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A Bacterial Gut Check

By Stephen Ornes

The right bacterial mix in the gut can make a big difference to cancer patients, whose immune systems are often weakened by treatment and fighting disease. In 2014, a 39-year-old man with T-cell acute lymphocytic leukemia being treated at the Ohio State University James Cancer Hospital, in Columbus, developed a Clostridium difficile infection, sometimes called 
C. diff, a stubborn condition resistant to many forms of antibiotics that causes severe and potentially life-threatening diarrhea.

“He’d gone through everything we use for 
C. diff, and he had absolutely no response to any of them,” says leukemia clinical nurse specialist Lisa Blackburn, who worked with the patient (who preferred not to be interviewed for this article). “He’d been in the hospital a couple times at this point and had almost died a couple times from sepsis,” 
a serious inflammatory response to an infection that can be fatal.

Blackburn says someone on the patient’s health care team suggested he undergo a fecal microbiota transplant—a procedure in which stool from a healthy donor is transferred directly into a patient’s gut, often via colonoscopy. The earliest documented uses of this approach date back to fourth-century China, but it has become more widespread in the U.S. only in the past few years. The idea is to restore healthy bacteria to the ill person, but Blackburn admits it carries a significant “ick” factor. 

“It’s kind of gross for patients to think about, but it’s so effective,” says Blackburn, who described the case study in February 2015 in the Clinical Journal of Oncology Nursing. “This infection that kills so many of our patients really outweighs the grossness of it. I think we’re going to see it more and more.”
 
She says the patient initially resisted but finally consented. It worked quickly: By the time he returned to his room after the procedure, the patient said he no longer suffered from cramping pain and had an appetite. Blackburn says that the treatment not only helped him that time, but it seemed to reset his gut so the next time he developed C. diff, he responded immediately to conventional treatment. 

Blackburn says she has assisted in treating five patients using the procedure, all successfully, and she’s amazed at the results. “I would encourage any patient” with a C. diff infection to discuss it with their physicians, she says. 

Patients’ rapid response to the therapy has encouraged her to start a database of patient experiences and prepare user-friendly information about the procedure in an effort to reduce the “ick.”

06/24/2016
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