and medical co-morbidities. Due to the low event rate for late GU and GI toxicities, a competing risk regression (CRR) analysis was done with death as the competing event. Results. Median follow-up time was 8.5 years. On CRR univariate analysis, only the presence of DM was significantly associated with GU toxicity grade >2 (P = 0.43, HR 2.35, 95% Cl = 1.03–5.39). On univariate analysis, RT and DM were significantly associated with late GI toxicity. On multivariable analysis, both variables remained significant (RT: P = 0.038, HR = 4.71, CI = 1.09–20.3; DM: P = 0.008, HR = 3.81, 95% Cl = 1.42–10.2). Conclusions. Late effects occur with all treatment modalities. The presence of DM at the time of treatment was significantly associated with worse late GI and GU toxicity. RT was significantly associated with worse late GI toxicity compared to PI and RP.