Antibiotics, Cancer, and Fecal (yes, fecal) Transplants

Written by Dr. Colin Champ
Posted January 9, 2017

Around a decade ago, a group of researchers revealed compelling data that antibiotics may be linked to breast cancer.1 Specifically, after analyzing the records of over 10,000 women, they found an increased risk of breast cancer and fatal breast cancer with an increased usage of antibiotics. As antibiotics are regularly prescribed medications, such a finding proves worrisome.

Another study looked at women already treated for breast cancer and found a modestly increased rate of recurrence or secondary breast cancer with an increased usage of antibiotics.2

These two studies found a correlation between antibiotic usage with cancer — one with an increased risk of cancer diagnosis and another with cancer recurrence.

So what can possibly explain the link between cancer and antibiotics?

The way I see it, there are five possible answers:

  1. The link is simply coincidental.

  2. Those with cancer get more infections, thus are prescribed more antibiotics.

  3. Those with an unknown cancer are given antibiotics before they are actually diagnosed as the cancerous symptoms are thought to be from an infection. In other words, the antibiotic is prescribed to treat the symptoms of the undiagnosed cancer as a “shotgun approach,” which happens quite commonly in medicine.

  4. Antibiotics directly cause cancer (mechanism unknown).

  5. Antibiotics indirectly cause cancer (possible mechanism below).

The first three are difficult to prove or disprove. The fourth is possible, but I know of no data to turn to for this theory. Regarding the fifth, I have my own theory, and yes, you are going to read about it below.

Antibiotics, bowel bacteria, and fecal (yes fecal) transplantation

Our gastrointestinal tract, also known as a giant bag of bacteria, provides many vital functions for the human body. These functions go well beyond simply digesting food. This may be at least partially related to the fact that there are over 100 trillion microbial cells within our bodies.3

If these bacteria were that bad for us (requiring antibiotics), we would hardly have survived as a species over the past several millions of years. Instead, as is more often the case in evolutionary medicine, our bodies have likely been forged to function optimally in the face of the 100 trillion microbial cells.4 Or perhaps we have learned to use them to our advantage…

Yet, few realize the importance from the contents of this bag of bacteria. The diverse amount of bacteria in our bowels provides many vital functions. The list is endless, but the top seven (in no particular order) are:

  1. Decrease inflammation and inflammatory bowel disease5

  2. Fight harmful bacteria like C. diff6

  3. Increase and strengthen the immune system to leave it better able to fight invaders and less often fighting itself (i.e. autoimmune disease and inflammation)7

  4. Detoxification of harmful and life-threatening toxins within the bowel8

  5. It provides a physical barrier to protect our body and intestines from harmful substances within the bowels8

  6. Help the host (us) more aptly deal with stress,9 thus the term “gut feelings”

  7. Though more controversial, bowel bacteria may help digest, degrade, and convert estrogens and other hormones10 that can enter the circulation and feed tumors (especially tumors with estrogen receptors on them, like most breast cancers)

The integrity of the gastrointestinal tract is so important that it may help us to withstand otherwise lethal events. For instance, scientists have shown that when the integrity of the GI tract (bowels) in animals is enhanced, the body is able to withstand lethal doses of chemotherapy and radiation.11 The normal flora and bacteria within the bowel are so vital, that physicians are now performing fecal transplants. During these procedures, a tube is placed in the nose and extended down the throat and esophagus and into the duodenum (a nasogastric tube) or via a tube placed in the other end (colonoscopic infusion).

To put it bluntly, feces from someone else (full of normal bacteria) are then pushed into the GI tract of someone without normal flora via a South Park-like moment. A recent study has shown it to be effective at eliminating the dangerous C. diff 81% of the time, versus the old standard of giving more antibiotics, which is only effective a mere 31% of the time.12 Bowel bacteria may even go as far as predicting those who would successfully receive liver transplantations.13

The issue with taking antibiotics and wiping out trillions of important microbial cells within our bodies becomes more obvious when we realize their importance, and it is likely that we only know a mere fraction of their importance.

Can antibiotics directly cause cancer?

While there is no strong, direct link between cancer and antibiotic usage, there is likely a strong link between medical ailments that often require antibiotics and leave one at higher risk of cancer. For instance, another study revealed a strong link between antibiotic usage and lung cancer, with different risks based on the different types of antibiotics that cancer patients were given.14 This may simply have been that lung cancer patients are frequently smokers who often have COPD, poor lung function, poorer general health overall, and experience a significant amount of lung infections.

Multiple lifestyle factors can lead to poor health and eventual excessive antibiotic usage. These consist of many, but the most common (in no particular order) are:

  1. Smoking

  2. Diabetes, high blood sugar, and associated recurrent infections

  3. Poor sleep habits

  4. Poor immune system function from an unhealthy lifestyle

  5. Excessive alcohol consumption

  6. Poor diet with high consumption of sugar and bread

  7. Excessive Facebook usage (trust me)

  8. Excessive inactive time (television and other)

  9. Asking physician for antibiotic prescription with normal seasonal viral infections

  10. Shopping for different physicians to write you a prescription for antibiotics after first physician refuses

Considering most cold symptoms are related to viral infections (and thus antibiotics do not help this condition), in my experience those that take antibiotics rarely need them. In fact, giving antibiotics when not needed more often leaves a patient with dysbiosis of the gastrointestinal track (i.e. improper mixture of normal bacteria in the GI tract), yeast infections, side effects, and a plethora of other potential issues, which may actually lead to infections that were “treated” in the first place.

Lactobacillus, which is part of the normal bacteria of our GI tract, creates lactic acid, which in itself is antibacterial. A main difference is that lactic acid kills harmful gram-negative bacteria like E. coli.15 While antibiotics appear to wipe out a massive amount of our bacteria, our normal, healthy bacteria appears to selectively aim to kill the harmful bacteria. Killing these healthy bacteria with antibiotics paradoxically leaves us more open to infection.

Stay tuned for next week’s installment where we discuss the link between antibiotics, bowel bacteria, and cancer.

To Your Health,

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Dr. Colin Champ

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References:

1. Velicer CM, Heckbert SR, Lampe JW, Potter JD, Robertson CA, Taplin SH. Antibiotic use in relation to the risk of breast cancer. JAMA 2004;291(7):827-35. doi:10.1001/jama.291.7.827.

2. Wirtz HS, Buist DSM, Gralow JR, et al. Frequent antibiotic use and second breast cancer events. Cancer Epidemiol. Biomarkers Prev. 2013;22(9):1588-99. doi:10.1158/1055-9965.EPI-13-0454.

3. Whitman WB, Coleman DC, Wiebe WJ. Prokaryotes: The unseen majority. Proc. Natl. Acad. Sci. 1998;95(12):6578-6583. doi:10.1073/pnas.95.12.6578.

4. Ley RE, Lozupone CA, Hamady M, Knight R, Gordon JI. Worlds within worlds: evolution of the vertebrate gut microbiota. Nat. Rev. Microbiol. 2008;6(10):776-88. doi:10.1038/nrmicro1978.

5. Ott SJ. Reduction in diversity of the colonic mucosa associated bacterial microflora in patients with active inflammatory bowel disease. Gut 2004;53(5):685-693. doi:10.1136/gut.2003.025403.

6. Chang JY, Antonopoulos DA, Kalra A, et al. Decreased diversity of the fecal Microbiome in recurrent Clostridium difficile-associated diarrhea. J. Infect. Dis. 2008;197(3):435-8. doi:10.1086/525047.

7. Clemente JC, Ursell LK, Parfrey LW, Knight R. The impact of the gut microbiota on human health: an integrative view. Cell 2012;148(6):1258-70. doi:10.1016/j.cell.2012.01.035.

8. Sekirov I, Russell SL, Antunes LCM, Finlay BB. Gut microbiota in health and disease. Physiol. Rev. 2010;90(3):859-904. doi:10.1152/physrev.00045.2009.

9. Sudo N. Stress and gut microbiota: Does postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response? Int. Congr. Ser. 2006;1287:350-354. doi:10.1016/j.ics.2005.12.019.

10. Rowland I, Wiseman H, Sanders T, Adlercreutz H, Bowey E. Metabolism of oestrogens and phytoestrogens: role of the gut microflora. Biochem. Soc. Trans. 1999;27(2):304-8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10093753. Accessed November 11, 2014.

11. Zhou W-J, Geng ZH, Spence JR, Geng J-G. Induction of intestinal stem cells by R-spondin 1 and Slit2 augments chemoradioprotection. Nature 2013;501(7465):107-11. doi:10.1038/nature12416.

12. Van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N. Engl. J. Med. 2013;368(5):407-15. doi:10.1056/NEJMoa1205037.

13. Ren Z, Jiang J, Lu H, et al. Intestinal microbial variation may predict early acute rejection after liver transplantation in rats. Transplantation 2014;98(8):844-52. doi:10.1097/TP.0000000000000334.

14. Zhang H, García Rodríguez LA, Hernández-Díaz S. Antibiotic use and the risk of lung cancer. Cancer Epidemiol. Biomarkers Prev. 2008;17(6):1308-15. doi:10.1158/1055-9965.EPI-07-2817.

15. Alakomi H-L, Skytta E, Saarela M, Mattila-Sandholm T, Latva-Kala K, Helander IM. Lactic Acid Permeabilizes Gram-Negative Bacteria by Disrupting the Outer Membrane. Appl. Environ. Microbiol. 2000;66(5):2001-2005. doi:10.1128/AEM.66.5.2001-2005.2000.

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