Colorectal cancer

The Causal Role of the Microbiome in Colorectal Cancer

Recent research has revealed a significant connection between chronic inflammation, bacteria, and tumors. Perhaps the greatest breakthrough came in 2018, when experimental studies showed that a form of colorectal cancer previously thought to be entirely caused by genetic mutations - its hereditary form - was actually linked to the gut microbiome. Under experimental conditions, germ-free animals did not develop the cancer. However, when two specific bacteria, enriched in the polyps of human FAP syndrome patients, were introduced together, the same cancer developed in these animals. Here’s the sensational part: individually, these bacteria did not cause cancer. Moreover, using a targeted anti-inflammatory technique, the bacteria-induced tumors could be prevented.

What followed is like a fast-paced Netflix series full of twists. Researchers identified the mechanism by which these two bacteria promote tumor formation and, through this, discovered the “final common pathway,” providing a key insight into the precise molecular mechanism of colorectal cancer development.

Two key factors must be examined simultaneously: the permeability of the gut - referred to as intestinal barrier function - and the bacteria capable of causing so-called “mutagenic” inflammation when the barrier is impaired, which can lead to polyp formation and ultimately tumors in the colon.

The good news is that these factors are now accessible in routine clinical practice, offering potential strategies for cancer prevention, recurrence prevention after successful surgery or adjuvant chemotherapy, and even for cases of colorectal cancer not amenable to surgery. It is important to note that not all molecular mechanisms of colorectal cancer have been fully mapped yet, but significant progress has been made.

A Systems-Based Approach to Colorectal Cancer Development

How can colorectal cancer be prevented, and what can specialists do to support prevention? The following video is intended for healthcare professionals.

What factors contribute to the development of colorectal cancer? How can barrier damage and impaired contact inhibition lead to tumor formation even without pathogenic gene alterations? What drives the emergence of a carcinogenic gut flora? It appears that the bacteria living within us, and the restoration of microbiome balance, play a critical causal role in colorectal cancer development. How can this be recognized, and how can colorectal cancer be prevented?

In the video below, Dr. Gábor Pajkos, oncologist, and Dr. Richárd Schwab, gastroenterologist, discuss these questions for medical professionals.

The bacteria that live with and within us send signals about what we should eat, drink, how we should feel, and even whom we should mate with. However, those bacteria that cannot communicate their “wants” will disappear from the gut microbiome if the host does not consume the nutrients necessary for their survival. Our body, together with these microbes, forms an ecosystem much like the collection of species in a botanical garden. Therefore, the microbiome and our lifestyle are closely linked to human metabolism as well as to inflammatory and cancerous diseases.

In the podcast below, alongside medical specialists, genetic counselor Júlia Déri, molecular biologist Edit Várkondi from Oncompass Medicine, and Orsolya Bán, head of the MIND Clinic microbiome interpretation team, explain in a way accessible to non-specialists: What is the role of the microbiome in the development of colorectal cancer?

Examining the microbiome and treating dysbiosis is often key to preventing colorectal cancer. In colorectal cancer prevention, the microbiome test available at our clinic and its expert interpretation play an important role.

The Role of Precision Oncology in Cancer Treatment: What Is Personalized Oncological Care?"

All cancers have a genetic origin, and for many tumor-causing gene defects, personalized oncological treatment is now possible. Molecular diagnostics uncover the underlying cause of the disease. Based on the identified gene defects, a specialized oncology software determines the tumor’s target (molecular target) and the personalized drugs associated with that target. But what exactly does precision oncology aim to answer?

These are the questions we explore for our patients as well. The tests are conducted at our partner company, Oncompass, whose co-founders - research physician and molecular pharmacologist Dr. István Peták, and gastroenterologist Dr. Richárd Schwab - explain to Katalin Rangos what precision oncology can do in the treatment of colorectal cancer.

Every cancer is driven by unique genetic defects, and molecular diagnostics is designed to identify these. Precision medicine then links the genetic alterations revealed by molecular diagnostics to potential therapeutic options.

Dr. István Peták and Dr. Richárd Schwab discuss the search for these causes, the answers provided, and their practical applications in the video/podcast.

The microbiome not only plays a role in maintaining health and in cancer development, but it is also increasingly recognized for its influence on how cancer patients respond to certain treatments. The international research group OPTIMISTICC, led by Matthew Meyerson and Wendy Garrett, investigates the clinical potential of microbiome modulation. This group conducted the first study examining the prognostic and predictive potential of Fusobacterium nucleatum in locally advanced rectal cancer (LARC). The research built on prior knowledge that a high abundance of F. nucleatum is associated with poorer outcomes in colorectal cancer, with the aim of identifying links between the microbiota, the tumor, and patient characteristics.

One of the most important elements in colorectal cancer prevention is screening, which is done via colonoscopy. Request an appointment if you are over 50 years old or if you are experiencing any symptoms. Every examination is preceded by a specialist consultation.

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At the European Society for Medical Oncology (ESMO) Congress, the cancer prevention campaign (PrEvCan) was presented, aiming to place much greater emphasis on prevention and early detection than before. According to projections, by 2040 the number of cancer cases could rise to 5.96 million, with deaths increasing to 2.91 million. One key strategy to avoid this scenario is prevention, promoting and encouraging a healthier lifestyle.

How Can Cancer Be Prevented? What Do Precision Oncology and Molecular Diagnostics Mean, and Who Can Benefit from Them? At Abaházi Presszó, the co-founders of Oncompass - Dr. István Peták, oncologist and molecular pharmacologist, and Dr. Richárd Schwab, gastroenterologist - also discuss how the development of cancer can be prevented and the role of precision oncology and molecular diagnostics in this process.

Alongside smoking and obesity, alcohol is one of the greatest risk factors for developing cancer.

Research by the American Institute for Cancer Research (AICR) shows that alcohol increases the risk of at least six types of cancer, including colorectal, breast, esophageal, liver, stomach, and oral cancers.

“This research confirms AICR’s own surveys, which indicate that more than 50% of the U.S. population is unaware that alcohol can cause cancer,” said Nigel Brockton, PhD, Vice President of Research at AICR. “Alcohol is a known carcinogen, and it is important for people to understand the risks so they can make informed decisions.”