Many cancer screening tests have been shown both to find cancer early and to improve survival rates. Colonoscopy, the gold standard for detection of colorectal cancer, is an unpleasant procedure that has yielded low rates of patient compliance. Other screening techniques include flexible sigmoidoscopy and barium enema x-ray tests, both of which are less invasive forms of colonoscopy but again, are unpleasant. Poor levels of patient compliance are common.
What to do?
Breathe in, breathe out, and relax. A possible solution to invasive diagnostic tests and procedures may be as close as, well, your breath.
A UK-based diagnostics company has developed a breathalyzer for the early detection of cancer. Originally developed as a gas detector for harmful chemicals in the air, the device non-invasively collects and measures the levels of volatile organic compounds (VOCs) in a person’s breath.
Volatile organic compounds include biomarkers that can be used to precisely characterize disease processes, according to Owlstone Medical, maker of the device, marketed as Biopsy Breath.
Although breath tests for single compounds in non-cancer indications already exist, they are unable to analyze multiple compounds simultaneously like Breath Biopsy, Owlstone CEO Billy Boyle tells seekingalpha.com. “We’re taking tentative steps, but I think we will be the first to make significant headway in the diagnostic applications which are so problematic.”
As blood circulates throughout the body before returning to the lungs, the VOC biomarkers in breath provide a holistic snapshot of a person's metabolites, or small molecules created as byproducts by the chemical reactions of living cells. It takes about one minute for blood to flow around the entire circulatory system. By sampling breath for a minute or longer, even very low levels of systemic VOC biomarkers can be pre-concentrated, collected and analyzed. These volatile organic compounds (VOCs) are exhaled and provide a source of useful biomarkers directly linked to the body's metabolism.
Owlstone Medical claims its breathalyzer is particularly valuable for diagnosing diseases that reside in the lungs or airways. For example, VOC biomarkers originating from pulmonary tissue are relevant for diseases like lung cancer and metabolites relating to infectious bacterial diseases like tuberculosis.
Breath analysis is also sensitive to potentially important endogenous VOCs, such as drug metabolites. The company says its disease breathalyzer technology is being used to stratify asthma patients by inflammatory subtype, matching patients to the correct treatment to both improve patient outcomes and save healthcare organizations money.
Due to the diffusion of metabolic volatiles from circulating blood into inhaled air in the lungs, VOCs in exhaled breath originate from the whole human system as well as from metabolic activity in local airways tissue. This combination makes breath biopsies sensitive to both pulmonary conditions like asthma and lung cancer, as well as diseases elsewhere in the body.
“VOC biomarkers represent a new way to think about how cancer and, potentially, many other diseases are found in the body,” says Billy Boyle, CEO of Owlstone Medical, tells Pharmaphorum's Marco Ricci. “More and more research is suggesting they are directly influenced by cancer, with some VOCs even being cancer type-specific.”
Breath Biopsy’s underlying technology is called field asymmetric ion mobility spectrometry (FAIMS). The process involves separating gas ions in a breath sample based on their electric charge, which, in this case, occurs through a silicon microchip.
The company currently is conducting trials in both lung and bowel cancer to determine the efficacy of its device as a screening tool, as well as in asthma as a patient stratification test.
BCC Research projects that the global market for VOC gas detectors will grow from more than $131.4 million in 2016 to $154.7 million in 2021 at a five-year compound annual growth rate (CAGR) of 3.3% from 2016 through 2021.