Multiple myeloma, a type of blood cancer that develops in the bone marrow, is known to be the second most common blood cancer in the United States, with a notable prevalence among non-Hispanic Black adults.
However, when this condition coexists with diabetes, patients’ survival rates are considerably affected, and intriguingly, racial disparities have been observed in these survival outcomes.
Diabetes and Cancer: A Connection
Diabetes is increasingly becoming a common health condition, affecting around 13% of the U.S. population, as per the Centers for Disease Control and Prevention.
It has been long established that patients with both multiple myeloma and diabetes generally have lower survival rates.
However, a new study, published in Blood Advances, is the first to explore the racial disparities in survival outcomes between white and Black patients with these comorbid conditions.
Investigating Racial Disparities
Researchers, led by Dr. Urvi Shah, a specialist in multiple myeloma, conducted an extensive retrospective study, examining electronic health records of 5,383 multiple myeloma patients.
They noticed a prevalent trend of lower survival rates in patients with both diabetes and multiple myeloma but discovered that this trend was significantly prominent in white patients as compared to Black patients.
Dr. Shah pointed out the unforeseen observation that diabetes affected the survival outcomes adversely in white individuals with multiple myeloma, but the same was not observed in Black individuals.
This difference in outcomes was significant despite the higher prevalence of diabetes among Black individuals.
Age and Risk Factors
Age is a considerable risk factor for developing diabetes, and as age increases, overall survival decreases.
Within the studied cohort, it was observed that diabetes was 50% more prevalent among Black patients aged 45-60 years old than among white patients over 60 years old.
It is hypothesized that younger patients might be tolerating multiple myeloma treatments better than older ones, possibly explaining some of the observed racial differences in survival outcomes.
While delving deeper into the underlying mechanisms, the study utilized genetically engineered mouse models to discern that multiple myeloma tumors grew more rapidly in non-obese diabetic mice compared to their non-diabetic counterparts.
This acceleration in cancer growth is believed to be due to higher insulin levels in diabetic mice, suggesting the potential benefit of simultaneous treatment for multiple myeloma and diabetes.
Future Paths and Considerations
This study, while enlightening, was retrospective and hence, there are inherent limitations, including not accounting for the quality of diabetes care received by the patients and self-reported race.
Dr. Shah and her team aim to refine their research further, investigating therapies that halt both the progression of multiple myeloma and the overactive insulin signaling pathway.
They are also examining how lifestyle changes and modifiable risk factors, like diet and microbiome, can optimize cancer outcomes.
Dr. Shah emphasizes the importance of considering comorbidities and modifiable risk factors along with pharmacological interventions to enhance patient survival outcomes in conditions like multiple myeloma, especially when accompanied by diabetes.
This study sheds light on the nuanced ways in which race, age, and comorbidities interplay to determine health outcomes and underscores the need for personalized and comprehensive approaches to healthcare.
If you care about diabetes, please read studies that not all whole grain foods could benefit people with type 2 diabetes, and green tea could help reduce death risk in type 2 diabetes.
For more information about nutrition, please see recent studies about unhealthy plant-based diets linked to metabolic syndrome, and results showing Mediterranean diet could help reduce the diabetes risk by one third.
The research findings can be found in Blood Advances.
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