Impact of metabolic disorders on prostate cancer growth: Androgen and insulin resistance perspectives

BACKGROUND: A high prevalence of cancers in metabolic disorders, like metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM), recently has been noted, including prostate cancer (PC), which is androgen‐sensitive. However, the pathological relationship among testosterone and insulin and insulin‐like growth factor (IGF)‐1 signaling in relation to MetS and T2DM with PC remains unclear. METHODS: Papers were reviewed, including those by the authors. RESULTS: In MetS or the initial stage of T2DM accompanying insulin resistance, insulin and IGF‐1 signaling could be essential for PC growth. In the advanced stage of T2DM, the decrease in insulin secretion might work against PC growth. A decrease in testosterone concentration with T2DM also might suppress PC proliferation. Androgen deprivation therapy in patients with PC might increase the risk of MetS and/or T2DM and consequently cardiovascular events. Certain drugs for T2DM treatment, such as metformin and glucagon‐like peptide‐1 analog, potentially might be useful for the treatment of PC. CONCLUSION: The improvement of insulin resistance appears to be essential for the prevention of PC growth. Further studies are needed to clarify the complicated pathophysiology of metabolic disorders in PC growth.