Can a Saliva Test Spot Early Pancreatic Cancer?
Early Research Suggests Bacteria in the Mouth May One Day Help Diagnose Pancreatic Cancer
Test Not Ready for Prime Time
Margaret Tempero, MD, says the new paper is interesting, exciting, and evocative, but a lot more work is needed. She is the director of research programs and deputy director at the UCSF Helen Diller Family Comprehensive Cancer Center in San Francisco.
"Everybody would agree that an early diagnostic test for pancreatic cancer would be the key ingredient to curing more patients," says Tempero, who is also a member of the Pancreatic Cancer Action Network's scientific advisory board. "We know that if we can diagnose pancreatic cancer early and if we have a chance to remove the cancer, we can cure it, so anything that gets us close to that is important."
But -- and it's a big but -- it's not likely there will ever be a simple indicator that says you've got pancreatic cancer.
"Taking a blood test or a swab of saliva and saying we have a test for pancreatic cancer isn't likely to happen," she says.
Such a test may one day be the first layer in a screening program.
"We may get a group of people in whom we can say, 'This pancreas is not right,' and therefore we should do more testing," Tempero says. In these cases, people could get follow-up with specialized imaging tests to look at the pancreas to see exactly what is going on.
"This study is provocative," agrees Peter Kozuch, MD. He's a pancreatic cancer expert at Beth Israel and St. Luke's-Roosevelt Hospitals, which are part of the Continuum Cancer Centers of New York.
"There is an unmet need for identifying pancreatic cancer or precancerous lesions in the pancreas as early as possible because this disease, once advanced, is highly [lethal]" says Kozuch. He is also an associate professor of clinical medicine at Albert Einstein College of Medicine in the Bronx, N.Y.
Still, this test is not ready for prime time yet, he says.
To really develop an early detection program for pancreatic, or any, cancer, "we need to identify an at-risk group, a method for finding the disease at an early point, and an intervention that improves survival," Kozuch tells WebMD.
The new study may help with the first step in this multistep process, he says.
Gagandeep Singh, MD, is less optimistic about the possibility of diagnosing pancreatic cancer based on bacteria in saliva. He is the chief of hepatobiliary and pancreatic surgery at the City of Hope, a cancer center located in Duarte, Calif.
It does, however, help advance the theory that chronic inflammation may increase the risk for pancreatic cancer, he tells WebMD.
"Chronic inflammation is definitely associated with chronic pancreatitis, which may be a risk for pancreatic cancer," Singh says. Gum disease can be a sign of inflammation in the mouth.
"We can't say that inflammation in your mouth is a representation of pancreatic cancer or chronic pancreatitis yet," he says.