Use this URL to cite or link to this record in EThOS:
Title: The interplay between type two diabetes mellitus and prostate cancer
Author: Crawley, Danielle Jane
ISNI:       0000 0004 7223 5394
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2018
Availability of Full Text:
Access from EThOS:
Access from Institution:
Aims/Objectives: This thesis aims to explore the interplay between type two diabetes mellitus (T2DM) and prostate cancer (PCa) with regards to treatments of both conditions and disease outcomes. Background: PCa and T2DM are both increasingly prevalent conditions, meaning that they often occur together. However, the relationship between the two is complex. Plan of investigation/Methods: To investigate the complex interplay between the two, the thesis was divided into the following projects: (1) Using data from Prostate Cancer data Base Sweden (PCBaSe) Sweden this thesis investigated: i) the impact of co-existing T2DM on receiving curative treatment for PCa; ii) the impact of a PCa diagnosis on T2DM treatment; iii) how the type and duration of androgen deprivation therapy (ADT) may affect risk of getting T2DM. (2) Evaluation of whether presence of T2DM and other components of the metabolic syndrome (MetS) affects response to ADT using data from patients enrolled in the STAMPEDE trial. (3) Assessment of which tumour components are affected by metformin through a randomised controlled trial, METAL (Metformin And Longevity). Results: Men with T2DM were 20% less likely to receive curative treatment for intermediate and high risk PCa compared to those without T2DM after adjusting for age, co-morbidity and tumour characteristics. Moreover, men with pre-existing T2DM were at increased risk of needing treatment escalations following a PCa diagnosis, particularly those treated with ADT. An increased risk of T2DM following treatment with ADT was also shown in which the duration and type of ADT received was important. Finally, baseline metabolic aberrations, including T2DM, in men commencing ADT for advanced PCa increased the risk of local and metastatic progression. Conclusion: This thesis highlights the complexity of the interplay between T2DM and PCa, in which both conditions impact on both the treatment and disease outcomes of the other.
Supervisor: Van Hemelrijck, Mieke ; Rudman, Sarah Maria Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available