Probiotics as a potential adjuvant therapy for the treatment of colorectal cancer

Colorectal cancer (CRC), also known as colon cancer or bowel cancer is a cancer resultingfrom uncontrolled cell proliferation or growth in the colon or rectum or in the appendix. 5-fluorouracil (5-FU) and Oxaliplatin are most frequently prescribed drugs for treatment of CRC. But many side effects like mucositis, diarrhea, nausea; vomiting, neurotoxicity, hand foot syndrome, tinnitus, and myelosuppression, anaphylactic reactionsetc are the problems with chemotherapy. Probiotics are bacterial cultures comprising of potentially beneficial bacteria or yeast, administered in adequate amounts confer a health benefit on the host. Lactic acid bacteria (LAB) are the most common microbes used. Prebiotics are non-digestible fibre compounds that act as substrate for the probiotics and stimulates the growth of useful bacteria oflarge intestine and probiotics. The ingestion of probiotics, prebiotics or combinations of both (synbiotics) represents a novel new therapeutic option. Probiotics and prebiotics act to alter the intestinal microflora by increasing concentrations of beneficial bacteria such as Lactobacillus and Bifidobacteria, and reducing the levels of pathogenic micro-organisms. This strategy has the potential to inhibit the development and progression of neoplasia via mechanisms including: decreased intestinal inflammation, enhanced immune function and anti-tumorigenic activity, binding to potential food carcinogens including toxins found in meat products, and a reduction in bacterial enzymes which hydrolyzeprecarcinogenic compounds, such as beta-glucuronidase. The present review is an attempt to explore the role of combination of probiotics with the drugs to observe the efficiency profile of the drugs in the management of CRC.