Oncology
|
October 15, 2024

Exploring the Presence of Bacteria in Tumors

Medically Reviewed by
Updated On
October 28, 2024

The discovery of microorganisms, such as bacteria, fungi, and parasites, inside cancer cells dates back to 1884. However, when 19th-century research methods failed to identify these microorganisms, the theory of microbial involvement in cancer lost traction.(24,58) Since then, oncology (cancer) and microbiology (bacteria) have largely been treated as separate fields in research and medicine.Β Β 

Recent scientific advancements have reignited interest in the role of microorganisms in cancer development. Researchers are now studying how these microorganisms may influence tumor cell behavior, with the goal of uncovering new insights that could guide future treatments and diagnostic approaches.Β 

This article discusses the nature of intratumoral and intracellular bacteria, how bacteria enter tumors and cancer cells, their effects on cancer progression and treatment, and the ongoing research in this field.

[signup]

Intratumoral and/or Intracellular Bacteria

Bacteria may be found in the tumor microenvironment, which is often immune-suppressed, where they can access nutrients and avoid some immune responses.(53) The distinction between β€œintratumoral” and β€œintracellular” bacteria commonly refers to their location.Β 

  • Intracellular bacteria reside inside cancer cells, affecting cancer cells from within.
  • Intratumoral bacteria are located in the tumor adjacent to the cancer cells and influence cancer cells from outside interactions within the tumor microenvironment.Β Β 

Getting Inside the Cancer Cells

Bacteria are typically about 1/10 the size of the average cancer cell and invade cancer cells through two primary methods: the trigger or the zipper mechanisms.(2,49,57)

  • Trigger: Bacteria β€œbreak into” the cancer cells by manipulating the cell’s surface, forcing the cancer cell to engulf the bacteria, similar to a burglar prying open a door.
  • Β Zipper: Similar to a lock and key, proteins on the bacteria’s cell surface bind to receptors on the cancer cell’s surface. This interaction causes the cancer cell membrane to "zip" around the bacteria, drawing them inside methodically.

After the bacteria enter the cancer cell, they are typically enclosed in a vacuole β€”a membrane-bound compartment within the cell that helps manage waste and foreign substances. Some bacteria, such as Shigella, have evolved mechanisms to escape the vacuole and survive within the host cell, allowing them to avoid immune detection and replicate freely.(55) Other bacteria use different strategies to bypass and escape the vacuole.(63)

Once bacteria are inside cancer cells, they use the cancer cell’s machinery for their own survival and replication. While doing this, bacteria feed off of the cancer's nutrients and often escape immune surveillance (62). These bacteria are often called tumor-resident intracellular microbiota (TRIM).Β 

The percentage of cancers containing bacterial DNA may vary by cancer type – ranging from 14% for melanoma to over 60% for breast, pancreatic, and bone cancers.(53) Cancers that have suggested bacterial presence include:

o Β  Esophageal

o Β  Melanoma

o Β  Breast

o Β  Liver

o Β  Pancreatic

o Β  Oral

o Β  Lung

o Β  Gastric

o Β  Colorectal

o Β  Cervical

o Β  Prostate

Where Do the Bacteria Come From?

Most intratumoral and intracellular bacteria come from the body’s own microbiota, including healthy bacteria from the GI tract, mouth, nose, and throat. These bacteria may become harmful when they move to tissues where they don’t belong. As tumors grow, they can disrupt epithelial and mucosal barriers, allowing bacteria from adjacent tissues to invade.Β 

This situation is especially relevant in colorectal cancer, where the proximity of the GI tract makes bacterial migration into the tumor microenvironment more likely.(59) Because of this, intratumoral and intracellular bacteria in colorectal cancer is one of the most studied areas. The exact mechanisms by which bacteria travel to tumor microenvironments is unclear, but bacteria are capable of traveling through the bloodstream and the lymphatic system where they can spread to other tissues.(56,61)Β 

Since bacteria typically found in the GI tract has been observed in other cancer types (ex. breast and liver), researchers are actively investigating the connection between intratumoral microbiota and the gut microbiome.(18,26,34)Β 

Some cases have also reported intratumoral or intracellular bacteria that originated from food, water, or surgical procedure contamination.(25,28,45)Β 

The Chicken or The Egg

Which came first? Many wonder whether bacteria can cause cancer or whether they merely thrive in the cancerous environment. Currently, Helicobacter Pylori (H. Pylori), an intracellular bacteria, in gastric cancer is the first and only bacterium recognized by the World Health Organization (WHO) to potentially cause cancer (carcinogen).Β 

H. Pylori can induce chronic inflammation and adversely affect cellular pathways, triggering gastritis and subsequently gastric cancer.(43) While this bacterium’s carcinogenic role is established, researchers are just beginning to uncover other bacteria’s role in cancer development and metastasis.Β 

Intratumoral and Intracellular Bacteria Effects on Cancer

Intracellular bacteria, which invade and live inside cancer cells, can alter cell signaling pathways, cause chronic inflammation, and evade immune detection β€” all factors that contribute to cancer progression and metastasis.Β 

  • Bacterial invasion in cells can trigger strong immune responses, including the recruitment of immune cells through pro-inflammatory signaling cascades.Β 
  • Certain bacteria may produce toxins, such as reactive oxygen species (ROS), and metabolites that promote DNA damage, leading to mutations that drive cancer development.(20,33,54)Β 
  • Recent studies have highlighted the role of intracellular bacteria in promoting breast cancer metastasis.(37)

Growing evidence suggests that bacteria can interfere with the effectiveness of cancer treatments, such as chemotherapy and immunotherapy. For example:

  • Some studies suggest bacteria could interact with chemotherapy drugs, potentially impacting their effectiveness, or influence immune responses in ways that might affect immunotherapy outcomes. This interference can cause drug resistance and increase the likelihood of cancer relapse after treatment.Β 
  • Additionally, bacteria can inhibit autophagy in cancer cellsβ€”a process by which cells degrade and recycle their componentsβ€”further contributing to chemotherapy resistance.(29,39,46,63,69)Β 
  • Bacteria can also enhance the toxicity of certain drugs to normal tissues, worsening side effects and further promoting pro-inflammatory responses.(65)Β 

Consequently, understanding the interactions between bacteria and cancer therapies has become an important area of research for improving treatment outcomes.Β Β 

Ongoing Research

Ongoing research is exploring how intratumoral and intracellular bacteria may interact with cancer cells, potentially influencing inflammation, DNA interactions, and cellular pathways that could impact cancer progression and treatment responses. These factors differ for each type of cancer and each type of bacteria, which means we have only scraped the surface.Β 

Given bacteria’s potential role in drug resistance, there is increased interest in combining antibiotics with anti-cancer treatments. However, antibiotics’ lack of specificity to intratumoral or intracellular bacteria poses a challenge, as their broad-spectrum action can disrupt the patient’s gut microbiota, which can influence the efficacy of immune checkpoint inhibitors and chemotherapy.(35,38,41)

A recent mouse study overcame this hurdle by combining anti-cancer and antibiotic treatments into a nanoparticle formulation selective for cancer cells which restored anti-tumor immune surveillance and reduced cancer relapse.(65)Β 

Because of bacteria’s preference for tumor microenvironments, identifying unique microbial signatures from bacteria could be used as diagnostic and prognostic biomarkers for cancer screening or predictions of cancer metastasis. Ongoing studies are currently exploring this idea in lung, oral, esophageal, and colorectal cancer.(27,42,70)

Scientists are also investigating the use of bacteria as potential drug or gene delivery vehicles, taking advantage of their ability to specifically target tumors.(60) Certain bacteria, such as Salmonella and Listeria, have already shown potential as anti-tumor agents in preclinical studies and clinical trials.(50,52,64) The bacteria could be engineered to deliver tumor-suppressor genes, anti-angiogenic genes (which inhibit blood vessel formation), or other therapeutic agents directly to the tumor site.(36,44,52,60)

[signup]

Key Takeaways

The emerging role of intratumoral and intracellular bacteria in cancer biology marks a significant shift in how we understand tumorigenesis and cancer treatment. These microorganisms, once overlooked, are now recognized as significant contributors to cancer. Key takeaways from this article include:

  • Intratumoral and intracellular bacteria may play a role in cancer progression and metastasis, potentially influencing tumor environments, immune responses, and cell behavior.
  • Intratumoral and intracellular bacteria can alter therapeutic response and contribute to therapeutic resistance in cancer therapies, interfering with chemotherapy and immunotherapy, leading to drug resistance, relapse, and heightened toxicity in cancer treatments.
  • Ongoing research is dedicated to understanding the role bacteria play in cancer treatment.

As research continues to unravel the intricate relationships between bacteria and cancer cells, new opportunities may arise for microbial-based diagnostics and therapies. Future research holds promise for transforming cancer care and enhancing patient outcomes.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

Learn more

No items found.

Lab Tests in This Article

No lab tests!

1. (2022). Chemotherapy. Retrieved from https://my.clevelandclinic.org/health/treatments/16859-chemotherapy

2. Experiments Using Tumor Cell Lines. Retrieved from https://ccr.cancer.gov/pediatric-oncology-branch/gist-clinic/research/cell-line#:~:text=The%20size%20of%20an%20average,is%20approximately%2010%2D20%20microns.

3. (2022). Immune Checkpoint Inhibitors. Retrieved from https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/checkpoint-inhibitors

4. (2022). Immunotherapy. Retrieved from https://my.clevelandclinic.org/health/treatments/11582-immunotherapy

5. (2022). In brief: What are microbes? Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279387/

6. (2023). Liver Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/liver-cancer/symptoms-causes/syc-20353659

7. (2024). Mouth Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/syc-20350997

8. (2023). Ovarian Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941

9. (2024). Pancreatic Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421

10. (2024). Prostate Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087

11. (2024). Stomach Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/stomach-cancer/symptoms-causes/syc-20352438#:~:text=Stomach%20cancer%2C%20which%20is%20also,that%20starts%20in%20the%20stomach.

12. (2024). Vacuole. Retrieved from https://www.genome.gov/genetics-glossary/Vacuole

13. What is Microbiology? Retrieved from https://microbiologysociety.org/why-microbiology-matters/what-is-microbiology.html

14. (2024). What Is Oncology? Retrieved from https://www.cancer.org/cancer/managing-cancer/finding-care/what-is-oncology.html

15. Achuff J. (2024). Navigating Diet, Genetics, and Colorectal Cancer Risk. Rupa Health. Retrieved from https://www.rupahealth.com/post/navigating-diet-genetics-and-colorectal-cancer-risk

16. Achuff J. (2024). The Power of Microbiome Diversity: A Shield Against Pathogen Invasion. Rupa Health. Retrieved from https://www.rupahealth.com/post/the-power-of-microbiome-diversity-a-shield-against-pathogen-invasion

17. Alhmoud JF, Woolley JF, Al Moustafa AE,Malki MI. (2020). DNA Damage/Repair Management in Cancers. Cancers (Basel), 12(4). doi:10.3390/cancers12041050 https://www.ncbi.nlm.nih.gov/pubmed/32340362

18. Alvarez-Mercado AI, Del Valle Cano A, Fernandez MF,Fontana L. (2023). Gut Microbiota and Breast Cancer: The Dual Role of Microbes. Cancers (Basel), 15(2). doi:10.3390/cancers15020443 https://www.ncbi.nlm.nih.gov/pubmed/36672391

19. Anderson NM,Simon MC. (2020). The tumor microenvironment. Curr Biol, 30(16), R921-R925. doi:10.1016/j.cub.2020.06.081 https://www.ncbi.nlm.nih.gov/pubmed/32810447

20. Arthur JC, Perez-Chanona E, Muhlbauer M, et al. (2012). Intestinal inflammation targets cancer-inducing activity of the microbiota. Science, 338(6103), 120-3. doi:10.1126/science.1224820 https://www.ncbi.nlm.nih.gov/pubmed/22903521

21. Bardaweel SK, Gul M, Alzweiri M, Ishaqat A, HA AL,Bashatwah RM. (2018). Reactive Oxygen Species: the Dual Role in Physiological and Pathological Conditions of the Human Body. Eurasian J Med, 50(3), 193-201. doi:10.5152/eurasianjmed.2018.17397 https://www.ncbi.nlm.nih.gov/pubmed/30515042

22. Bryant A. (2024). Esophageal Cancer: Causes, Diagnosis, Staging, and Treatments. Rupa Health. Retrieved from https://www.rupahealth.com/post/esophageal-cancer-causes-diagnosis-staging-treatments

23. Bryant A. (2024). The Staging of Lung Cancer and How to Treat with Integrative Medicine. Rupa Health. Retrieved from https://www.rupahealth.com/post/the-staging-of-lung-cancer-and-how-to-treat-with-integrative-medicine

24. Butlin HT. (1884). Malignant Tumours and Parasitism. Br Med J.Β  https://pubmed.ncbi.nlm.nih.gov/20750785/

25. Chakladar J, Kuo SZ, Castaneda G, et al. (2020). The Pancreatic Microbiome is Associated with Carcinogenesis and Worse Prognosis in Males and Smokers. Cancers (Basel), 12(9). doi:10.3390/cancers12092672 https://www.ncbi.nlm.nih.gov/pubmed/32962112

26. Chang CM,Pekkle Lam HY. (2024). Intratumoral Microbiota: Unraveling their Oncogenic Impact on Cancer Progression With Focus on Breast Cancer Therapeutic Outcomes. Anticancer Res, 44(6), 2271-2285. doi:10.21873/anticanres.17035 https://www.ncbi.nlm.nih.gov/pubmed/38821615

27. Chen H, Ma Y, Xu J, et al. (2024). Circulating microbiome DNA as biomarkers for early diagnosis and recurrence of lung cancer. Cell Rep Med, 5(4), 101499. doi:10.1016/j.xcrm.2024.101499 https://www.ncbi.nlm.nih.gov/pubmed/38582085

28. Choi JK, Naffouje SA, Goto M, et al. (2023). Cross-talk between cancer and Pseudomonas aeruginosa mediates tumor suppression. Commun Biol, 6(1), 16. doi:10.1038/s42003-022-04395-5https://www.ncbi.nlm.nih.gov/pubmed/36609683

29. Choi Y, Lichterman JN, Coughlin LA, et al. (2023). Immune checkpoint blockade induces gut microbiota translocation that augments extraintestinal antitumor immunity. Sci Immunol, 8(81), eabo2003. doi:10.1126/sciimmunol.abo2003 https://www.ncbi.nlm.nih.gov/pubmed/36867675

30. Cicchese JM, Evans S, Hult C, et al. (2018). Dynamic balance of pro- and anti-inflammatory signals controls disease and limits pathology. Immunol Rev, 285(1), 147-167. doi:10.1111/imr.12671 https://www.ncbi.nlm.nih.gov/pubmed/30129209

31. Cloyd J. (2024). Antibiotics 101: What You Need To Know. Rupa Health. Retrieved from https://www.rupahealth.com/post/antibiotics-101-what-you-need-to-know

32. Connor B. (2024). Helicobacter pylori. Retrieved from https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/helicobacter-pylori#:~:text=Designated%20as%20a%20carcinogen%20by,for%20non%2Dcardia%20gastric%20adenocarcinoma.

33. Dejea CMF, P.; Craig, J. M.; Boleij, A.; Taddese, R.; Geis, A. L.; Wu, X.; DeStefano Shields, C. E.; Hechenbleikner, E. M.; Huso, D. L.; Anders, R. A.; Giardiello, F. M.; Wick, E. C.; Wang, H.; Wu, S.; Pardoll, D. M.; Housseau, F.; Sears, C. L. . (2018). Patients with familial adenomatous polyposis harbor colonic biofilms containing tumorigenic bacteria. Science, 359, 592-597.Β  https://pubmed.ncbi.nlm.nih.gov/29420293/

34. Effenberger M, Waschina S, Bronowski C, et al. (2023). A gut bacterial signature in blood and liver tissue characterizes cirrhosis and hepatocellular carcinoma. Hepatol Commun, 7(7). doi:10.1097/HC9.0000000000000182 https://www.ncbi.nlm.nih.gov/pubmed/37314752

35. Elkrief A, El Raichani L, Richard C, et al. (2019). Antibiotics are associated with decreased progression-free survival of advanced melanoma patients treated with immune checkpoint inhibitors. Oncoimmunology, 8(4), e1568812. doi:10.1080/2162402X.2019.1568812 https://www.ncbi.nlm.nih.gov/pubmed/30906663

36. Felgner S, Kocijancic D, Frahm M, et al. (2018). Engineered Salmonella enterica serovar Typhimurium overcomes limitations of anti-bacterial immunity in bacteria-mediated tumor therapy. Oncoimmunology, 7(2), e1382791. doi:10.1080/2162402X.2017.1382791 https://www.ncbi.nlm.nih.gov/pubmed/29308303

37. Fu AY, B.; Dong, T.; Chen, Y.; Yao, J.; Liu, Y.; Li, H.; Bai, H.; Liu, X.; Zhang, Y.; Wang, C.; Guo, Y.; Li, N.; Cai, S. (2022). Tumor-resident intracellular microbiota promotes metastatic colonization in breast cancer. Cell, 185, 1356-1372.Β  https://pubmed.ncbi.nlm.nih.gov/35395179/

38. Gao Y, Shang Q, Li W, et al. (2020). Antibiotics for cancer treatment: A double-edged sword. J Cancer, 11(17), 5135-5149. doi:10.7150/jca.47470 https://www.ncbi.nlm.nih.gov/pubmed/32742461

39. Geller LT, Barzily-Rokni M, Danino T, et al. (2017). Potential role of intratumor bacteria in mediating tumor resistance to the chemotherapeutic drug gemcitabine. Science, 357(6356), 1156-1160. doi:10.1126/science.aah5043 https://www.ncbi.nlm.nih.gov/pubmed/28912244

40. Glick D, Barth S,Macleod KF. (2010). Autophagy: cellular and molecular mechanisms. J Pathol, 221(1), 3-12. doi:10.1002/path.2697 https://www.ncbi.nlm.nih.gov/pubmed/20225336

41. Gopalakrishnan V, Spencer CN, Nezi L, et al. (2018). Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients. Science, 359(6371), 97-103. doi:10.1126/science.aan4236 https://www.ncbi.nlm.nih.gov/pubmed/29097493

42. Huang J,Huang J. (2022). Microbial Biomarkers for Lung Cancer: Current Understandings and Limitations. J Clin Med, 11(24). doi:10.3390/jcm11247298 https://www.ncbi.nlm.nih.gov/pubmed/36555915

43. Ishaq SN, L. (2015). Helicobacter pylori and gastric cancer: a state of the art review. Gastroenterol Hepatol Bed Bench., 8.Β  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495426/

44. Jia LJ, Wei DP, Sun QM, Huang Y, Wu Q,Hua ZC. (2007). Oral delivery of tumor-targeting Salmonella for cancer therapy in murine tumor models. Cancer Sci, 98(7), 1107-12. doi:10.1111/j.1349-7006.2007.00503.x https://www.ncbi.nlm.nih.gov/pubmed/17498202

45. Khodavirdipour A, Jamshidi F, Nejad HR, Zandi M,Zarean R. (2021). To Study the Anti-cancer Effects of Shigella Flexneri in AspC-1 Pancreatic Cancer Cell Line in Approach to Bax and bcl-2 Genes. J Gastrointest Cancer, 52(2), 593-599. doi:10.1007/s12029-020-00433-9 https://www.ncbi.nlm.nih.gov/pubmed/32524303

46. Mager LF, Burkhard R, Pett N, et al. (2020). Microbiome-derived inosine modulates response to checkpoint inhibitor immunotherapy. Science, 369(6510), 1481-1489. doi:10.1126/science.abc3421 https://www.ncbi.nlm.nih.gov/pubmed/32792462

47. Malani S. (2024). An Integrative Medicine Approach to Breast Cancer Prevention. Rupa Health. Retrieved from https://www.rupahealth.com/post/an-integrative-medicine-approach-to-melanoma

48. Mansoori B, Mohammadi A, Davudian S, Shirjang S,Baradaran B. (2017). The Different Mechanisms of Cancer Drug Resistance: A Brief Review. Adv Pharm Bull, 7(3), 339-348. doi:10.15171/apb.2017.041 https://www.ncbi.nlm.nih.gov/pubmed/29071215

49. Mendelaar PAJ, Kraan J, Van M, et al. (2021). Defining the dimensions of circulating tumor cells in a large series of breast, prostate, colon, and bladder cancer patients. Mol Oncol, 15(1), 116-125. doi:10.1002/1878-0261.12802 https://www.ncbi.nlm.nih.gov/pubmed/32949099

50. Mills H, Acquah R, Tang N, et al. (2022). The Use of Bacteria in Cancer Treatment: A Review from the Perspective of Cellular Microbiology. Emerg Med Int, 2022, 8127137. doi:10.1155/2022/8127137 https://www.ncbi.nlm.nih.gov/pubmed/35978704

51. Mitchell MJ, Billingsley MM, Haley RM, Wechsler ME, Peppas NA,Langer R. (2021). Engineering precision nanoparticles for drug delivery. Nat Rev Drug Discov, 20(2), 101-124. doi:10.1038/s41573-020-0090-8 https://www.ncbi.nlm.nih.gov/pubmed/33277608

52. Nallar SC, Xu DQ,Kalvakolanu DV. (2017). Bacteria and genetically modified bacteria as cancer therapeutics: Current advances and challenges. Cytokine, 89, 160-172. doi:10.1016/j.cyto.2016.01.002 https://www.ncbi.nlm.nih.gov/pubmed/26778055

53. Nejman D, Livyatan I, Fuks G, et al. (2020). The human tumor microbiome is composed of tumor type-specific intracellular bacteria. Science, 368(6494), 973-980. doi:10.1126/science.aay9189 https://www.ncbi.nlm.nih.gov/pubmed/32467386

54. Nougayrede JP, Homburg S, Taieb F, et al. (2006). Escherichia coli induces DNA double-strand breaks in eukaryotic cells. Science, 313(5788), 848-51. doi:10.1126/science.1127059 https://www.ncbi.nlm.nih.gov/pubmed/16902142

55. Ray K, Marteyn B, Sansonetti PJ,Tang CM. (2009). Life on the inside: the intracellular lifestyle of cytosolic bacteria. Nat Rev Microbiol, 7(5), 333-40. doi:10.1038/nrmicro2112 https://www.ncbi.nlm.nih.gov/pubmed/19369949

56. Ribet D,Cossart P. (2015). How bacterial pathogens colonize their hosts and invade deeper tissues. Microbes Infect, 17(3), 173-83. doi:10.1016/j.micinf.2015.01.004 https://www.ncbi.nlm.nih.gov/pubmed/25637951

57. Riley M. (1999). Correlates of Smallest Sizes for Microorganisms. In Size Limits of Very Small Microorganisms: Proceedings of a Workshop. https://www.ncbi.nlm.nih.gov/books/NBK224751/

58. Russell W. (1890). An address on a characteristic organism of cancer. Br Med J., 1356-1360.Β  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2208600/

59. Schorr L, Mathies M, Elinav E,Puschhof J. (2023). Intracellular bacteria in cancer-prospects and debates. NPJ Biofilms Microbiomes, 9(1), 76. doi:10.1038/s41522-023-00446-9 https://www.ncbi.nlm.nih.gov/pubmed/37813921

60. Sedighi M, Zahedi Bialvaei A, Hamblin MR, et al. (2019). Therapeutic bacteria to combat cancer; current advances, challenges, and opportunities. Cancer Med, 8(6), 3167-3181. doi:10.1002/cam4.2148 https://www.ncbi.nlm.nih.gov/pubmed/30950210

61. Siggins MK, Lynskey NN, Lamb LE, et al. (2020). Extracellular bacterial lymphatic metastasis drives Streptococcus pyogenes systemic infection. Nat Commun, 11(1), 4697. doi:10.1038/s41467-020-18454-0 https://www.ncbi.nlm.nih.gov/pubmed/32943639

62. Stelzner K, Vollmuth N,Rudel T. (2023). Intracellular lifestyle of Chlamydia trachomatis and host-pathogen interactions. Nat Rev Microbiol, 21(7), 448-462. doi:10.1038/s41579-023-00860-y https://www.ncbi.nlm.nih.gov/pubmed/36788308

63. Tang B, Lu X, Tong Y, et al. (2023). MicroRNA-31 induced by Fusobacterium nucleatum infection promotes colorectal cancer tumorigenesis. iScience, 26(5), 106770. doi:10.1016/j.isci.2023.106770 https://www.ncbi.nlm.nih.gov/pubmed/37216106

64. Tangney MvP, J. P.; Gahan, C. G. M. (2010). The use of Listeria monocytogenes as a DNA delivery vector for cancer gene therapy. Bioeng Bugs., 1(4), 284-287. doi:10.1089/hum.2009.022 https://www.ncbi.nlm.nih.gov/pubmed/20105075

65. Wang Y, Han Y, Yang C, et al. (2024). Long-term relapse-free survival enabled by integrating targeted antibacteria in antitumor treatment. Nat Commun, 15(1), 4194. doi:10.1038/s41467-024-48662-x https://www.ncbi.nlm.nih.gov/pubmed/38760364

66. Weinberg JL. (2024). An Integrative Medicine Approach to Gastritis. Rupa Health. Retrieved from https://www.rupahealth.com/post/6-natural-treatments-for-gastritis

67. Weinberg JL. (2024). A Root Cause Medicine Approach to Melanoma. Rupa Health. Retrieved from https://www.rupahealth.com/post/an-integrative-medicine-approach-to-melanoma

68. Yang L, Li A, Wang Y,Zhang Y. (2023). Intratumoral microbiota: roles in cancer initiation, development and therapeutic efficacy. Signal Transduct Target Ther, 8(1), 35. doi:10.1038/s41392-022-01304-4 https://www.ncbi.nlm.nih.gov/pubmed/36646684

69. Yu T, Guo F, Yu Y, et al. (2017). Fusobacterium nucleatum Promotes Chemoresistance to Colorectal Cancer by Modulating Autophagy. Cell, 170(3), 548-563 e16. doi:10.1016/j.cell.2017.07.008 https://www.ncbi.nlm.nih.gov/pubmed/28753429

70. Zeller G, Tap J, Voigt AY, et al. (2014). Potential of fecal microbiota for early-stage detection of colorectal cancer. Mol Syst Biol, 10(11), 766. doi:10.15252/msb.20145645 https://www.ncbi.nlm.nih.gov/pubmed/25432777

Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless β€” and best of all, it's free for practitioners.

Latest Articles

View more on Oncology
Subscribe to the magazine for expert-written articles straight to your inbox
Join the thousands of savvy readers who get root cause medicine articles written by doctors in their inbox every week!
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey Practitioners! On December 11th, join Dr. Terry Wahls in a free live class where she'll share her groundbreaking methods for managing MS and autoimmune patients. This live session will address your most pressing questions and will take a closer look at treatment options beyond the conventional standards of care. Register here.

Register Here