# The Role of Gut Microbiome in Prostate Cancer: Current Evidence and Emerging Opportunities

## TL;DR

The gut microbiome can influence prostate cancer by affecting inflammation, immune response, and treatment effectiveness, offering new ways to manage the disease through dietary and microbial interventions.

## Contribution

This paper highlights the gut microbiome as a modifiable factor in prostate cancer progression and treatment resistance, suggesting new therapeutic strategies.

## Key findings

- Gut microbiome dysbiosis promotes inflammation and weakens immune response, contributing to prostate cancer progression.
- Microbial metabolites like SCFAs and TMAO can influence tumor growth and treatment resistance in prostate cancer.
- Modulating the gut microbiome through diet or probiotics may improve treatment outcomes and immune regulation.

## Abstract

This article explains how the gut microbiome, meaning the bacteria living in our intestines, can affect prostate cancer. When these bacteria are out of balance, they can increase inflammation in the body, weaken the immune system, and produce substances that help cancer grow. Some gut bacteria can even make or recycle male hormones, which can reduce how well common prostate cancer treatments work. On the other hand, healthy gut bacteria may help treatments work better and slow cancer progression. Because gut bacteria are influenced by diet, medications, and lifestyle, changing the microbiome through food choices, supplements, or other therapies may offer new ways to support prostate cancer treatment in the future.

Prostate cancer (PCa) is one of the most common malignancies in men, and growing evidence implicates the gut microbiome as a significant, modifiable contributor to disease evolution and management. Dysbiosis influences PCa biology through effects on inflammation, immune regulation, metabolism, and hormone signaling. Microbial imbalance can promote systemic inflammation and increase intestinal permeability, activating immune signaling pathways such as NF-κB–IL-6–STAT3. In parallel, microbiome-driven metabolic effects, including IGF-1 signaling and microbial androgen synthesis or recycling, may contribute to resistance to androgen deprivation therapy (ADT). Microbial metabolites, notably short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), exert context-dependent effects on tumor growth, treatment resistance, and progression. Conversely, beneficial microbes have been associated with improved treatment sensitivity and immune regulation. Together, these insights support the gut microbiome as a potential biomarker and emerging therapeutic target in PCa. Modulation strategies, including diet, probiotics, antibiotics, and fecal microbiota transplantation (FMT), are being explored to improve treatment response and address resistance. As mechanistic evidence continues to grow, ongoing monitoring of the gut microbiome may help inform risk stratification and treatment optimization in prostate cancer.