1. < Prostate Cancer

Metformin and ADT

Posted by hanscasteels @hanscasteels, 6 days ago

If metformin can sensibly reduce some of the metabolic side effects of androgen deprivation therapy, should we be quietly grateful that a diabetes drug is doing more for hormone therapy patients than some actual hormone therapy support protocols—asking, of course, purely in the spirit of clinical curiosity and not pharmaceutical existentialism?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

clandeboye1 | @clandeboye1 | 4 days ago
In reply to @callibaetis "I can't say that I knew of any patients who received metformin that weren't diabetic. I..." + (show)
@callibaetis

I can't say that I knew of any patients who received metformin that weren't diabetic. I saw it used in a number of women who had PCOS (which does have a diabetic component in some patients).

Given the findings of the STAMPEDE trial, I can see its value in prostate cancer patients. Will the addition of metformin to ADT become standard of care? Well, time will tell. We know that ADT has a variety of undesirable metabolic side effects, notably raising blood sugar and cholesterol. Metformin may be a viable addition to ADT if it can safely be used to offset the deleterious effects of ADT. For example, we know that weight is a common issue with ADT. Wouldn't it be beneficial if we could curtail adding poundage with the temporary addition of metformin? Heck, I'm skinny, and still managed to gain eleven pounds over six months of Orgovyx therapy. For someone who's never had any body fat, that was most unpleasing. Fortunately, I've been able to shed some of it.

So, I don't have the ultimate answer to whether we should or shouldn't use it, or whether a doctor will or won't prescribe it. The medical community can make that decision. The data from this study is compelling though.

Jump to this post

@callibaetis I just googled THE MAST TRIAL which addressed my Metformin question .

REPLY
1 reply
callibaetis | @callibaetis | 4 days ago

No harm in trying. It might be worth printing the article from European Urology that I've referenced above and taking it to your next meeting for discussion.

I have to give this disclaimer...I retired from pharmacy a half dozen years ago. So, I'm not completely in the loop when it comes to new drug development. I do "cherry pick" the literature for topics of interest. As a patient, I have a vested interest in prostate related stuff. Certainly, the metformin issue is most interesting.

Good luck!

REPLY
callibaetis | @callibaetis | 4 days ago
In reply to @clandeboye1 "@callibaetis I just googled THE MAST TRIAL which addressed my Metformin question ." + (show)
@clandeboye1

@callibaetis I just googled THE MAST TRIAL which addressed my Metformin question .

Jump to this post

An interesting study with worthwhile results. Thanks for mentioning it. Even though the study didn't show a reduction in the progression of low risk cancers I still think that metformin may have some utility especially in patients on ADT who also suffer from metabolic syndrome.

REPLY
clandeboye1 | @clandeboye1 | 4 days ago

@callibaetis I agree , it's application with those on ADT may be more applicable .

REPLY
surftohealth88 | @surftohealth88 | 4 days ago

Yes, BUT, why patients who use metformin in general population have lower incidence of PC than ?

Phil, metformin does not lower glucose like insulin. It has different pathway - it just helps regulating sugar metabolism. Metformin is prescribed "off label" to people without diabetes all the time - like for women who have polycystic ovary syndrome. I have a friend that uses metformin for her testosterone dominance syndrome, etc. So yes, it CAN and IS prescribed to patients WITHOUT diabetes and it does not cause low blood sugar. Same way as Wegovy is now prescribed off-label to many other issues inclooding to people who wish to loose weight.

I think that massive use of semaglutides will soon show many benefits in different unrelated medical conditions like Metformin does . There are already promising results with PCOS etc.

REPLY
heavyphil | @heavyphil | 4 days ago

I’ve tried to copy and post an article from Nature.com from 2024 validating metformin use and the lowered incidence and recurrence of PCa.
Many of you have tried to assist me in doing this but I just cannot get it to work.
Anyway, google “metformin use in prostate cancer” or go to the nature.com website and search.
It’s an Asian/european study. Best,
Phil

REPLY
1 reply
jeffMar | @jeffmarc | 3 days ago
In reply to @heavyphil "I’ve tried to copy and post an article from Nature.com from 2024 validating metformin use and..." + (show)
@heavyphil

I’ve tried to copy and post an article from Nature.com from 2024 validating metformin use and the lowered incidence and recurrence of PCa.
Many of you have tried to assist me in doing this but I just cannot get it to work.
Anyway, google “metformin use in prostate cancer” or go to the nature.com website and search.
It’s an Asian/european study. Best,
Phil

Jump to this post

This is the link! Does it work?
https://www.nature.com/articles/s41598-018-38285-w

REPLY
2 replies
surftohealth88 | @surftohealth88 | 3 days ago

Now if we could somehow persuade doctors to prescribe it off-label for PC patients it would be great ...

REPLY
1 reply
View MoreView Less
Please sign in or register to post a reply.