Gut microbiome in integrative oncology

The gut microbiome, a precious ecosystem of microorganisms residing in the gut, plays a significant role in local (gut) and systemic function and contributes to numerous diseases. In cancer, the gut microbiome is increasingly recognized to influence almost all aspects across the disease continuum, from development to treatment and survivorship. As an integrative oncology clinician, it is vital to understand the gut microbiome's emerging and crucial role in cancer care and how evaluating, and manipulating, it may improve patient symptoms, physical and emotional wellbeing, and potential treatment response. This chapter explores the mechanisms by which the gut microbiome may impact cancer development and how it is disrupted during and after cancer treatment, leading to development of acute and chronic side effects, relapse, and poor treatment efficacy. It will emphasize the relationship between these alterations and treatment outcomes and toxicity. Finally, this chapter discusses emerging microbial therapeutics in supportive cancer care, such as diet, prebiotics, probiotics, and fecal microbiome transplantation, highlighting their potential to optimize patient care and improve cancer outcomes, with key considerations for their use. Four key areas covered: 1. What is the gut microbiome and relevance to cancer : overview. 2. Cancer prevention. 3. Optimizing response to treatment. 4. Improving Symptom management. 5. Empowering patient to make diet and lifestyle changes to improve QOL and outcomes.