By: Megan Garlapow, PhD
From: oncologynurseadvisor.com
Results from a comprehensive gastrointestinal (GI) assessment and analysis of the gut microbiome in patients with breast cancer undergoing chemotherapy indicated potential microbiome effects of the burden of GI symptoms.
In this study, bacteria of the gut microbiome were correlated with GI inflammation and mucus degradation in 22 patients with breast cancer undergoing chemotherapy, and changes in these bacteria during treatment might explain chemotherapy-associated GI symptoms many patients experience. These findings were published in Biological Research for Nursing.
This study elucidated occurrence, duration, severity, and distress of 19 GI symptoms and measured the alpha diversity, beta diversity, and microbial abundance of the GI microbiome in patients with breast cancer undergoing chemotherapy compared with age-matched and sex-matched healthy persons (control group) as a means to identify possible routes by which the GI microbiome changes during treatment and results in GI symptom burden.
Although the study included 22 participants each in the patient and control groups, specimens from several participants in the control group could not be sequenced, so 17 specimens were available for analysis from that group. Of the 19 GI symptoms examined, 6 were present in at least half of those in the breast cancer group with worse than mild severity, duration, and distress. These symptoms were change in taste, diarrhea, dry mouth, flatulence, lack of appetite, and nausea.
Alpha diversity of the GI microbiome indicates species richness and evenness. It was not significantly different between the breast cancer and control groups. However, beta diversity was significantly different between the 2 groups (P <.05).
Various analyses of microbial abundance revealed several species of bacteria were depleted, and others were enriched in the breast cancer group compared with the control group.
Notably, 59% of patients received low emetogenic chemotherapy, whereas 41% received highly emetogenic treatment. Despite this difference, the overwhelming majority of patients (91%) received at least 1 antiemetic medication. Furthermore, 68% of patients received an antacid and 23% received a stool softener. Nonetheless, GI symptoms in these patients were often severe.
Limitations included the small sample size, stool collection that only allowed for DNA microbiome profiling, no assessment of adherence to medication, and no assessment of other factors such as taking antibiotics that could affect the gut microbiome.
“Ideally, the future of cancer-related symptom management will include regular assessments of the GI microbiome and GI-microbiome targeting interventions will be part of standard cancer care,” stated the authors.
Reference
Hoang J, Gilbertson-White S, Cady N, et al. Preliminary analysis of gut microbiome and gastrointestinal symptom burden in breast cancer patients receiving chemotherapy compared to healthy controls. Biol Res Nurs. Published online October 13, 2023. doi:10.1177/10998004231205277
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