How do you speak Risk of Cancer and Periodontal Disease with your patients?

 

 

Dr McGlennen: Cancer is a word that receives a lot of attention. There are walks, runs and bike rides every day to raise awareness of various types of cancers and billions of dollars are spent on research directed to improve diagnosis and treatments. As health care professionals, we should perform a cancer risk assessment for each patient with a goal to reduce the patient’s risk and to find cancers earlier when cure is more likely. One way that the dental office can contribute to helping patients reduce their risk of cancer is to test for oral pathogens, several of which are now known to be linked to the development of these worrisome diseases.

As it turns out, advanced periodontal disease is associated with a 2.5-fold increase in smoking related cancers.1 Breast cancer is common, but persons with elevated levels of the bacteria A.a. and P.g. have a greater chance of failed response to treatment and recurrence. In another prospective study, persons with the periodontal pathogen P.g. showed a 59% increased risk of pancreatic cancer. There are other reports of oral A.a. and T.d. also linked to pancreatic tumors.2 P.g., T.d. and T.f. are also linked to risk of esophageal cancers.3,4  Among the more provocative discoveries of late are studies that show that F.n. can be observed within the malignant cells that comprise a certain type of colon cancer, and further, that when these tumors metastasize, the pathogenic bacteria are carried to those distant sites as well as to lymph nodes.5,6 This is a newly observed phenomenon that will surely affect how some cancers are treated in the future.  Reducing the risk of developing cancer by treating periodontal infections is just another compelling reason to visit your healthcare provider and request MyPerioPath®.

Many dental and medical practitioners are incorporating an overall health approach. We have invited one of those teams, Michael C. Rogers, DMD, to share how they present to a patient, communicating the link between periodontal pathogens and cancer.

Michael C. Rogers DDS: We say to our patients: “Your mouth is the gateway to the rest of your body meaning what we see in there is a snapshot of what is going on in other parts of your body. The bacteria that you have in your mouth can get into your blood stream and travel to other organs. Current medical studies show that these bacteria are linked to major medical conditions such as diabetes, heart attack, stroke, Alzheimer’s disease and cancers. If diagnosed with periodontal disease, your body must fight this chronic infection 24 hours a day, which weakens your immune system, compromising your overall health. There are specific bacteria in your mouth that are linked to different types of cancers such as esophageal, colon, pancreatic and breast. A simple non-invasive salivary test, that we can do right now, will screen not only for the bacteria that are known to cause gum disease, bone and tooth loss, but linked to cancer and major medical diseases as well.

I cannot predict that you will or will not get cancer due to these bacteria, but the best approach is to do everything we can to not get cancer in the first place. Eliminating the pathogenic/problematic oral bacteria and addressing other risk factors, such as sugar in our diet that feed the bacteria, mutagenic (processed) foods, alcohol and tobacco products, will greatly reduce your risk of developing cancer. So, let’s get started today by addressing the bacterial infection you have by using this simple salivary test to find out what we’re fighting.”

References:

  1. Zeng XT, Xia LY, Zhang YG, Li S, Leng WD, Kwong JS. Periodontal Disease and Incident Lung Cancer Risk: A Meta-Analysis of Cohort Studies. J Periodontol 2016:1-13.
  2. Jacob JA. Study Links Periodontal Disease Bacteria to Pancreatic Cancer Risk. JAMA 2016;315:2653-4.
  3. Nieminen MT, Listyarifah D, Hagstrom J, et al. Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation. Br J Cancer 2018;118:428-34.
  4. Baba Y, Iwatsuki M, Yoshida N, Watanabe M, Baba H. Review of the gut microbiome and esophageal cancer: Pathogenesis and potential clinical implications. Ann Gastroenterol Surg 2017;1:99-104.
  5. Amitay EL, Werner S, Vital M, et al. Fusobacterium and colorectal cancer: causal factor or passenger? Results from a large colorectal cancer screening study. Carcinogenesis 2017;38:781-8.
  6. Yamamura K, Baba Y, Nakagawa S, et al. Human Microbiome Fusobacterium Nucleatum in Esophageal Cancer Tissue Is Associated with Prognosis. Clin Cancer Res 2016;22:5574-81.
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Michael C. Rogers, DDS