Cancer patients may one day be given faecal transplants to boost their levels of ‘good bacteria’ and prevent damage to their gut from radiotherapy
- Radiotherapy treatment can cause gastrointestinal problems such as diarrhoea
- Patients with a lower diversity of gut bacteria had higher odds of the side effects
- They hope they could prevent symptoms like diarrhoea by improving gut health
Cancer patients could in the future be given a boost of ‘good bacteria’ from a faecal transplant to prevent damage to their gut from radiotherapy, scientists say.
People with pelvic, prostate and gynaecological cancers frequently face gut damage from their treatment. It can lead to symptoms such as diarrhoea, pain, nausea, weight loss, and bleeding from the rectum.
Researchers have discovered patients with a lower diversity of gut bacteria before radiotherapy faced higher odds of the side effects.
Therefore, the severity of damage may be halted by improving the gut biome before the gruelling treatment starts, the experts claim.
People with pelvic, prostate and gynaecological cancers frequently face gut damage from their treatment for years. Scientists have discovered those who have less gut bacteria diversity are more at risk, and therefore could one day be given a boost of ‘good bacteria’
Experts at The Institute of Cancer Research, London, have now said they will explore whether faecal transplants could help patients.
But academics have said that ‘looking after you diet’ has a big impact on increasing diversity of bacteria and is ‘probably a safer method’.
Professor David Dearnaley, co-author of the study, said: ‘We still need to do further studies to confirm the role of good bacteria.
‘But if we can identify patients at the highest risk of gut damage we could intervene to control, treat or even prevent the side effects of radiation.
‘If microbial treatments such as faecal transplants are found to reduce damage, for example, it could substantially improve patients’ quality of life.’
He said the study is the first to show gut bacteria have an ‘important influence’ on how susceptible patients are to gastrointestinal side effects from radiotherapy.
Faecal microbiota transplantation (FMT) is the transfer of stool from a healthy donor into the gastrointestinal tract of a patient. It is most commonly used to treat recurring C. difficile infection
FMT can replenish bacterial balance as it acts like a probiotic, with samples of faeces often containing up to 1,000 different species of bacteria.
The transplant is done via tubes – inserted into the nostril, down the throat and into the stomach – or directly into the colon. However, the faecal sample can also be transplanted through enemas or pills containing freeze-dried material.
Around 80 per cent of patients report a change in their bowel habit after pelvic radiotherapy, according to figures.
Some 10 to 25 per cent have significant, long-term damage to their gut.
Lead author Dr Miguel Reis Ferreira,said: ‘The bacteria may be used to predict patients at higher risk of side-effects, thereby allowing for tailoring treatment in an even more personalised way.
MICROBIOME: DOES IT CONTROL EVERYTHING?
Researchers now estimate that a typical human body is made up of about 30 trillion human cells and 39 trillion bacteria.
These are key in harvesting energy from our food, regulating our immune function, and keeping the lining of our gut healthy.
Interest in, and knowledge about, the microbiota has recently exploded as we now recognise just how essential they are to our health.
A healthy, balanced microbiome helps us break down foods, protects us from infection, trains our immune system and manufactures vitamins, such as K and B12.
It also sends signals to our brain that can affect mood, anxiety and appetite.
Imbalances in the gut are increasingly being linked to a range of conditions. Last year, scientists at California Institute of Technology found the first ever link between the gut and Parkinson’s symptoms.
The composition of our gut microbiota is partly determined by our genes but can also be influenced by lifestyle factors such as our diet, alcohol intake and exercise, as well as medications.
‘Further studies are needed, such as confirmatory evidence and larger clinical trials.’
The team at The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust and Imperial College London recruited 134 men who were about to receive high-strength radiotherapy to the prostate and pelvis lymph nodes.
Their gut health was assessed with faecal samples taken at the beginning and after 2/3 weeks, 4/5 weeks, 12 weeks, six months and 12 months. Some patients were assessed after two years.
The patients self-reported symptoms of bowel damage as well as being clinically assessed.
Those with low gut diversity before treatment were more likely to suffer immediate – less than 90 days after starting treatment – and long-term side effects of radiotherapy on the gut.
Patients started experiencing symptoms as early as four weeks from the start of their treatment, according to the findings published in Clinical Cancer Research.
The researchers believe patients with poor gut diversity may be more susceptible to side effects when their bacteria is killed by blasts of radiation.
As well as killing cancer cells, radiotherapy can damage some healthy cells in the area being treated.
The researchers also found three particular bacteria – Clostridium IV, Roseburia and Phascolarctobacterium – had been recorded at higher levels before treatment, but were killed by radiation.
It is not clear why they had higher levels before the treatment, but the researchers theorise it indicates an underlying gut problem.
The bacteria, found naturally in the gut, help produce short-chain fatty acids, which support the gut by repairing cells.
Commenting on the findings, Dr Megan Rossi, a research fellow at King’s College London and founder of The Gut Clinic told MailOnline: ‘Radiotherapy essentially burns good cells as well as the cancerous ones.
‘The body has to do a lot of re-generating of cells.
‘The hypothesis is that if we nurture our gut microbiomes, it will produce the chemicals needed to protect our body – including short-chain fatty acids which can regenerate the gut lining.’
Dr Rossi, a former radiotherapy dietitian, said: ‘There is hope for that, but it’s something for people to be cautious of getting.
‘I think looking after your diet has a big impact on increasing bacteria diversity and is probably a safer method until more research is done.’
The research is the first to explore the protective effects of the microbiome for preventing the late effects of radiotherapy.
It supports studies that find people who suffer with diseases such as colitis, IBS and IBD have imbalances in their gut biome.
WHAT IS A FAECAL MICROBIOTA TRANSPLANT? THE BIZARRE PROCEDURE THAT REBALANCES BACTERIA IN THE STOMACH
Faecal microbiota transplantation (FMT) is the transfer of stool from a healthy donor into the gastrointestinal tract of a patient.
WHAT CAN IT TREAT?
It is most commonly used to treat recurring C. difficile infection – spread by bacterial spores found within faeces. It is 90 per cent effective.
It can also be used to treat gastrointestinal conditions such as colitis, irritable bowel syndrome and constipation – but success rates are much lower.
Recent studies have delved into the benefits of treating conditions linked to a poor balance of ‘good’ and ‘bad’ bacteria in the gut, such as autism.
Faecal microbiota transplantation (FMT) is the transfer of stool from a healthy donor into the gastrointestinal tract of a patient
FMT can replenish bacterial balance as it acts like a probiotic, with samples of faeces often containing up to 1,000 different species of bacteria.
HOW IS IT PERFORMED?
The transplant is done via tubes – inserted into the nostril, down the throat and into the stomach – or directly into the colon.
However, the faecal sample can also be transplanted through enemas or pills containing freeze-dried material.
IS IT SAFE?
There have been reports of patients showing unexpected weight gain after treatment, bouts of vomiting and even abdominal pain.
However, the long-term safety and effectiveness of FMT is relatively unknown, and researchers have called for more studies to determine the risks.
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