South Australian researchers are investigating whether a simple fibre supplement could provide substantial health benefits for women in the acute and post phases of breast cancer treatment.

Dr Courtney Cross, a Veronika Sacco Clinical Cancer Research Fellow at SAHMRI and the University of Adelaide, is leading a new SA-based trial exploring whether fibre supplementation can reduce the impact of common chemotherapy side effects by bolstering gut microbiome.

“Breast cancer treatment saves lives, but the side effects can be incredibly challenging to cope with,” Dr Cross said.

“We’re looking at whether something as straight forward as boosting fibre intake could relieve some of these unpleasant symptoms.”

Funded by Tour de Cure and SAHMRI’s Bright Spark program, the trial aims to recruit 30 South Australian women who will take a fibre supplement twice daily for three months.

Participants will be monitored to measure changes in their experiences of a range of side effects, especially those related to the brain, including brain fog, fatigue, nausea, anxiety, sleep disturbances and pain.

Breast cancer survivor, Jan-Maree Wauer knows the detrimental impact these side effects can have on quality of life.

Diagnosed in 2019, the mother of two had to endure a double mastectomy and hysterectomy while undergoing chemotherapy.

"Cramps, hair loss, fatigue, joint pain, and really bad brain fog. I’d forget why I entered a room and have to write everything down to remember what I needed to do; I still struggle with it now,” Ms Wauer said.

Now in remission, the 51-year-old is on a daily hormone therapy regime to prevent relapse, but finds the medication negatively affects her cognition.

"At work, my mantra is: If you think I’ve forgotten something, I probably have, so please remind me."

"You just have to grit your teeth and try to get through it and follow the advice from your medical team, because for me there was no alternative. I went into full survival mode.”

Cancer and lymphoedema survivor, Monique Bareham, has also experienced excruciating periods of immense pain and discomfort caused by the many debilitating side effects of her chemotherapy treatment.

“I was incredibly unwell during my chemotherapy. I experienced intense nausea, headaches, and bowel issues, as well as peripheral neuropathy in my fingers, toes and scalp. My sense of taste was badly affected, and I developed painful mouth ulcers which made it hard for me to eat. My hair dropped out, my nails turned black and my skin developed acne and became extremely itchy and hyper-sensitive.

Monique’s extremities also became swollen and extremely painful, leading to her lymphoedema diagnosis.

“My brain seemed to turn to mush, I was unable to concentrate, couldn't remember things including normal words, and lost my ability to make decisions. This affected my confidence, how I communicated and stopped me reading too, which I had always loved doing,” Ms Bareham said.

“I’d never experienced anything like this level of sickness, it was a huge shock that made me feel useless and powerless. I was unable to work for the duration of my active treatment, which was stressful because I felt like I was letting my colleagues down, plus I had a mortgage and all the normal bills which didn't stop just because I was sick. I couldn't even pick up the phone to talk to the bank because of my chemobrain and fatigue.”

Before cancer struck at age 37, Monique was a manager in a busy public sector job, often described as a 'pocket rocket' by her colleagues. She says chemobrain set in immediately after her first dose of chemotherapy when she lost the ability to think and felt like she aged 30 years overnight.

“Although my chemobrain did improve over time, I feel that I never regained the same level as prior to my chemotherapy. The experience was so profound, I discussed this with my psychologist and it continues to frighten me even today,” Ms Bareham said.

Dr Cross says these side effects are a result of the body’s inflammatory response to cancer therapy.

“When gut health is disrupted by chemo, harmful bacteria flourishes. Fibre may counteract this by supporting the health of good bacteria in our gut, which produce anti-inflammatory compounds that can protect the body and the brain,” Dr Cross said.

Australia’s average fibre intake is known to be well below recommendations, which may make Australians more vulnerable to these side effects during cancer treatment.

Following promising pre-clinical studies, researchers are hoping this clinical trial will provide compelling evidence that fibre supplementation is effective for reducing these symptoms in humans.

“This research could pave the way for an affordable and effective new addition to cancer care that boosts quality of life,” Dr Cross said.

“If something like fibre could help with these side effects, it would have made a huge difference in the worst moments,” Ms Wauer said.

“If an evidence-based supplement which offered to reduce the side effects of my chemotherapy had been provided to me, I would have grabbed it with both hands. Anything to help people better manage the side effects of chemotherapy including chemobrain would be really beneficial,” Ms Bareham said.

Recruitment is currently underway with support from Breast Cancer Network Australia and the trial is expected to start in April. For more information on how to get involved, email fibre@sahmri.com.