Sperling Prostate Center

Do You Have the Guts for Prostate Cancer?

This blog title might sound like I’m daring you to get prostate cancer (PCa). But no. What I’m really asking is, do you have the gut microbiome that may be connected with getting PCa? Put another way, are the bacteria in your gut raising your chances of developing this disease?

That’s a scary question. Here you are, innocently walking around with trillions of microbial organisms in your intestines and other parts of the body. You have no idea how many different kinds there are, or what they’re up to. In fact, research increasingly shows that they are silently involved in biochemical “crosstalk” which influences your immune system, how much energy you have, and how your cells utilize fats and sugars. Sounds a little creepy, but it’s nature’s way. In a 2022 article, de Vos, et al. write:

The gut microbiota is now considered as one of the key elements contributing to the regulation of host health. … Nowadays, gut microbiota deviations are linked with many diseases including obesity, type 2 diabetes, hepatic steatosis, intestinal bowel diseases (IBDs) and several types of cancer.[i]

In case you’re wondering if you have any control over the inhabitants you’re hosting, the answer is complicated. It starts even before you’re born, based on influences like what your mother eats and her exposure to antibiotics. Once you pop out, what goes in your own mouth now plays a role (breast milk or formula). Then, as you grow, “the gut microbiome is affected by several factors including diet, exercise, genetic background, sex, race, and region.”[ii] Ultimately, then, each person’s gut microbiome is unique unto himself, but throughout your life, diet continues to be key to its composition.

Not long ago, I posted a blog on the possible interrelationship among dietary lifestyle, gut microbiome, and PCa. I cited a particular 2020 Japanese study by Matsushita et al. in which the authors present evidence that the high fat diet (HFD) of Western countries, with its disproportionate content of red meat, processed meat, potatoes, and high-fat dairy products makes men more prone to PCa. On the other hand, men who eat a prudent Japanese-style diet containing greater amounts of vegetables, fish and chicken have much less incidence of PCa.

Since then, a new article came out in the journal Nature Reviews Urology exploring the biological mechanisms by which gut bacteria contribute to the start of PCa.[iii] Some types of bacteria are less “user-friendly” than others. For instance, certain strains of E. coli generate genotoxins which can damage DNA and cause harmful gene mutations, allowing PCa cells to become cancerous. As another example, an unhealthy gut microbiome can affect the signaling of androgen receptors on prostate cells, fostering resistance to PCa treatment.

Thus, we have the mystery of how to get the healthiest microbiome possible. The strongest clue lies in diet. Eliminating—or at least greatly reducing—red meat, processed meat, and fatty dairy products is a good start. Embracing non-inflammatory food plans such as the Mediterranean and DASH diets can boost the body’s immune system and other functions that are taxed by chronic inflammation. There is also evidence that “implementing regimens that promote beneficial gut bacteria through probiotics/prebiotics may lessen the risk of developing prostate cancer men that are at high risk.”[iv] A word of caution, though: not all probiotic supplements are created equal, so the Cleveland Clinic has posted a helpful article on choosing the right probiotic product for you.

You are the only person who can create the guts to help prevent PCa in your life. Beware of the Western high fat diet and what it’s doing to your body. Remember that trillions of organisms are there with potential anti-PCa mechanisms, so help them out by eating prudently.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] de Vos WM, Tilg H, Van Hul M, Cani PD. Gut microbiome and health: mechanistic insights. Gut. 2022 May;71(5):1020-1032.
[ii] Fujita K, Matsushita M, Banno E, De Velasco MA, Hatano K, Nonomura N, Uemura H. Gut microbiome and prostate cancer. Int J Urol. 2022 Aug;29(8):793-798.
[iii] Pernigoni N, Guo C, Gallagher L, Yuan W et al. The potential role of the microbiota in prostate cancer pathogenesis and treatment. Nat Rev Urol. 2023 Jul 25.
[iv] Fujita, ibid.


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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