The Influence of Antidiabetic Medications on the Development and Progression of Prostate Cancer

Introduction

Diabetic individuals have increased risks for some types of cancer. The risk also arises from the unique biological factors in diabetic patients. Natural elements like hyperglycemia and hyperinsulinemia increase the risk of cancer. This situation creates a controversial scientific situation. Antidiabetic medication may have either a protective or a destructive role concerning cancer to the diabetic individual. Research has shown that metformin has a protective role concerning cancer. Metformin is a form of antidiabetic medication for type 2 diabetes mellitus. Researchers have linked metformin with the inhibition potential concerning cancer cells (Abdel-Rahman, 2018). Managing diabetes with Metformin creates supra-physiologic serum insulin and does not have any risks for prostate cancer patients (Hitron, Adams, Talbert, & Steinke, 2012). Metformin reacts in a manner that reenergizes the body's ability to fight illness and increase strength. According to (Richards et al., 2018), metformin activates the body's ability to sense cellular energy change. It also reactivates pathways that produce energy. As a result, the body can deal with the residual cancerous cells. Also, metformin reduces cardiovascular risks. Hence, metformin is a proven antidiabetic therapy that helps the body in fighting cancer. This paper seeks to examine the influence of antidiabetic medication on the development and progression of prostate cancer.

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The relationship between cancer and other antidiabetic drugs is still unclear or ambiguous. According to Rathmann and Kostev (2017), the use of dipeptidyl peptidase-4 inhibitors (DPP-4i) in the treatment of type 2 diabetes does not increase the risk of metastases. However, insulin is a potential growth catalyst and could have some significant effect on cancer cell migration and growth of cancerous tumors. According to Dabrowski, Szymanska-Garbacz, Miszczyszyn, Derezinski, and Czupryniak (2018), older adults have higher cancer prevalence than the young. Insulin may have either a direct or indirect impact on the growth of cancerous cells. Prostate cancer is one of the most common types of cancer. In its early stages, prostate cancer is curable. However, it is challenging to deal with in advanced stages. The impact of most oral agents and other antidiabetic medication on tumors concerning prostate cancer is unclear. According to Hirtron et al. (2012), some studies have reported that diabetic medication has adverse or positive effects on prostate cancer. Dabrowski et al. (2018) argue that insulin is a potential growth stimulation hormone for cancer. Abdel-Rahman (2018) also opines that treatment with insulin increases the risk of diabetic patient mortality with cancer. The relation emanates from the possibility of acting as a growth hormone in the presence of the mitogenic type A insulin receptor. For prostate cancer cell lines, insulin has the potential to stimulate IGFR-1 receptors and increasing the mortality risk. According to Hitron et al. (2012), insulin can lead to the creation of mitogenic and angiogenesis pathways for prostate cancer patients. Hence, the relationship between cancer and insulin is high, though researchers are yet to confirm with certainty. Insulin creates an elevated risk of malignancy. However, this action is difficult to establish when using insulin and metformin together (Dabrowski et al., 2018). Metformin negates the risks that insulin creates concerning cancer including prostate cancer.

Research Questions

The primary objective of this study is to the influence of antidiabetic medications on the development and progression of prostate cancer.

The specific objective is to investigate the effects of insulin on the growth of prostate cancer metastases in patients with type 2 diabetes.

The research question is derived from the specific objective. Hence, the research question for this study is: How does insulin (in the absence of metformin) affect the growth of prostate cancer metastases?

The Significance of the Study

Currently, researchers have established that there is possibly a link between insulin and mortality risks associated with prostate cancer. This study aims at developing the influence of insulin as an antidiabetic medication on prostate cancer. It seeks to provide a reference for the use or prohibition of the use of insulin in the treatment of diabetic patients with cancer risks. By establishing a link between prostate cancer risks and insulin, the study will either confirm or disprove fears that insulin is risky to diabetic patients. It will test the effects of insulin in the absence of metformin. Researchers have established that metformin negates the risks that insulin creates for cancer patients with diabetes. By so doing, the research will provide significant information for use in healthcare and research. The study also seeks to clarify the current misunderstanding seen as different researchers have produced ambiguous results concerning insulin. The paper will also set the record straight by establishing the errors that may have resulted in the ambiguous results from previous studies. It will analyze contradicting studies to determine the causes of the ambiguity, thus providing the necessary information for scholars to use in future research on the topic. It is also essential in resolving the contradiction in prior studies on the subject. Most importantly, conclusive research on the issue is necessary to find better treatment methods and reduce risks associated with some medication. By establishing the drugs that have a particular impact on cancer, the research will help determine the best alternative treatment.

Limitation of the Study

One of the primary limits of all the studies associated with this topic is time and resources. To conduct a cohort study on a given test sample requires adequate financing. Also, such a review needs sufficient time to observe the research subject. A cohort study is longitudinal research that requires several intervals of cross-sectional studies. Doing so enables the researcher to make a final and meaningful observation. Investigating over a short period may give unreliable and misguiding results. Also, another limitation is the sample size. Having a small sample size may limit the ability to identify significant effects. Having a minute sample size increases the possibility of a type II error (Faber & Fonseca, 2014). Type II error is the probability of failing to reject a null hypothesis that is false. A small sample size skews the results, thus making the study unrealistic.

Another limitation is the fact that type two diabetes advances with time. This situation implies that the amount of medication will increase with time. Hence, it becomes difficult to measure the impact of the insulin used on the prostate cancer metastases. The amount of insulin used is prone to change, implying that the effect may seem exaggerated. It is also difficult to establish whether other factors during the time of the study may have contributed to the growth or reduction in the metastases. Diabetes-relation medical complications such as hyperglycemia and hyperinsulinemia can increase the risk factors for cancer advancement. A study of the consequences of such conditions may improve the financial limitations of the study.

Future Direction of the Research

Given that research shows a significant link between insulin and cancer, it is essential to determine the effect of insulin in a more extended period. Investigating for a longer period increases the reliability of the results from a cohort study. Also, it is essential to research the effectiveness of insulin in the treatment of medical conditions associated with diabetes for cancer patients. Avoiding such situations during the study is critical for the accuracy of the results. Conditions like hyperglycemia may increase the risks of cancer growth. If such happens, the case will distort the result of the cohort study. The results will not reflect the real cause and effect relationship. Also, researchers may consider increasing the scope of the review to incorporate a larger sample size. Increasing the sample size reduces the possibility of a Type II error. However, increasing the size of the sample increases the cost implication of the study. Increasing the sample size may also imply an increase in the geographic scope of the review due to the availability of patients.

Method

The study will employ an empirical review of prior studies to investigate the contribution to the topic. The research involves a critical evaluation of the methodology that previous researchers used and evaluate the cause of the differences in results and findings. The study then follows an analysis of the limitations of previous studies. The shortcomings provide a means towards a critical review of the differences in conclusions. The selection criteria for the topic focus on the relevance of the research to the subject. It also analyzes the type of medication under review in any specific study. Inclusion also depends on the methodology that the author employed while conducting the research. In this case, only cohort study designs and empirical reviews are relevant to the topic due to the objective of this study. The limitations of this study rely on the shortcomings of the previous studies. The study seeks to understand the cause of the differences in research findings and to present a particular view of the topic.

Literature Review

Introduction

This chapter involves a review of prior research on the topic. To establish the research gap, the researcher will analyze several prior studies on the subject. The analysis will highlight the manner in which previous researchers could not find conclusive answers to the research question. Besides, this section will highlight essential findings and information that previous studies have brought to light. The research will first provide a brief description of prostate cancer, diabetes, and antidiabetic medications associated with the disease.

Prostate Cancer

Prostate cancer is one of the most common cancers in the world. It is a form of malignancy in the male reproductive system that develops when cells in the prostate multiply uncontrollably. Cell mutation in any body part is, but the body usually keeps the multiplication and variation in check. When the body loses this control, the cells grow uncontrollably forming a tumor. This type of growth may result from a change in an individual's deoxyribonucleic acid (DNA). Risk factors include age, genetics or close relatives, and vitamin E. The symptoms include weak urine flow and an increase in the urge to urinate. Prostate cancer may also lead to blood in urine or semen. At an advanced stage, prostate cancer can also migrate to other parts of the body leading to different types of cancer. At such a phase, the patient may experience bone pain among other symptoms. Prostate cancer is easy to treat when detected early. It also develops slowly, making it treatable and easily manageable. According to Chen and Zhao (2013), available treatment methods include surgery, chemotherapy, and hormonal therapy among others. According to Richards et al. (2018) prostate cancer treatment also includes ADT. Changes in lifestyle may also help to reduce risks of prostate cancer. Lifestyle changes can consist of exercises and weight control.

Diabetes Mellitus

Diabetes mellitus is a group of diseases that result from the body's inability to produce insulin or the inability to use it. The patient often suffers from chronic hyperglycemia (Kharroubi & Darwish, 2015). Chronic hyperglycemia can fail different organs such as kidney and eyes. Diabetes is a meta...