The Impact of Gut Microbiota Changes Among Colon Cancer Patients Undergoing Surgery: A Prospective Study

Sunday, 17 November 2019

Eleni Pellazgu, MSN
School Of Nursing, Rutgers University, Morristown, NJ, USA

Purpose/Specific Aims:

Colon Cancer (CC) is the third leading cause of cancer-related fatalities in the US and was projected to cause over 50,000 deaths in 2017 alone. Significant risk factors are diet, environmental factors, genetics, and chronic inflammation, ultimately linked with the gut microbiome dysbiosis (alteration). However, it is unclear how these changes develop over time and whether they directly affect tumorigenesis or if they are an unrelated consequence of CC development. Genomics is an emerging field and nursing, especially oncology nurses and nurse practitioners, being at the forefront as educators, and providers need to understand these processes first hand in order to provide efficient, evidenced-based care.

The purpose of this study is to gain a better understanding of whether changes in the human microbiome can be correlated with changes in human health including clinical outcomes, patient-reported outcomes, and diet tolerance.

Aim 1: To investigate the changes the microbiota goes during the perioperative period.

Aim 2: To explore relationships between these changes and patient's self-reported outcomes.

Aim 3: To examine the impact of these changes on surgical outcomes including postoperative infections.

Aim 4: To observe the time of return of bowel function and diet tolerance during the post-surgical period.

Rationale/ Significance of Study: It is important to understand the changes the microbiome undergoes during the perioperative period in order to identify ongoing processes and patients at risk for adverse effects so we can identify ways to modulate the gut microbiota in favor of patients during this critical period and improve overall care.

Methods: this is a single center observational prospective study in progress looking at microbiota analysis, pain, fatigue, infection rates, bowel function, and diet tolerance. The study is to be conducted at Cancer inclusive of 20 patients of 18-80 years of age diagnosed with colon cancer undergoing cancer removal surgery.

Implications for Practice. Understanding microbiome and the effects of dysbiosis among cancer patients is crucial. These patients may have other adverse effects and infection processes secondary to surgery such as surgical site infections, Clostridium difficile infections, urinary tract infections, pneumonia, delay in bowel function and diet tolerance and prolonged length of stay. Other factors can be pain, fatigue, depression, and anxiety. These factors affect the patients’ outcomes, their quality of life, and the healthcare organizations as well and increasing healthcare expenditure.