The Use of Prebiotic and Probiotic Interventions for Treating Gastrointestinal and Psychosocial Health Symptoms in Cancer Patients and Survivors: A Systematic Review

Abstract

Background: Cancer treatments can cause significant gastrointestinal (GI) health issues, and negatively affect patient’s psychosocial health and quality of life (QOL). Novel, integrative strategies using prebiotics and probiotics have been explored for treating adverse cancer treatment-related side effects. We evaluated the current literature for interventions using prebiotics or probiotics specifically to treat GI and psychosocial health issues in cancer patients and survivors. Methods: Five databases (PubMed, MEDLINE (Ovid), CINHAL, PsychINFO, Web of Science) were searched for studies with prebiotic or probiotic interventions where GI and/or psychosocial health outcomes were measured in adult cancer patients and survivors, and published before September 12th 2021. Results: Twelve studies (N = 974 participants) meeting the inclusion criteria were identified (randomized controlled trials [n = 10], single-group pre-post studies [n = 2]). Ten studies were conducted with patients on active cancer treatment, and 2 studies treated patients after anti-cancer therapies. Three studies used prebiotics, 7 studies used probiotics, and 2 studies used a combination therapy. The most commonly used probiotic strains were from the Lactobacillus genus. There was minimal evidence for prebiotics to improve GI or psychosocial health. Probiotics were associated with significant improvements in abdominal pain (n = 2), gas/bloating (n = 2), and especially diarrhea (n = 5), and with improvements in anxiety (n = 1), depression (n = 1), fatigue (n = 1), and QOL (n = 2). Conclusions: Studies specifically examining effects of prebiotics and probiotics on GI and psychosocial health outcomes are scarce. Probiotic intervention may improve some GI symptoms in cancer patients, and QOL in survivors. Controlled trials that consistently include GI and psychosocial health outcomes are needed.

Improved Survival and Quality of Life Through an Integrative, Multidisciplinary Oncological Approach: Pathophysiological Analysis of Four Clinical Cancer Cases and Review of the Literature

“…Probiotics are live microorganisms that are known to attenuate the side effects of AC and in general to restore intestinal eubiosis and nutrient absorption, which are the key mechanisms to improve outcomes and HR-QoL. Administered in adequate doses, they confer benefits such as improved immune function and support for the competitive exclusion of pathogens ( Deleemans et al, 2021 ). In oncological settings, they may help to maintain the balance of the intestinal microbiota, to reduce potential pathogenic bacterial infection, improve bowel regularity, and restore homeostasis to the intestinal microbiota after AC ( Barbieri et al, 2017 ; Rossi et al, 2018 ; Garau et al, 2021 ).…”

Prebiotics: Ignored player in the fight against cancer

“… 57 In addition to physical symptoms, chemotherapy induced gut dysbiosis also causes psychological and cognitive effects in cancer patients and survivors, including depression, anxiety, and post‐traumatic stress disorder. 58 They observed a considerable improvement in GI symptoms such as nausea, vomiting, constipation, and sore throat. 59 When prebiotics are fermented by the bacteria in the colon, they produce SCFA.…”

“…This can cause more inflammation and make cancer patients more likely to experience gastrointestinal (GI) problems during treatment 57 . In addition to physical symptoms, chemotherapy induced gut dysbiosis also causes psychological and cognitive effects in cancer patients and survivors, including depression, anxiety, and post‐traumatic stress disorder 58 . They observed a considerable improvement in GI symptoms such as nausea, vomiting, constipation, and sore throat 59 .…”

Global Trends in Research of Pain–Gut-Microbiota Relationship and How Nutrition Can Modulate This Link

“…Prebiotics can increase resistance to pathogens, the regulation of immunity, mineral absorption, and healthy intestinal function, as well as affecting metabolism and satiety. Researchers recommended that prebiotics only, or combined with probiotics, could be used as an intervention to relieve pain in various diseases for treating gastrointestinal and psychosocial health symptoms, from cancer [58] to functional bowel disorder [59,60], irritable bowel syndrome (IBS) [26,61,62], inflammatory bowel disease (IBD) [63], and constipation [64]. However, only 13 publications suggested prebiotics as a potential preventive and therapeutic approach to nutritional management in patients with chronic pain.…”