Disturbances in the microbial ecosystem have been implemented in chronic inflammation, immune evasion and carcinogenesis, with certain microbes associated with the development of specific cancers. In recent times, the gut microbiome has been recognised as a potential novel player in the pathogenesis and treatment of malignant melanoma. It has been shown that the composition of gut microbiota in early‐stage melanoma changes from in situ to invasive and then to metastatic disease. The gut bacterial and fungal profile has also been found to be significantly different in melanoma patients compared to controls. Multiple studies of immune checkpoint inhibitor (ICI) therapies have shown that the commensal microbiota may have an impact on anti‐tumor immunity and therefore ICI response in cancer patients. When it comes to chemotherapy and radiotherapy treatments, studies demonstrate that gut microbiota are invaluable in the repair of radiation and chemotherapy‐induced damage and therapeutic manipulation of gut microbiota can be an effective strategy to deal with side effects. Studies demonstrate the oncogenic and tumor‐suppressive properties of the gut microbiome, which may play a role in the pathogenesis of melanoma. Despite this, investigations into specific interactions are still in its infancy, but starting to gain momentum as more significant and clinically relevant effects are emerging.
The gut microbiome is a novel player in the pathogenesis and treatment of breast cancer. The term “microbiome” is used to describe the diverse community of micro-organisms existing within the gastrointestinal tract. The gut microbiome plays an important role in oestrogen metabolism through its ability to deconjugate oestrogens within the gut resulting in their reabsorption. Therefore, it is not unsurprising that “dysbiosis”, the disruption of normal gut microbiota composition, is now thought to play a role in the development of the disease, as women with breast cancer have been shown to have altered gut microbiota and this has been correlated with tumour characteristics. There is emerging evidence to suggest that the gut microbiota may also impact on breast cancer treatment, by mediating both drug efficacy and toxicity. The present review will discuss the influence of the gut microbiota on systemic treatments for breast cancer, including chemotherapy, anti-HER2 therapy, endocrine therapy and immunotherapy as well as other targeted treatments.
Keratocystoma of the parotid gland is a rare benign tumour, with only a handful of case reports in literature. We report a case of a man in his 70s who presented to the head and neck clinic with a 2-month history of a gradually increasing left neck swelling. Fine-needle aspiration showed contents of an epidermal cyst; however, an MRI showed a solid/cystic mass with a low T2 signal, suggesting increased risk of malignancy. The patient went on to have a left superficial parotidectomy and level IIa supraselective neck dissection. The lesion contained laminated keratin and was lined by squamous epithelium, with nodal extension. Features were those of a keratocystoma; metastatic cystic well-differentiated squamous cell carcinoma was not favoured. This is the first reported case of a parotid keratocystoma with nodal extension of the lesion. This case report demonstrates that surgical excision and clinical monitoring can be a safe management strategy for these benign tumours.
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