Pancreatic Cancer and Fungal Infections

On October 3, 2019, The New York Times published an article titled, "In the Pancreas, Common Fungi May Drive Cancer," reporting on findings of a study published in the prestigious Nature journal. According to this study: fungi migrate from the gut lumen to the pancreas, and that this is implicated in the pathogenesis of Pancreatic ductal adenocarcinoma (PDA), which is a malignancy of the exocrine pancreas with the worst prognosis among all solid tumors, and soon to become the second leading cause of cancer-related deaths.

PDA tumors in humans and mouse models of this cancer displayed an increase in fungi of about 3,000-fold compared to normal pancreatic tissue. Solid tumors excrete acid and the spread of cancer cells is stimulated by acidic conditions in the surrounding tissues. Acid is a byproduct of glucose metabolism, which ties in with research showing cancer feeds on and is accelerated by a diet high in sugar.

According to the researchers, PDA tumors had far greater amounts of a common fungal genus called Malassezia. Killing off the mycobiome with an anti-fungal drug was found to be protective, slowing down the progression of the tumor. The team found that treating mice with a strong antifungal drug called amphotericin B reduced tumor weight by 20–40%. The treatment also reduced ductal dysplasia, an early stage in the development of pancreatic cancer, by 20–30%. Sodium bicarbonate, for many reasons, is a far superior anti-fungal than amphotericin B for it also addresses the conditions that lead to pancreatic distress while it kills fungi.

To further sustain the connection between pancreatic cancer and fungus these researches found that repopulating the tumor with Malassezia accelerated tumor growth, except when Candida, Saccharomyces or Aspergillus genera were used. This suggests Malassezia is the main culprit in this kind of cancer. When other genera were included, tumor growth was much slower.

In summary, the fungi trapped in the pancreas appears to drive tumor growth. Fungus infections are now officially one more factor to consider in the alphabet soup of factors affecting cancer proliferation. The fungal population in the pancreas is a biomarker for who's at risk for developing cancer because it is part of an army of infections well known to cause cancer.