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Treatment of synchronous prostate and rectal cancers is a rare yet challenging problem with compounded toxicities. We report a case of a 65-year-old man who underwent proton beam therapy (PBT) with concurrent capecitabine and hormonal therapy for his synchronously found prostate (intermediate-risk) and rectal (cT2, N2b, stage IIIB) cancers; he also received low anterior resection. Before PBT, the patient experienced hematochezia. His baseline American Urological Association symptom score was a total of 0, and he was not sexually active. He completed PBT with grade 1 acute toxicities including fatigue, nausea, and increased urinary and bowel frequencies. He also developed mild anemia (10.7), which was resolved. Subsequent surgical pathology showed a pathologic complete response in his rectum. At follow-up of 2.5 years, he remained disease-free on surveillance imaging for both malignancies and reported increased bowel urgency and frequency, minimal urinary leakage when having urgency, and peripheral neuropathy. This case, along with a succinct literature review, demonstrates that PBT can be successful in the definitive treatment of synchronous prostate and rectal cancers with minimal toxicities. Further research is required to evaluate the efficacy and side effect profiles of PBT.

Mutations or other alterations in the RET gene have been implicated in a variety of malignancies – most commonly thyroid, but also chronic myelomonocytic leukemia, acute myeloid leukemia, and lung, breast, pancreatic, and colon cancers. Here we present a case of a gentlemen initially diagnosed with and treated for non-small cell lung adenocarcinoma. Genomic profiling of his tumor specimen revealed a RET point mutation with a known association with medullary thyroid cancer (MTC). Further pathological and molecular diagnostic evaluation confirmed a diagnosis of MTC, leading to a change in treatment from standard chemotherapy for non-small cell lung cancer to targeted therapy against RET and potential implications regarding inherited cancer risk for his offspring. The patient experienced a clinical response to treatment and several months of improved quality of life. This case illustrates the capacity of genomic profiling to uncover molecular drivers of disease and help ensure proper diagnosis and management of cancer.

Aim: To determine overall survival (OS) and glycemic control in patients with cancer and diabetes. Materials & methods: Patients of our institution with breast, colon, lung, pancreas and prostate cancer were retrospectively reviewed. OS was compared between matched patients with and without diabetes, and changes in glucose value over time were assessed. Results: For 3934 patients each with and without diabetes, adjusted analysis showed no difference in OS according to diabetes status (hazard ratio: 1.07; 95% CI: 0.96–1.20). Mean glucose values decreased over time in patients with and without diabetes (p = 0.01). Conclusion: In this large study of patients with five common cancers, the co-occurrence of diabetes did not affect OS. Cancer did not adversely affect glucose levels.

Aim: This study examined the impact of diabetes mellitus (DM) on survival in squamous cell carcinoma (SCC) patients, and the impact of SCC on glycemic control. Materials & methods: Patients with newly diagnosed SCC with and without DM were matched 1:1 (2007–2017). Overall survival and recurrence-free survival were estimated using the Kaplan–Meier method. Hemoglobin A1c (HbA1c) and glucose level during the year following cancer diagnosis were compared using mixed models. Results: HbA1c decreased over time in DM patients (p = 0.04). The 5-year overall survival was 61% in DM patients, compared with 78% in patients without DM (p = 0.004). Conclusion: The presence of co-existing DM adversely impacted survival in patients with SCC. SCC did not affect glycemic control.

Aim: We aimed to determine the impact of diabetes mellitus (DM) on survival of patients with neuroendocrine tumors (NETs) and of NETs on glycemic control. Patients & methods: Patients with newly diagnosed NETs with/without DM were matched 1:1 by age, sex and diagnosis year (2005–2017), and survival compared (Kaplan–Meier and Cox proportional hazards). Mixed models compared hemoglobin A1c (HbA1c) and glucose during the year after cancer diagnosis. Results: Three-year overall survival was 72% (95% CI: 60–86%) for DM patients versus 80% (95% CI: 70–92%) for non-DM patients (p = 0.82). Hazard ratio was 1.33 (95% CI: 0.56–3.16; p = 0.51); mean DM HbA1c, 7.3%. Conclusion: DM did not adversely affect survival of patients with NET. NET and its treatment did not affect glycemic control.

Aim: To evaluate associations between survival and glycemic control in age-matched patients with endometrial or ovarian cancer, with/without diabetes mellitus (DM). Patients & methods: Patients with newly diagnosed ovarian or endometrial cancer with and without DM were compared. Results: The study included 84 patients with ovarian cancer (28, DM); 96 with endometrial cancer (48 with, 48 without DM). DM patients did not have worse overall or progression-free survival than non-DM patients. Glycemic control was not associated with either cancer. Conclusion: There was no association between DM and survival for patients with uterine or ovarian cancer. In addition, there was no association between uterine and ovarian cancer and glycemic control. Additional studies to confirm these observations in larger populations are required.

Aim: We examined the association between diabetes and survival in patients with acute and chronic myeloid leukemia and the association of leukemia with glycemic control. Patients & methods: Patients with leukemia with and without diabetes (2007–2015) were retrospectively identified and matched 1:1 (n = 70 per group). Overall survival was estimated by the Kaplan–Meier method. Hemoglobin A1c and glucose levels the year after leukemia diagnosis were compared by mixed models. Results: Among 25 of 70 patients with diabetes, mean hemoglobin A1c during the year after leukemia diagnosis was 6.8%. Kaplan–Meier-estimated 3-year survival was 46% for diabetes patients versus 45% for controls (p = 0.79). Conclusion: No associations were found between leukemia, diabetes, survival and glycemic control.

Aim: We examined the effect of diabetes on survival in patients with lymphoma and the effect of lymphoma on glycemic control. Patients & methods: Patients with lymphoma with and without diabetes (2005–2016) were retrospectively identified and matched 1:1. Overall survival and progression-free survival were estimated by the Kaplan–Meier method. Hemoglobin A1c (HbA1c) and glucose levels during the year after cancer diagnosis were compared by mixed models. Results: For patients with diabetes, mean HbA1c during the year after lymphoma diagnosis was 6.7%. Estimated 5-year progression-free survival for patients with versus without diabetes was 63% (95% CI: 53–76%) versus 58% (95% CI: 46–71%) (p = 0.42). Conclusion: Lymphoma and its treatment did not affect glycemic control. Diabetes did not decrease lymphoma-specific survival.

Aim: To evaluate overall survival (OS), glycemic control in cancer patients with and without diabetes mellitus (DM). Patients & methods: Patients (2010–2015) with newly diagnosed prostate, breast, lung, colorectal and pancreatic cancers were identified in institutional cancer registry. Data linked to National Death Index for vital status. 5-year OS estimated; glucose and hemoglobin A1c assessed during year postdiagnosis. Results: We identified 1404 patients (non-DM, n = 936; DM, n = 468). DM cohort had 168 deaths (36%); non-DM, 267 (29%). 5-year OS estimated at 58% (95% CI: 53–64%) for DM and 67% (95% CI: 64–71%) for controls; for matched pairs, hazard ratio: 1.35 (95% CI: 1.02–1.79). Cancer did not harm glycemic control. Conclusion: OS among cancer patients with DM was lower than without DM.

Aim: To examine effects of diabetes mellitus (DM) on survival in gastric or esophageal (GE) cancer and the cancers’ effects on glycemic control. Materials & methods: Patients with GE cancer with and without DM were matched 1 to 1 (2006–2016). Characteristics were compared and survival assessed with Kaplan–Meier method and Cox regression. Mixed models compared hemoglobin A1c and glucose over time. Results: Among DM cases, mean hemoglobin A1c was 6.8% in the year after cancer diagnosis. Three-year overall survival was 46% with DM versus 52% without DM (hazard ratio [95% CI]: 1.95 [1.14–3.34]; p = 0.02). Conclusion: GE cancer and its treatment did not affect glycemic control. Risks of death and progression were greater for patients with DM than patients without DM.