I have had diabetes for 5 years and have just been diagnosed with stage 2 breast cancer. Can I have surgery? What are the risks of complications? (Lam Ngoc, 55 years old, Binh Duong)
Reply:
Diabetes is a metabolic disorder in which blood sugar levels are higher than normal, due to a lack of insulin (a hormone produced by the pancreas) or insulin resistance.
People with high blood pressure have reduced oxygen supply to tissues, causing wounds to heal slowly and increasing the risk of infection. Uncontrolled disease can easily lead to complications such as chronic kidney failure, peripheral neuropathy, etc., which also slow wound healing.
You can have surgery to treat breast cancer. If your blood sugar is well controlled before surgery, the surgery is safe and the rate of post-operative complications is low. The supportive treatment for cancer is the same as for people without diabetes, including chemotherapy, immunotherapy, and hormone therapy.
Typically, an HbA1C level (average blood sugar level over three months) of 6.5-7% is favorable for surgery. If a cancer patient does not reach this target, the doctor may prescribe intensive insulin therapy to allow for surgery as soon as possible.
Diabetic patients with breast cancer need to control their blood sugar levels before surgery. Illustration: Freepik
Before surgery, the Endocrinologist - Diabetes specialist and the Breast Surgery department consult and evaluate blood sugar. Patients who fast for about 8 hours before surgery can easily cause hypoglycemia. Stress also causes blood sugar to increase or decrease suddenly, so this condition needs to be controlled.
During surgery, patients need to have their blood pressure, breathing rate, and blood sugar levels continuously monitored to ensure safety. Women with diabetes who do not have good blood sugar control should be carefully considered when undergoing breast reconstruction. Because the surgery involves a large incision, there is a high risk of infection and fluid accumulation.
After surgery, patients need to control symptoms such as nausea, vomiting, pain, and avoid large fluctuations in blood sugar. Diabetic wounds may take longer to heal. Doctors combine antibiotics and active diabetes medication (insulin) to help wounds heal quickly.
When there are signs of fever, the surgical wound is red, hot, swollen, more painful than usual or has discharge, the patient needs to see a doctor in the Department of Endocrinology - Diabetes and Breast Surgery to adjust the diet and medication appropriately.
Patients need to take medication as prescribed by their doctor, eat a nutritious diet, exercise, limit stress, drink enough water and check their blood sugar regularly. If there is any abnormality, the patient needs to notify the doctor immediately for timely adjustment.
Master, Doctor Huynh Ba Tan
Department of Breast Surgery, Tam Anh General Hospital, Ho Chi Minh City
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