Can a Breath Test Detect Cancer?

The Breath Biopsy, a device that could detect cancer before a patient even show symptoms, is undergoing clinical trials. Owlstone Medical Ltd

Screening for cancer may soon be as easy as letting out a deep breath.

The PAN Cancer trial for Early Detection of Cancer in Breath is a collaborative effort between the Cancer Research UK Cambridge Institute and Owlstone Medical. The goal is to test Owlstone’s Breath Biopsy device and to create breath biopsy tests for early detection of a number of different kinds of cancer.

"We urgently need to develop new tools, like this breath test, which could help to detect and diagnose cancer earlier, giving patients the best chance of surviving their disease," Rebecca Fitzgerald, the lead trial investigator at Cancer Research UK Cambridge Institute, said in a statement.

Deep breath

This may sound like science fiction, but there's real science to back up the concept of a Breathalyzer-like device aimed at detecting cancer.

Normal biochemical reactions in cells release volatile organic compounds (VOCs). These compounds release odorous molecules that can be detected. If a cell's VOC pattern has been altered, that could indicate something is going on with the cell, like cancer. The Breath Biopsy detects these VOC biomarkers in a non-invasive way.

To test whether or not the Breath Biopsy is the VOC-detector of the future, Fitzgerald and her team will collect samples from 1,500 people who were referred to Addenbrooke's Hospital in Cambridge due to cancer concerns. The clinical trial will start with patients with suspected esophageal and stomach cancers before expanding to prostate, kidney, bladder, liver and pancreatic cancers a few months later.

Trial participants will take the breath test before they undergo other diagnostic exams. They will breathe into the device for 10 minutes, and Owlstone Medical will analyze the results.

Understanding how VOCs change

By looking across cancer types, researchers hope to determine if different cancers have different signals and how early these signals are detectable. Breath samples between those who do and those who don't develop cancer will be compared to gain a stronger understanding of how VOCs work.

If the Breath Biopsy can accurately identify cancer, then the device could be a screening tool for general practitioners to use before referring their patients to specialists. This could be a boon for both doctors and patients since it will reduce test times and the invasive nature of other types of biopsies.

"There is increasing potential for breath-based tests to aid diagnosis, sitting alongside blood and urine tests in an effort to help doctors detect and treat disease," said Billy Boyle, co-founder and CEO of Owlstone Medical. "The concept of providing a whole-body snapshot in a completely non-invasive way is very powerful and could reduce harm by sparing patients from more invasive tests that they don't need."

Some patients have already tried the device, like Rebecca Coldrick, a participant in the clinical trial who is now in her 50s. When she was in her early 30s, Coldrick was diagnosed with Barrett's esophagus, a condition in which the cells lining the esophagus are abnormal. Thirteen in 100 patients with Barrett's in the U.K. may go on to get esophageal adenocarcinoma. As such, the condition requires routine medical checking, including an endoscopy every two years.

"I was very happy to take part in the trial and I want to help with research however I can," she said. "Initially, I thought I might feel a bit claustrophobic wearing the mask, but I didn't at all. I found watching the display on the computer during the test interesting and soon we were done, without any discomfort. I think the more research done to monitor conditions like mine and the kinder the detection tests developed, the better."