Preventing gut problems for chemo patients

19 January, 2015

Severe gut problems for patients undergoing chemotherapy for cancer may be able to be prevented, research has suggested.

Between 60-80 per cent of patients being treated with chemotherapy experience debilitating side effects in the gut, depending on the dosage and type of chemotherapy used.

Immune receptor

In a paper published in the journal Cancer Treatment Reviews, researchers from the University of Adelaide say an immune receptor could be to blame for exacerbating people's reactions to chemotherapy.

"While the treatment of the cancer itself is usually seen to be of prime importance, chemotherapy can and does have severe side effects for patients – such as diarrhoea, abdominal pain and in some cases, sepsis," said PhD student and lead author of the paper, Hannah Wardill.

"Treatment for these symptoms is limited and often not effective. 

"Side effects of chemotherapy can cause multiple, co-existing health problems which greatly reduce the patient's quality of life and impact on the long term outlook for patients."

Wardill said the gut – one of the areas that is worst affected by chemotherapy – is the biggest organ in the body that is involved in generating an immune response, and growing evidence shows it can impact on the central nervous system.

"Our research has focused on the immune receptor known as Toll-Like receptor 4 (TLR4), which has been implicated not only in the development of gastrointestinal symptoms, but also appears to control people's sensitivity to pain," she said.

"In our laboratory studies, we found that TLR4 sets up an inflammatory response that is exacerbated by chemotherapy. By knocking out the TLR4 receptor, we saw improvements across all key markers of gut toxicity as well as signs of reduced pain."

Chemotherapy toxicity underreported

Fellow PhD student and a co-author on the paper, Ysabella Van Sebille, says toxicity from chemotherapy continues to be underreported. 

"Toxicities associated with chemotherapy are a major concern within the field of supportive care in cancer, but we still don't understand the full extent of the problem," she said.

"Our research has highlighted the potential to treat multiple side effects of chemotherapy by targetting TLR4, which if successful could streamline symptom management.

"The ultimate aim of our studies is to help find a way to mitigate the adverse health problems caused by chemotherapy, which could lead to improved overall care for cancer patients.  So far, TLR4 seems to be a promising target for further research."