“It was predicted I had only a few months left due to colon cancer, but an unexpected and unpleasant discovery ended up being the savior of my life.”

Tim Story, a high school football coach in Mississippi, does not consider himself a crying man. 

But when he learned he had late-stage colon cancer and months to live, he and his wife broke down in their living room.

After surgery and chemotherapy were unsuccessful in treating his colon cancer four years ago, Mr. Story decided to participate in a clinical trial for an innovative treatment: fecal transplant.

He was to be given a poop sample from a patient with advanced cancer who had been completely cured by immunotherapy

Mr Story said: ‘I knew I was kind of a guinea pig, but the only other option was staying at home, and I wasn’t going to make it.’

The concept behind fecal transplants is that the unique bacteria present in the donor sample can potentially activate the immune system to target and combat the cancer cells.

A year and a half later, Story’s tumors began shrinking, and by 2024, he was cancer-free.  

Minnie Hatch, a 29-year-old from Salt Lake City, Utah, struggled with recurrent C. diff infections that were resistant to antibiotic treatments. It’s worth noting that Ms. Hatch is not related to Tim Story.

Mr Story received his diagnosis in 2020 when he was 49. He was diagnosed with stage 3 small bowel cancer after doctors found a tumor in his small intestine, according to NBC News.

Even after surgery and various medicines, the cancer had spread to other parts of his body.

Early in his treatment, Story received a PD-1 inhibitor, an immunotherapy drug that helps the immune system attack tumors.

It’s usuall effective against microsatellite instability-high (MSI-H) tumors like his, which have more DNA mutations than typical tumors.

While the drugs have been dubbed miraculous by doctors, this one didn’t work for Mr Story, leading to the plan to do a fecal transplant.

In 2021, oncologists in the US and Israel administered fecal transplants to 15 patients with metastatic melanoma to enhance their response to PD-1 inhibitors. 

The treatment proved effective for three patients, with one, Mr Story, achieving complete remission.

The sample transplanted into him came from an elderly woman with metastatic colorectal cancer who had been cured with PD-1 inhibitors.

Good bacteria is extracted from healthy donor and processed into pills or a liquid. It is then is given to patients using an enema — fluid administered up the rectum

Dr Michael Overman, an oncologist at MD Anderson Cancer Center in Houston, Texas, said: ‘Her tumors had been growing, and they suddenly shrank by 90 percent, to the extent where we could do surgery to get rid of the last little bit.’

The woman’s response prompted Dr Overman to launch the trial that enrolled 15 people including Mr Story.

Over a month, 10 patients received multiple infusions of the super-donor’s stool, with five also taking freeze-dried capsules for six more months. 

Mr Story did not reveal whether he was one of the subjects who took freeze-dried samples. 

Meanwhile, Dr Overman resumed PD-1 inhibitor treatment, which continued for a year, monitoring their responses.

Everyone’s microbiome is made up of bacteria and other microorganisms that help with digestion, immune function, and overall health. The makeup of the microbiome influences how the body responds to growing cancer cells. 

Fecal transplants are most commonly used to treat Clostridioides difficile (C. diff) infections when antibiotics don’t work. 

Minnie Hatch, 29, from Salt Lake City, Utah, endured years of recurring C. diff infections, which antibiotic treatments could not resolve. After undergoing multiple fecal transplants starting in 2016, she faced significant setbacks, but her persistence paid off. 

After several fecal transplants starting in 2016, Minnie Hatch faced setbacks, but by 2021, she was infection-free for three years, the longest since her diagnosis. Ms Hatch is not related to Mr Story

By 2021, she had gone infection-free for three years, the longest period since her diagnosis. 

They’re also being studied for other conditions like inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and colon inflammation (colitis). 

Suzanne Singletary, 70, of Shell Point Beach, Florida, was diagnosed with extensive stage small cell lung cancer in 2017 and underwent various treatments including chemotherapy, radiation, and immunotherapy. 

When immunotherapy caused debilitating diarrhea, her doctors recommended a fecal transplant. 

Suzanne said: ‘I thought that was the funniest thing I had ever heard. 

‘Less than two weeks after the procedure, I started to feel a difference. I remember waking up one morning and my diarrhea was suddenly gone. By day 12, I was doing great.’  

Despite recurrence of colitis, subsequent transplants helped manage her condition, allowing her to resume treatment. 

Suzanne Singletary [left] was diagnosed with extensive stage small cell lung cancer in 2017 and received chemotherapy, radiation, and immunotherapy. Her colon became inflamed as a result of her treatment

In some studies, particularly those involving immunotherapy, fecal transplant has been found to potentially enhance the effectiveness of treatments by rebalancing the gut microbiome and boosting immune function, which may help the body better recognize and attack cancer cells. 

After learning that his tumors had shrunk so drastically, Mr Story said: ‘For me and my wife, it felt like winning the lottery because before the trial we had no options left.

‘This past fall, I’ve been able to go back to work for the first time in four years. I’m back coaching football and teaching schools. It’s my passion. I’ve missed it so much because I had to retire. Now it feels like I’ve had a second chance at life.’

Fecal transplantation, while highly promising, is challenging to scale up.

One donor, such as the elderly woman who was cured, cannot supply the roughly 153,000 new CRC patients each year or the 80,000 Americans with recurrent bacterial infections who might benefit from a transplant.

However, the trial highlights the strong connection between the gut and the immune system. Microbes in the gut can influence how the immune system detects bacteria and cancer cells and defends against them.

MD Anderson has teamed up with Kanvas Biosciences, a biotech startup that created HiPR-FISH, a tool designed to analyze the connections between gut microbes and immune response.

By applying this technology to study the super donor’s stool, Kanvas Biosciences identified key microbial strains, which were then encapsulated into a pill.

Ms Singletary, pictured with her niece, noticed a significant improvement after her fecal transplant, with her diarrhea disappearing. Despite colitis recurrence, subsequent transplants helped manage her condition, enabling her to resume treatment

This pill will be tested in upcoming clinical trials at MD Anderson and other cancer centers across North America to determine whether it can help enhance the immune system’s response to PD-1 inhibitors on a larger scale.

Dr Matthew Cheng, a trained medical microbiologist and the Kanvas co-founder, said: ‘We have essentially made a synthetic version of the superdonor stool and then optimized and immortalized it so that it can be reproduced and used in the treatment of cancer patients worldwide.’

A balanced gut microbiome has been linked to better responses to immunotherapies like the one Mr Story took for years by stimulating the immune system to fight cancer cells.

Restoring gut biodiversity through fecal transplantation could boost the immune system’s capability to launch an effective assault in cancer patients, who generally have weaker immune systems.

The rate of colorectal cancers has been climbing in the US in recent years, primarily among people under 50, as Mr Story was when he was diagnosed. 

About 37 percent of colorectal cancers are in people younger than 50 years old, compared to 24 percent of those in people 65 or older.

And CRCs have increased two percent in people younger than 55 since the mid-1990s and deaths have increased one percent since the mid-2000s.

The five-year survival rate for CRCs is 64 percent, but that drops to 14 percent if the cancer has spread, which commonly occurs in early-onset cases because symptoms are often not present or are misdiagnosed until the cancer has spread throughout the body.

Symptoms include changes in bathroom habits, blood in stool, weakness, fatigue, nausea, loss of appetite, a lump in the abdomen or rectum, diarrhea, abdominal cramping, constipation and vomiting.