Any kind of pancreatic inflammation, experts in the field tell us, raises the risk of pancreatic cancer. There is an increased risk of cancer in people who have hereditary pancreatitis, in people who have cystic fibrosis, and in those who have inflammation caused by alcoholism, or irritation and inflammation caused by diseases doctors cannot identify. There is something about chronic irritation and inflammation that causes cells with damaged DNA to accumulate and cancerous cells to proliferate. And inflammation is an important consideration in the development of the disease precisely because the pancreas is not exposed to the toxic stresses that are known to cause metastatic tumors in other organs.
The liver, for example, constantly detoxifies literally tens of thousands of different chemicals from food, medication, the environment, and the body itself. The kidneys and the bladders are exposed to concentrated water-soluble toxic substances. The lungs respond to air pollution and tobacco smoke. The skin is damaged by sunlight.
But the pancreas is more or less protected from all these outside influences. When cancer develops here, it's far more likely to be due to "inside" influences.
Researchers often refer to carcinomas of the liver, kidneys, lungs, skin, thyroid, and so on as a "caretaker defect." The watchdog genes that repair damaged DNA for some reason fail to do their job so cancer results.
Researchers refer to carcinoma of the pancreas, on the other hand, as a "landscaper defect." The problem is not just defective DNA inside cells, but also irritant chemicals surrounding them. There are genes that increase the risk of pancreatic adenocarcinoma, but these genes don't get activated unless there are also (1) processes of inflammation and (2) toxic triggers from the environment. Smoking, for instance, greatly increases the risk of pancreatic tumors--but in people who already have pancreatitis.
If there is any good news about this kind of cancer, it may be that since more than one factor is required to cause, there may be more than one way to prevent it. One of the overlooked factors in this disease is the role of the bacteria in the colon, which I'll discuss tomorrow.
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