Pancreatic Cancer and the Oral Microbiome

Abstract

Pancreatic Cancer (PC) is among the most difficult cancers to detect in its earliest stages when treatment is most effective. Factors that may contribute to PC include periodontal disease, smoking, chronic diabetes, obesity, immune factors, poor diet, chronic inflammation of the pancreas, gender and age. Understanding the relationship of oral pathogens due to periodontal disease may help reduce the risk for PC. In this research, we focused on bacteria that is associated with periodontal disease. Periodontal disease is one of the most common inflammatory diseases that affects the human body and is possibly correlated to PC. The oral cavity contains numerous bacteria including Porphyromonas gingivalis (P. gingivalis), Aggregatibacter actinomycetemcomitans (Aa) and Fusobacterium Nucleatum (F. Nucleatum). P. gingivalis and Aa have the ability to penetrate in two different pathways into the pancreas. Firstly, oral bacteria can penetrate the gingival and alveolar tissue and reach the bloodstream. Lastly, oral bacteria that is swallowed can travel via gastrointestinal tract to the pancreas. These bacteria work in conjunction with each other and initiate an inflammatory response in the pancreas leading to the increased risk of PC. It is essential for dental healthcare professionals (DHP) to educate the public regarding oral risk factors such as periodontal disease that may increase the risk for PC. Preventing oral disease by encouraging good oral hygiene and the management of periodontal disease through non-surgical periodontal therapy by DHP may reduce oral pathogens and decrease the risk for PC. The DHP can make a difference by educating the public about the risk factors correlating to PCs. Further research into better early screening methods should include salivary markers and oral microbiome population as possible indication of early PC.