Nav: Home

Does lung damage speed pancreatic cancer?

January 29, 2020

(PHILADELPHIA) -Chronic obstructive pulmonary disease or COPD is associated with higher rates of many cancers, including lung, esophagus, colon, bladder and breast cancer. Often a result of many years of smoking, the disease makes it hard to breathe, leaving patients with lower levels of oxygen and higher levels of carbon dioxide in their blood. Low oxygen, called hypoxia, is a known feature of the pancreatic cancer microenvironment and a contributor to tumor aggressiveness and resistance to therapy. However, the impact of high CO2 levels on pancreatic cancer has been considerably less studied.

Recent work from the Division of Surgical Research in the Jefferson Pancreas, Biliary, and Related Cancer Center demonstrates that CO2 drives both the aggressiveness of pancreatic tumor cells and their resistance to treatment. The research findings were published as an "article in press" on the website of the Journal of the American College of Surgeons on January 29th, ahead of print, and offers the possibility of correcting these levels prior to treatment.

"Patients with these respiratory diseases usually start to accumulate excess CO2 in their bodies before they develop symptomatic lack of oxygen," says first author Avinoam Nevler, MD, a researcher with the Sidney Kimmel Cancer Center (SKCC) - Jefferson Health, and at the department of surgery. "If carbon dioxide indeed contributes to disease progression, we may have an opportunity to improve treatment response not only by focusing on oxygen, but by normalizing carbon dioxide levels in patients as well."

Dr. Nevler, together with PhD candidate Samantha Brown and senior authors Jonathan Brody, PhD, co-leader of the SKCC GI Cancer Program, and Charles Yeo, MD, Chair of the Department of Surgery and others looked at both pancreatic tumor cell lines in the lab and historical patient data for associations between obstructive pulmonary diseases and pancreatic cancer.

Earlier research had shown that the pancreatic tumor microenvironment harbors increased levels of CO2. Here, the team showed that increasing the CO2 in cell cultures to levels observed in pulmonary patients was enough to increase their growth and aggressiveness. When these high-CO2-cultured cells were then treated with common chemotherapeutic agents and radiation therapy, they showed increased resistance compared to cells cultured in normal CO2 conditions.

The researchers also looked at whether they could see the same relationship in people. Dr. Nevler and colleagues queried pancreatic-cancer patient surgical records for those who also had a diagnosis of asthma or COPD. Although it was impossible to separate the contribution of CO2 and oxygen levels in these patients, the researchers did see that of the 578 patients they examined, cases with chronic lung disease patients had a 60% increased risk of cancer recurrence.

"Although there's more work to do in order to solidify the association we're seeing," says Dr. Nevler, "what's really exciting is that carbon dioxide levels can be reduced in patients through smoking cessation, using a tailored exercise and respiratory therapy regimen and even changing the diet. We are currently in the process of designing a clinical trial to test these modalities and hopefully extend patients' lives by normalizing CO2 levels and re-sensitizing the cancers to standard pancreatic chemotherapy," says Dr. Nevler.
This work was supported by a Mary Halinski Fellowship, the W. Kim Foster Pancreatic Cancer Research Endowment, and in part, with grant support from the Newell Devalpine Foundation. J.R. Brody is supported by an NIH-NCI R01 CA212600 grant and also supported by the NCI of the NIH under Award Number P30CA056036 SKCC Core Grant to K.Knudsen, Thomas Jefferson University.

Article Reference: Avinoam Nevler, Samantha Z. Brown, David Nauheim, Carla Portocarrero, Jonathan Bassig, Christopher W. Schultz, Grace A. McCarthy, Harish Lavu, Theresa P. Yeo, Charles J. Yeo, and Jonathan R. Brody, "The late effects of smoking: hypercapnia, and element of obstructive respiratory disorders, contributes to pancreatic cancer chemoresistance and progression," JACS, 2019.

Media Contact: Edyta Zielinska, 215-955-7359,

Thomas Jefferson University

Related Pancreatic Cancer Articles:

Bringing the 'sticky' back to pancreatic cancer
A multidisciplinary team of researchers at Japan's Tohoku University has found that a gene regulator, called BACH1, facilitates the spread of pancreatic cancer to other parts of the body.
Does lung damage speed pancreatic cancer?
High levels of CO2 in the body, due to chronic respiratory disorders, may exacerbate pancreatic cancer, making it more aggressive and resistant to therapy.
Scientists have identified the presence of cancer-suppressing cells in pancreatic cancer
Researchers have identified cells containing a protein called Meflin that has a role in restraining the progression of pancreatic cancer.
Pancreatic cancer discovery reveals how the aggressive cancer fuels its growth
A new discovery about pancreatic cancer sheds light on how the cancer fuels its growth and may help explain how promising cancer drugs work -- and for whom they will fail.
Overcoming resistance in pancreatic cancer
In pancreatic cancer cells' struggle to survive, the cells choose alternative routes when their main pathways are blocked by drugs.
Exposing how pancreatic cancer does its dirty work
Pancreatic cancer is a puzzle -- tumors slough off cells into the bloodstream early in the disease, but the tumors themselves have almost no blood vessels in them.
Targeting cell division in pancreatic cancer
Study provides new evidence of synergistic effects of drugs that inhibit cell division and support for further clinical trials.
Key to targeting the spread of pancreatic cancer
Targeting the tissue around pancreatic cancer cells may be the key to stopping their spread and improving chemotherapy outcomes.
Reprogramming pancreatic cancer
A type of white blood cell that has been especially susceptible to being deceived by pancreatic cancer cells into not attacking them can be 're-programmed' via a specially designed molecule that activates a protein found on their surfaces.
Pancreatic cancer collective comments on promising new pancreatic cancer
Lustgarten Foundation and SU2C offer comments on research describing a new combination drug therapy demonstrating promise for patients with pancreatic cancer.
More Pancreatic Cancer News and Pancreatic Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Debbie Millman: Designing Our Lives
From prehistoric cave art to today's social media feeds, to design is to be human. This hour, designer Debbie Millman guides us through a world made and remade–and helps us design our own paths.
Now Playing: Science for the People

#574 State of the Heart
This week we focus on heart disease, heart failure, what blood pressure is and why it's bad when it's high. Host Rachelle Saunders talks with physician, clinical researcher, and writer Haider Warraich about his book "State of the Heart: Exploring the History, Science, and Future of Cardiac Disease" and the ails of our hearts.
Now Playing: Radiolab

Insomnia Line
Coronasomnia is a not-so-surprising side-effect of the global pandemic. More and more of us are having trouble falling asleep. We wanted to find a way to get inside that nighttime world, to see why people are awake and what they are thinking about. So what'd Radiolab decide to do?  Open up the phone lines and talk to you. We created an insomnia hotline and on this week's experimental episode, we stayed up all night, taking hundreds of calls, spilling secrets, and at long last, watching the sunrise peek through.   This episode was produced by Lulu Miller with Rachael Cusick, Tracie Hunte, Tobin Low, Sarah Qari, Molly Webster, Pat Walters, Shima Oliaee, and Jonny Moens. Want more Radiolab in your life? Sign up for our newsletter! We share our latest favorites: articles, tv shows, funny Youtube videos, chocolate chip cookie recipes, and more. Support Radiolab by becoming a member today at