Cervical cancer, caused mainly by persistent infection with high-risk strains of the human papillomavirus (HPV), is still a major health concern for women all over the world. Recent research findings indicate that the vaginal microbiome, which are the community of bacteria and microorganisms residing in the vaginal area, could be crucial in preventing cervical cancer. Probiotics have been known for their ability to balance gut bacteria, and lately, it is being studied that they may even be helpful for a healthy vaginal microbiome to prevent cervical cancer.
Understanding the vaginal microbiome
The vaginal microbiome is primarily composed of Lactobacillus bacteria, which are responsible for maintaining a healthy environment. A healthy microbiome is important for preventing infections, such as HPV. However, an imbalance in this microbiome, often caused by antibiotics, stress, use of excessive vaginal washes, Immunocompromised state or a poor diet, can lead to an environment that fosters infections. It plays a significant role in cervical cancer development by potentially influencing the persistence of HPV infection and the progression of precancerous lesions to invasive cervical cancer through alterations in the local immune response, with a symbiotic microbiome (imbalance in bacterial species) which is associated with an increased risk of cervical cancer development. Particularly, a depletion of beneficial lactobacilli and an increase in certain anaerobic bacteria can create a pro-inflammatory environment conducive to cancer progression.
Role of probiotics in cervical cancer prevention
1. Balancing vaginal flora
Probiotics also support the recolonization of Lactobacillus ( which maintains acidic pH) in the vagina. Good flora helps control harmful bacteria and other micro organisms from growing, reducing the chance for infection.
2. Preventing HPV infection from lasting
Probiotics prevent the vagina from becoming too alkaline. Alkalinity allows for easier survival and proliferation of the HPV virus, giving it more time to create cancer in the body. Although probiotics is only an adjunct to timely screening and treatment.
3. Reducing the risk of bacterial vaginosis (BV)
Altered vaginal flora may also lead to development of bacterial vaginosis (due to Gardenella sp.) Probiotics can help prevent or help treat this infection by encouraging the growth of good bacteria that messes up the vaginal balance and makes it easier for HPV to infect the cervix.
4. Boosting the immune system
Support of the immune system helps the body fight infections. A stronger immune system would result in more efficient removal of the virus in the body hence a lesser chance of cervical cancer .
5. Support the Body to get rid of the virus
Some studies have shown that probiotics may assist the body in getting rid of an HPV infection faster, thereby lessening the chances that the virus could bring long-term damage to the cervix.
Research and evidence
While there is still much to be explored, but early reports from several clinical studies have reported the positive involvement of probiotics in cervical health. Some studies have established that oral or vaginal administration of Lactobacillus strains decreases the risk of HPV infections or helps in clearing the virus. However, it is important to note that probiotics should not be viewed as a substitute for regular cervical cancer screening (including Pap smears and HPV tests) and treatment.
Conclusion
Probiotics could be a very promising, adjuvant means of cervical cancer prevention through their support of healthy vaginal microbiomes. While more research needs to be conducted to understand these agents' potential efficacy, this balance may ultimately be a component in the overall reduction of persistence of HPV, and therefore of cervical cancer, in women.
Dr. Aruna Kalra, Director of Obstetrics and Gynaecology at CK Birla Hospital, Gurugram
