Probiotics are living microorganisms that provide a health benefit, and prebiotics are fibers that feed these friendly bacteria, mostly in your gut. These therapies, found in certain foods or as supplements, can manage gastrointestinal symptoms and some body terrainthe internal conditions of your body, including nutritional status, fitness, blood sugar balance, hormone balance, inflammation and more factors common in cancer, and they may lead to better recovery from surgery.
How do experts use probiotics and/or prebiotics?
Both medical groups and integrative experts provide recommendations for probiotics and prebiotics in treating people with cancer. Learn more about the approaches and meanings of recommendations.
Clinical practice guidelines
Evidence supports the use of probiotics containing Lactobacillus spp. for prevention of chemoradiotherapy and radiotherapy-induced diarrhea in patients with pelvic malignancy.
Published protocols, programs, and approaches
These protocolsa package of therapies combining and preferably integrating various therapies and practices into a cohesive design for care, programs, and approaches by leaders in integrative cancer care use or recommend probiotics and prebiotics.
We do not recommend specific integrative protocols or programs but provide information for you to evaluate with your healthcare team.
Lise Alschuler, ND, FABNO, and Karolyn Gazella
Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer: A Five-Step Integrative Plan to Reduce the Risk of Recurrence and Build Lifelong Health. Berkeley, California: Ten Speed Press. 2013.
The Definitive Guide to Cancer:
Alschuler and Gazella recommend probiotics to protect against or treat disruption to the microbiome:
- After surgery
- Gut-associated lymphoid tissue (GALT) support
- For digestion
- During radiation to reduce diarrhea
- Hormone balance
- Immune system
- Reversing insulin resistancea condition in which cells in your muscles, fat, and liver don’t respond well to insulin and can’t efficiently take up glucose from your blood for energy and improving insulin sensitivity
- Bladder cancer
- Breast cancer
- Colon cancer
- Pancreatic cancer
- Stomach cancer
The Definitive Guide to Thriving after Cancer:
Alschuler and Gazella describe positive influences of probiotics:
- Immune system
- Hormonal balance
- Insulin resistance
- Digestion and detoxification
Keith Block, MD
Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009.
The integrative Block Program has recommendations to people who are at different places along the cancer continuum:
- Those who’ve been recently diagnosed
- Those in treatment
- Those who’ve concluded treatment and need to remain vigilant to prevent recurrence
Prebiotics and probiotics are recommended for these uses:
- As part of core diet plan
- Diarrhea secondary to antibiotic or radiation enteritis
Lorenzo Cohen, PhD, and Alison Jefferies, MEd
Cohen L, Jefferies A. Anticancer Living: Transform Your Life and Health with the Mix of Six. New York: Viking. 2018.
This book introduces the concept of the Mix of Six, which is identical to six of our 7 Healing Practices ›
Dr. Cohen and Ms. Jefferies explain that while each plays an independent role, the synergy created by all six factors can radically transform health, delay or prevent many cancers, support conventional treatments, and significantly improve quality of life.
Pre-and probiotic foods are part of anticancer eating patterns.
Gerald M. Lemole, MD; Pallav K. Mehta, MD; and Dwight L. McKee, MD
Lemole GM, Mehta PK, McKee DL. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.
These doctors present easy-to-incorporate lifestyle changes to help you “turn on” hundreds of genes that fight cancer, and “turn off” the ones that encourage cancer, while recommending lifestyle approaches to address each type.
Use of probiotics with colorectal cancer:
- Before surgery to reduce side effects after surgery
- After treatment
Neil McKinney, BSc, ND
McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.
This book includes descriptions and uses of many natural and complementary protocols for cancer in general and for specific cancers. It also includes information on integrative support during conventional cancer treatment.
Probiotics are recommended to protect against or treat disruption to the microbiome from cancer treatment
- Protect against gut bacteria translocation to liver/blood during immunotherapy/chemotherapy
- Avastin, cisplatin, carboplatin, and oxaliplatin
- Gemcitabine and capecitabine
- For diarrhea after surgery
- Protect gut; protect immunity during radiation
- Radiation-induced diarrhea, proctitis, and reduce risk of radiation-related gut fibrosis
- Bladder cancer treatment
- Reduce breast cancer risk
- Colorectal cancer:
- Prevent polyps from converting to cancer
- During treatment
- Liver and gallbladder cancer: during treatment
Gurdev Parmar, ND, FABNO, and Tina Kaczor, ND, FABNO
Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Medicatrix Holdings Ltd. 2020.
This book provides information on the treatment of 24 cancers, plus the most effective treatments of the most common symptoms affecting cancer patients while they undergo chemotherapy, radiotherapy, or surgery.
Probiotics are recommended to balance the microbiome:
- Bladder cancer
- Colorectal cancer
- Esophageal cancer
- Head and neck cancer
- Stomach cancer
David Servan-Schreiber, MD, PhD
Servan-Schreiber D. Anticancer: A New Way of Life. New York: Penguin Books. 2009.
This book provides tips on how people living with cancer can fight it and how healthy people can prevent it.
Prebiotic and probiotic foods are recommended for gut and immune system health.
Nasha Winters ND, FABNO, LAc, DiplOM and Jess Higgins Kelley, MNT
Winters ND, Kelley JH. The Metabolic Approach to Cancer. 2017. Chelsea Green Publishing.
This book’s metabolic approach to cancer is a “naturopathic nutrition program that uses the medicinal powers of traditional foods, therapeutic diets and non-toxic lifestyle approaches as cancer counteragents and preventives.“ The program focuses on 10 terrain elements and how to assess them and bring them into balance.
Dr. Winters suggests trying to look for as many different strings of bacteria in supplements as possible. Research has found that our microbiota is most active at night, so the ideal time to take pro- and prebiotics is before bed. Rotate your brand of probiotics every ninety days to get the most benefit from the various stains. Keep in mind that cooking foods reduces existing prebiotic content by 25–75%, so consuming [prebiotic] foods in their raw state is optimal.
Use of prebiotic and probiotic foods and supplements
- During chemotherapy and radiation to the pelvic area
- After a course of antibiotics
- Improve immunity by balancing T-helper cells
- Improve mood: anxiety and/or depression
Other expert assessments
This 2014 book recommends use of prebiotics and probiotics to reduce risk of gastrointestinal cancers.
This 2018 survey identified probiotics as one of the most frequently identified interventions used by members of the Oncology Association of Naturopathic Physicians.
Microbiome, surgery, and probiotics
CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS: Integrative physician and CancerChoices advisor Keith Block, MD, and other clinician researchers suggest using prebiotics or probiotics before and after surgery to reduce the risk of infection and keep the protective inner lining of the intestines (mucosal barrier) healthy.1Block KI, Block PB, Gyllenhaal C. Integrative treatment for colorectal cancer: a comprehensive approach. The Journal of Alternative And Complementary Medicine. 2018 Sep/Oct;24(9-10):890-901. This is backed by research: Use of probiotics around the time of surgery improved the gut microbiome2Aisu N, Tanimura S et al. Impact of perioperative probiotic treatment for surgical site infections in patients with colorectal cancer. Experimental and Therapeutic Medicine. 2015;10(3):966–972. and protected the intestinal lining’s physical and biological barrier3Liu D, Jiang XY, Zhou LS, Song JH, Zhang X. Effects of probiotics on intestinal mucosa barrier in patients with colorectal cancer after operation: meta-analysis of randomized controlled trials. Medicine (Baltimore). 2016 Apr;95(15):e3342. after colorectal cancer surgery.
I encourage you to consult your surgeon and/or an integrative oncologist—such as a naturopathic oncologist or functional medicine physician—to recommend specific probiotics you can take as well as other measures to protect and restore your microbiome.
Keep reading about probiotics and prebiotics
|1||Block KI, Block PB, Gyllenhaal C. Integrative treatment for colorectal cancer: a comprehensive approach. The Journal of Alternative And Complementary Medicine. 2018 Sep/Oct;24(9-10):890-901.|
|2||Aisu N, Tanimura S et al. Impact of perioperative probiotic treatment for surgical site infections in patients with colorectal cancer. Experimental and Therapeutic Medicine. 2015;10(3):966–972.|
|3||Liu D, Jiang XY, Zhou LS, Song JH, Zhang X. Effects of probiotics on intestinal mucosa barrier in patients with colorectal cancer after operation: meta-analysis of randomized controlled trials. Medicine (Baltimore). 2016 Apr;95(15):e3342.|