Gut microbiota and prostate cancer: An analysis of bacterial communities across various clinical scenarios

Introduction and objectives

Gut microbiota (GM) comprises a diverse community of bacteria associated with a wide range of diseases. Emerging research indicates that GM dysbiosis may affect the progression of prostate cancer (PC) and its response to treatment. This study aimed to describe GM in patients with PC at various disease stages.

Materials and methods

A cross-sectional study was conducted at Complejo Hospitalario Universitario de Vigo between 2023 and 2024. 49 patientes were classified into three groups: active surveillance (AS), disease-free post-treatment (DF) and advanced disease (AD). Faecal samples were obtained for GM analysis and DNA was used for 16S rRNA sequencing. The structure of the microbial community was examined via alpha and beta diversity analysis, and differential abundance was measured using the LinDA model.

Results

Alpha diversity analysis revealed diminished taxon richness in patients under AS and in those treated with androgen receptor pathway in hibitors (ARPI). Beta diversity analysis indicated substantial changes attributable to the treatment group, radiation, hormone therapy, and ARPI. The AD group had a diminished number of potentially advantageous bacteria (Methanobrevibacter, Paraprevotella, Colidextribacter) and an elevated abundance of Terrisporobacter and Streptococcus compared to the DF group. The AS group showed reduction in Intestinibacter, Adlercreutzia, Subdoligranulum, and Methanobrevibacter, along with an increase in Fusicatenibacter, Lachnospiraceae, and Lachnoclostridium.

Conclusions

Patients who remain disease-free after therapy have restored microbiota abundant in potential beneficial bacteria, in contrast to individuals with severe disease or those under active monitoring. This study indicates that gut microbiome characteristics could assist in risk assessment and act as possible treatment targets for prostate cancer.