Tremendous advances have occurred in medicine over the last few decades. The human genome has been defined and precision medicine is on the rise. Technological innovations have also been catalyzed by the recent pandemic. But despite these advances, cancer remains a challenging condition with millions of deaths globally each year. In many cases, cancers are diagnosed late in their course making therapies less effective. And cancer screening methods remain limited in their abilities. But a breath test for cancer could change all of that.
Recent scientific research is beginning to show some promising results when it comes to a breath test for cancer. In many cases, existing cancer screening tests are cumbersome, at times invasive, and often expensive. On top of that, many have low detection rates that make them less feasible. A cancer breathalyzer, however, could offer an easy-to-us cancer screening method that could be performed broadly and often. The potential this has in revolutionizing cancer management is tremendous.
How Does a Breath Test for Cancer Work?
A breath test for cancer is an intriguing concept. The formal term for this process is called exposomics. This process involves measuring various volatile organic compounds (VOCs) that are released from the lungs. These particles can not only reveal much about our metabolism, diet, and medications, but can also provide information about our microbiome. In addition, the same compounds can change early in a malignancy. Thus, a cancer breathalyzer has been contemplated as a form of cancer screening test.
While this concept has been around for 50 years, technology in medicine has finally caught up with the idea. Artificial intelligence and machine learning are being used to identify breath patterns of specific VOCs that link to specific cancers. If enough cancer patients can be studied, and results are favorable, researchers believe this could be a great cancer screening tool. In fact, there are several studies that have begun exploring a specific breath test for cancer.
“With these strong results, we hope to trial the method in primary care settings, such as GP clinics, to further develop its use in early-stage screening for HNSCC in the community.” – Dr. Nuwan Dharmawardana, PhD. Research, University of Adelaide
Head and Neck Cancer Screening
Australian researchers have recently reported important results involving early cancer detection of head and neck cancers. Their study involved 181 patients with some having early head and neck cancers. Using a breath test for cancer that measured VOCs, the results showed good accuracy in identifying those with cancer. Specifically, it detected 85 percent of those with cancer. And of those it detected, it had an 85 percent accuracy rate. While these numbers are not tremendous, such an easy breathalyzer test could screen large populations. If a positive breath test for cancer resulted, then more precise screening could be performed.
Colorectal Cancer Screening
Another study has investigated a cancer breathalyzer to detect colorectal cancer. In this study, over 500 patients were enrolled and tested using an Aenose device, which is manufactured by The eNose Company. Two-thirds of the patients were used to train the cancer screening process of the device. The other third was actually tested. Compared to concurrent colonoscopy findings, the breath test for cancer has a 95 percent chance of detecting advanced cases of colon cancer. Its ability to detect non-aggressive forms was 79 percent. Once again, this is promising data given that such a test could be administered to large populations within minimal costs.
“At present the only way to diagnose esophageal cancer or stomach cancer is with endoscopy. This method is expensive, invasive and has some risk of complications. A breath test could be used as a non-invasive, first-line test to reduce the number of unnecessary endoscopies.” – Dr. Sheraz Markar, NIHR Clinical Trials Fellow, Imperial College
Stomach and Esophageal Cancer Screening
Another study involving a breath test for cancer took place among 4 London hospitals recently. The study examined 335 patients, with some having stomach or esophageal cancer and others being cancer free. The results of the cancer screening showed that the test had an 85 percent accuracy rate. Given the mortality rate with both of these cancers are high, an effective cancer breathalyzer test would be welcomed. Similar studies have also shown promise for the detection of less serious esophageal disorders like Barrett’s esophagitis. This suggests breath tests may offer potential fore screening other conditions besides cancer.
Prostate Cancer Screening
One of the more difficult tasks in cancer screening has been distinguishing between prostate cancer and an enlarged prostate (BPH). Blood tests, such as PSA testing, are no longer encouraged except in certain high-risk groups. Interestingly, however, a breath test for cancer involving the prostate gland is being tested. The study collected patients with both prostate cancer and BPH for the research. The cancer breathalyzer test was able to detect accurately 78 percent of the prostate cancer cases. It also identified 67 percent of the BPH patients accurately. Further research is being planned in this area as well.
How Good Is Good Enough?
As is evident from the ongoing research trials, many of the results appear quite promising. Even at an accuracy rate in the 80th percentile, their potential as a cancer screening tools in noteworthy. The number of lives such a breath test for cancer would save would be in the hundreds of thousands globally. Likewise, earlier detection would save a sizable amount in cancer diagnostics and treatments. Understandably, there is great excitement for new cancer detection tests to become available.
At this point, however, a larger number of patients need to be studied to ensure these will be effective cancer screening instruments. Certainly, the cost and ease-of-use is attractive. But a test with a high false positive rate could actually drive up healthcare expenditures. Therefore, additional studies will need to confirm these initial promising results. If larger-scale studies show similar findings, a number of breath tests for cancer may soon be on the market.
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