By: Cari Nierenberg, Contributing writer

Published: 07/25/2013 06:35 AM EDT on LiveScience


Bacterial infections may play a role in triggering pancreatic cancer, according to recent research.


A growing number of studies suggest a role for infections --primarily of the stomach and gums -- in pancreatic cancer[1] . The disease is a particularly deadly cancer, which the American Cancer Society estimates will kill nearly 38,500 Americans in 2013.


"Pancreatic cancer is the worst form of cancer that people can have," said Dr. Wasif Saif, director of the gastrointestinal oncology program at Tufts Medical Center in Boston.


"It's the cancer with the highest mortality rate[2] - 96 percent mortality," he said.


Although pancreatic cancer is extremely fatal, researchers don't really know its main causes, Saif said. The known major risk factors account for less than 40 percent of all cases.


Known risk factors for the disease include tobacco smoking, obesity, Type 2 diabetes, alcoholism and chronic pancreatitis, which is inflammation of the pancreas[3] .



"The major finding of this research is the possibility that bacterial infection may be leading to pancreatic cancer," said Saif, who was not involved in the study. [Why Is Pancreatic Cancer So Deadly?][4]


The findings were published online July 10 in the journal Carcinogenesis, and they were authored by Dominique Michaud, a professor of epidemiology at Brown University in Providence, R.I.


Infections linked to cancer


According to the study, two bacterial infections in particular have been strongly linked to pancreatic cancer in the scientific literature.


Data suggest that people who have been infected with Helicobacter pylori, a bacteria that is linked with stomach cancer and peptic ulcers, and Porphyrmomonas gingivalis, an infection involved in gum disease and poor dental hygiene, may be more prone to developing pancreatic cancer.


Several theories aim to explain why these infections may be contributing to the progression of pancreatic cancer, Saif said. One is that the infections cause bodywide inflammation, which is known to play a role in pancreatic cancer.


A second possible mechanism is that these bacterial infections lead to changes in the immune system. When the immune system is weakened or altered by infection, it doesn't work as well to defend the body against cancer.


What's more, risk factors for pancreatic cancer, such as smoking, obesity and diabetes, may further suppress immune response, opening the door to opportunistic infections, according to the study.


Other theories proposed in the paper are that these bacterial infections may directly activate pancreatic tumor signaling pathways, such as those that promote the growth of new blood cells that feed a tumor. Another possibility is that infections indirectly activate pancreatic cancer pathways that trigger an immune response in the environment surrounding the cancer, but not in the tumor itself.


Practical implications


The idea that some bacterial infections can lead to certain cancers[5] is not a new concept, Saif said. Researchers have been looking into this connection over the last decade, and have seen evidence of this association in blood cancers and solid tumors, he explained.


Cancers known to be linked with infections include liver cancer, which is linked to the hepatitis B and C viruses; cervical cancer, which is closely tied to the human papilloma (HPV) virus; and cancer in the nose and upper throat, which is associated with the Epstein-Barr virus.


A better understanding of the role of bacterial infections in pancreatic cancer may provide new opportunities for early detection and treatment, the paper suggests.


These findings may help pancreatic cancer patients who often want to know, "Why me?" Saif said.


And family members may listen and help out more when patients are asked to change their lifestyle habits, such as not smoking or improving poor dental hygiene. [7 Cancers You Can Ward Off with Exercise[6] ]


In addition, these findings "open new doors to research to look into pathways that may develop new therapies to treat this cancer," Saif said.


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  • Patrick Swayze


    The beloved star of "Ghost" and "Dirty Dancing" died after a battle with pancreatic cancer in September 2009, at the age of 57.

    "Now, a lot of things go through your head when you get a death sentence handed to you, starting with: 'Why me?'" he said in an audiobook titled <a href="http://www.people.com/people/package/article/0,,20290371_20308571,00.html" target="_hplink">"Time of My Life," People.com reported</a>. And though he blamed himself at first for the January 2008 diagnosis, he soon emerged with a new attitude.

    "I was not ready to go, and I'd be damned if this disease was going to take me before I was good and ready," <a href="http://www.people.com/people/package/article/0,,20290371_20308571,00.html" target="_hplink">he said in the tapes</a>. "So I said to my doctor, 'Show me where the enemy is and I'll fight him.'"

    In fact, he told Barbara Walters in 2009 that he was both optimistic and realistic.

    "I'd say five years is pretty wishful thinking," he said in the interview, <a href="http://www.huffingtonpost.com/2009/09/14/patrick-swayze-dead_n_286559.html" target="_hplink">according to a HuffPost report at the time of his death</a>. "Two years seems likely if you're going to believe statistics. I want to last until they find a cure, which means I'd better get a fire under it."

    In February 2009 <a href="http://www.washingtonpost.com/wp-dyn/content/article/2009/02/06/AR2009020602850.html" target="_hplink">he wrote an op-ed for <em>The Washington Post</em></a> as a plea to Congress to "vote for the maximum funding to let the National Institutes of Health fight cancer and other life threatening illnesses" as part of the stimulus package:

    <blockquote>When I was growing up in Texas, my family had a simple response for challenges like this: "Stop talking about it, and <em>do</em> something about it." That's how I feel about finding more money for cancer research. My hope is that some day, the words "a cure" won't be followed by the words "is impossible."</blockquote>

    He died 20 months after diagnosis. His wife, Lisa Niemi, has stayed active in raising awareness around pancreatic cancer, <a href="http://www.pancan.org/section_about/national_spokesperson/" target="_hplink">signing on as a national spokesperson for the Pancreatic Cancer Action Network</a>.

    "My husband Patrick not only touched the lives of millions with his work, but also with the strength and courage he displayed during his fight against pancreatic cancer; he was a hero around the world," <a href="http://www.pancan.org/section_about/national_spokesperson/" target="_hplink">she said when announcing a new awareness campaign for the organization</a>. "While it is bittersweet to mark this day, it is imperative that people understand the severity of this disease and the urgent need for increased research funding,"




  • Randy Pausch


    A <a href="http://www.thelastlecture.com/aboutr.htm" target="_hplink">professor of Computer Science, Human Computer Interaction and Design</a> at Carnegie Mellon University in Pittsburgh, Pausch delivered his last lecture in September 2007 after learning he was dying of pancreatic cancer. Soon, the speech, titled "Really Achieving Your Childhood Dreams," became a viral sensation, with a <a href="http://www.amazon.com/The-Last-Lecture-Randy-Pausch/dp/1401323251
    http://www.amazon.com/The-Last-Lecture-Randy-Pausch/dp/1401323251
    http://www.amazon.com/The-Last-Lecture-Randy-Pausch/dp/1401323251
    http://www.amazon.com/The-Last-Lecture-Randy-Pausch/dp/1401323251" target="_hplink">follow-up book released</a>, as well. "We cannot change the cards we are dealt, just how we play the hand," he said during the lecture, which he later explained was <em>really</em> for his three kids. (Watch the full video to the left).

    He died 11 months later on July 25, 2008 -- <a href="http://www.huffingtonpost.com/2008/07/26/randy-pausch-last-lecture_n_115137.html" target="_hplink">five months past the six months his doctors</a> once (optimistically) gave him to live.




  • Steve Jobs


    The founder and CEO of Apple may be the most public face of pancreatic cancer in the United States, having battled the disease for an estimated seven years before succumbing to it at the age of 56.

    For the rare form of pancreatic tumor that Jobs suffered from, a neuroendocrine pancreatic tumor, his survival was not unusual.

    Jobs was famously tight-lipped about the condition and his treatment protocol, though he did get a liver transplant in 2009, following surgery in 2004 to remove the tumor from his pancreas. As the<a href="http://online.wsj.com/article/SB10001424052970203476804576613722391627248.html" target="_hplink"> <em>Wall Street Journal</em> reported</a> at the time of Jobs' death, patients usually undergo tumor removal either if the cancer is contained to the pancreas and has not spread -- or if it has spread to the liver.

    "If you think it is confined to the pancreas, there is quite a good hope that the patient has gotten rid of it once and for all," Michaela Banck, a pancreatic cancer expert at the Mayo Clinic told the <em>Journal</em>, adding that in cases where it has spread to the liver, "you can't ultimately cure it. The more tumor you remove, you buy time for the patient."

    Though Jobs rarely spoke of his illness, he shared his thoughts on death with some frequency, including during a 2005 Stanford <a href="http://abcnews.go.com/Technology/steve-jobs-death-20-best-quotes/story?id=14681795#5" target="_hplink">commencement speech</a>:

    <blockquote>No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because death is very likely the single best invention of life. It is life's change agent. It clears out the old to make way for the new.</blockquote>




  • Ruth Bader Ginsburg


    In truth, it may have been Supreme Court Justice Ruth Bader Ginsburg's 1999 brush with colon cancer that saved her. Because she is a cancer survivor, Ginsburg gets routine CT scans as part of her yearly examinations. And in 2009, <a href="http://www.nytimes.com/2010/06/08/health/08brod.html" target="_hplink">one of these scans turned up a small tumor on her pancreas</a>.

    Unlike most pancreatic cancer patients, Ginsburg was lucky to find the cancer early and, as of this writing, remains cancer free following surgery to remove her spleen and part of her pancreas in 2009.

    <em>CORRECTION: In an earlier version of this slideshow, Ginsburg was described as "chief justice." She is an Associate Justice of the Supreme Court.</em>




  • Luciano Pavarotti


    In July 2006, Pavarotti's manager announced that the famous opera singer had been diagnosed with pancreatic cancer and underwent surgery for the removal of a malignant mass, <a href="http://www.washingtonpost.com/wp-dyn/content/article/2006/07/07/AR2006070700319.html" target="_hplink">the <em>Washington Post</em> reported at the time</a>.

    "Fortunately, the mass was able to be completely removed at surgery," the manager said in a statement, according to <a href="http://www.washingtonpost.com/wp-dyn/content/article/2006/07/07/AR2006070700319.html" target="_hplink">the <em>Post</em> report</a>. "Mr. Pavarotti is recovering well, and his physicians are encouraged by the physical and emotional resilience of their patient."

    He eventually died in his Northern Italy home in September 2007, <a href="http://www.nytimes.com/2007/09/06/arts/music/06pavarotti.html?pagewanted=all" target="_hplink"><em>The New York Times</em> reported</a>.




  • Jack Benny


    The violin player and vaudeville, radio, TV and movie star Jack Benny (pictured here with Marilyn Monroe) died from pancreatic cancer on December 26, 1974, <a href="http://www.imdb.com/name/nm0000912/bio" target="_hplink">according to IMDB.com</a>.




  • Donna Reed


    The actress first gained prominence for her award-winning role in <em>From Here to Eternity</em>, though she was perhaps better known for her television roles in "The Donna Reed Show" and "Dallas."

    Reed was <a href="http://articles.latimes.com/1986-01-14/news/mn-27829_1_donna-reed" target="_hplink">first admitted to the hospital</a> with bleeding ulcers, but screening tests revealed that she was suffering from a tumor in her pancreas. She died of the cancer within six weeks of diagnosis.




  • Charlie Louvin


    The country music star <a href="http://articles.cnn.com/2011-01-26/entertainment/obit.louvin_1_charlie-louvin-great-atomic-power-ira?_s=PM:SHOWBIZ" target="_hplink">died in January 2011 of pancreatic cancer</a> at the age of 83. Louvin, a Grammy nominee and Country Music Hall of Famer, was diagnosed with stage 2 of the disease in 2010 after visiting his doctor with, <a href="http://blogs.tennessean.com/tunein/2010/07/07/happy-birthday-charlie-louvin/" target="_hplink">what <em>The Tennessean</em> reported was a "minor complaint."</a>

    He performed all the way up until the December before his death -- at one of those last appearances, <a href="http://www.people.com/people/article/0,,20460856,00.html" target="_hplink">People.com reported that he said</a>: "In my world, you are worthless if you can't continue. Show business is all I really know how to do. I would like for that to be the last thing I do."




  • Ben Gazzara


    Gazzara, a long-time dramatic actor, died in early 2012 from pancreatic cancer, <a href="http://www.nytimes.com/2012/02/04/movies/ben-gazzara-actor-of-stage-and-screen-dies-at-81.html" target="_hplink"><em>The New York Times</em> reported at the time</a>.




  • Dizzie Gillespie


    <a href="http://online.wsj.com/article/SB123128087267758759.html" target="_hplink">According to friend Nat Hentoff</a>, as the jazz great Dizzie Gillespie lay dying of pancreatic cancer at New Jersey's Englewood Hospital and Medical Center, he made his doctors promise to help ailing musicians who were less fortunate than he was.

    That turned into the Dizzy Gillespie Memorial Fund and the Dizzy Gillespie Cancer Institute at Englewood -- an ongoing legacy that doesn't just help those with pancreatic cancer, but any musician who lacks health insurance or resources to help treat an illness.




  • Fred Gwynne


    The actor probably best known as the patriarch on the 1960s television series "The Munsters," Gwynne died from pancreatic cancer at age 66, <a href="http://articles.latimes.com/1993-07-03/news/mn-9469_1_fred-gwynne" target="_hplink">the <em>Los Angeles Times</em> reported at the time</a>. While his other roles included the television series "Car 54 Where Are You" and the play "Cat on a Hot Tin Roof," he always had a soft spot in his heart for Herman.

    "And I might as well tell you the truth. I love old Herman Munster. Much as I try not to, I can't stop liking that fellow," <a href="http://articles.latimes.com/1993-07-03/news/mn-9469_1_fred-gwynne" target="_hplink">the <em>LA Times</em> quotes him as saying</a>.

    Gwynne acted for 42 years, <a href="http://www.nytimes.com/1993/07/03/obituaries/fred-gwynne-popular-actor-is-dead-at-66.html" target="_hplink">according to <em>The New York Times</em></a>, and also once worked as both a writer and illustrator of children's books and as an advertising copywriter.




  • Joan Crawford


    Movie star Joan Crawford <a href="http://www.cnn.com/2011/10/06/health/conditions/pancreatic-cancer-steve-jobs/index.html" target="_hplink">suffered from pancreatic cancer</a> at the time of her death at age 72 in 1977, though the actual cause of death was <a href="http://www.nytimes.com/learning/general/onthisday/bday/0323.html">listed as a heart attack</a>.




  • Michael Landon


    Landon was famous for his roles in period Western dramas, like" "Bonanza" and "Little House on the Prairie," but the actor was also well-known for his battle with pancreatic cancer.

    In an interview with <em>LIFE</em> magazine three weeks after diagnosis, <a href="http://www.people.com/people/archive/article/0,,20115519,00.html" target="_hplink">he famously said</a>: "If I'm gonna die, death's gonna have to do a lot of fighting to get me."

    Despite chemotherapy, rest, an all-vegetarian diet and a course of vitamins and supplements, Landon died of the cancer at age 54 at his house in Malibu.




  • Count Basie


    William "Count" Basie was a famous bandleader and jazz musician who is considered responsible for much of the "Big Band" sound of the 1930s and 1940s.

    <a href="http://projects.latimes.com/hollywood/star-walk/count-basie/" target="_hplink">He died of pancreatic cancer</a> in 1984 at the age of 79.