[AlaskaAngel]

I originally suggested metformin in the nutrition column on this site before there was open discussion here about its possible helpful effect on cancer patients. I was suggesting it at that time only in the hope that it might help cancer patients who did treatment that included steroids as support drugs that were done in order to reduce their risk for recurrence, but then ended up with excessive weight gain that instead increases their risk, plus much more difficulty losing the weight due to menopause and aging (due to the loss of muscle mass, and testosterone and estrogen that results from treatment).

Since at that time there wasn't much info or active interest in it on the medical wavelengths and I had no substantiated basis for wanting it (other than the desperation of being someone who had never been overweight before in my life and suddenly was experiencing being overweight and doing increased exercise and diet with less and less effect over time as I continued to age), I documented my problem by getting a referral from my PCP to the Registered Dietitian at my cancer center in Seattle. At that time there was no focus AT ALL at the cancer center by oncology on doing anything to help manage the problems that patients like me were encountering with the increased risk from weight gain that was so obviously caused by treatment. It made no sense to me to put early stage patients thru such awful treatment for the purpose of reducing risk of recurrence, only to abandon the same patients to then have to struggle with weight gain that increased the risk.

I focused on coordinating the clinical basis for receiving treatment assistance for the problem. I made sure I got the formal referral from my PCP to the RD, and I made sure I copied their notes to each other. Eventually I did the same between both of them and an endocrinologist, in order to include authorized visits to an endocrinologist. None of this was done with any support whatsoever from any oncologist. I don't think the thought ever crossed their mind. Their focus has been primarily on other types of prescribed treatments that are generally more toxic.

I believe integrating endocrinologists into breast cancer care is very likely to be most helpful in finding more answers to many cancers that involve the endocrine system.

The medical system is archiac in this respect. Oncologists, whose training does not include much in the way of endocrinology, generally have failed to do any homework on its impact on cancers and progress in this regard continues to be very slow. I think that is one major reason why more answers to cancer have been so slow in coming. We are seen by PCPs, and then surgeons, and then oncologists, and then radiologists, and then packaged up with their conclusions without any input from the endocrine system portion of us that is being manipulated and changed by the treatment that these specialists collectively recommend.

At the very minimum, to make meaningful progress, endocrinologists will have to be trained to deal with cancers in the first place. Right now their schedule is full just with dealing with diabetes, thyroid disease, etc. Try getting an appointment with one if you don't have diabetes or thyroid disease. You will be lucky if you can.

I took my lab test results to the endocrinologist. I do not have diabetes or thyroid disease, and because endocrinologists have not had a background education in cancers in particular, there is little established connection for them to work with in our behalf. The endocrinologist gave me no further diagnosis. But eventually the endocrinologist did provide me with an Rx for metformin.

I am taking 500 mg a day (which is a small dose) and find it does help to at least not gain any more weight. I still have to exercise 7 days a week for a full hour and I still have to eat a very monitored diet (about half of what I ate prior to treatment with less exercise).

If we are going to get some answers about this on a wider basis, it would probably be best if you get your situation documented by visits with your PCP and a Registered Dietitian, to support any future referral for the visit with an endocrinologist.

AlaskaAngel