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Gut bacteria may fuel resistance to prostate cancer treatment


October 15, 2021 – One of the mainstays of prostate cancer treatment is depriving it of androgens, the hormones that make it grow. The testes are the main source of these hormones, so treatment may include the surgical removal of these organs or the use of drugs to block their hormone production.

Over time, some prostate cancers become resistant to these treatments and start to grow again. As with many cancers that exhibit these behaviors, it can be difficult to find exactly what makes them resistant.

A culprit can be bacteria that live in the intestine. The researchers found that in neutered mice and in people undergoing androgen deprivation therapy, some of these gut bacteria start to produce androgens which are easily absorbed into the bloodstream. Based on these new findings,published in the journal Science, androgens appear to promote prostate cancer growth and resistance to treatment.

This study is the first to show that bacteria can produce testosterone, although researchers don’t yet know what prompts them to start doing so. Androgen deprivation therapy may also lead to more of these hormone-producing microbes in the gut, the findings suggest. Fecal bacteria from people with treatment-resistant prostate cancer have also been shown to be associated with lower life expectancy.

Fecal transplants from mice with treatment-resistant prostate cancer may trigger resistance in animals with diseases sensitive to these hormones. When these mice received fecal transplants from humans with resistant cancer, the effect was the same: a switch to resistance to treatment.

But the reverse was also true: fecal transplants from mice or humans with hormone-sensitive cancer helped limit tumor growth.

The results may suggest new therapeutic targets: microbes living in the gut. In studies on mice, researchers found that when they eliminated these bacteria, the cancer was much slower to progress to resistance to treatment. The authors of a commentary accompanying the study say there are other places to look for bacteria that could also make these hormones, including the urinary tract or even within the tumor itself.

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