(RxWiki News) Many people have small growths of tissue in their lungs called nodules. While most are harmless, they can be cancerous. A new breath test may provide a simple means of diagnosis.
A recent pilot study has found that a simple breath test could provide an easy way to determine if a patient has cancerous nodules.
This study helps confirm the value of breath tests as a diagnostic tool for lung cancer.
"Ask a doctor about the latest advances in lung cancer screening."
Nir Peled, MD, head of the Research and Detection Unit for Thoracic Malignancies at the Sheba Medical Center, Tel Hashomer, Israel, worked with collaborators in Israel and Colorado on an initial study of the breath test.
More than half of all pulmonary (lung) nodules are noncancerous, or benign, according to the US government health information source MedlinePlus. The Cleveland Clinic says that nodules are 3 centimeters or less in diameter. In general, the bigger the nodule, the more likely it is to be cancerous.
Doctors typically spy pulmonary (lung) nodules using X-rays and CT scans. Sometimes a tissue sample is needed to determine if nodules are benign or malignant (cancerous).
For this study, scientists collected the exhaled breath from 74 patients who were being examined for pulmonary nodules. All patients had attended a referral clinic in Colorado between March 2009 and May 2010.
Using two techniques developed by Prof. Hossam Haick and his colleagues in the Technion-Israel Institute of Technology, investigators studied the exhaled volatile organic compounds. Gas chromatography with mass spectrometry and chemical nanoarrays analysis allowed the researchers to separate and analyze compounds.
To determine final diagnosis, patients underwent a bronchoscopy, wedge resection and/or lobectomy. Bronchoscopy is a visual examination of the lungs using a special scope. Wedge resection is a surgical procedure to remove a tissue sample. Lobectomy is surgery to remove a portion of the lung called the lobe.
From the breath samples, scientists accurately identified that 53 pulmonary nodules were malignant and 19 were benign. Nodules that either shrank or remained stable over a 24 month period were considered benign.
The authors noted that the nanoarray method provided more detailed information because it could distinguish different types of lung cancer, as well as early and advanced disease.
The Cleveland Clinic says that pulmonary nodules appear in about one of every 200 chest X-rays and most chest CT scans. To diagnose if nodules are harmful or not, doctors observe their growth—cancers grow very quickly, while benign nodules grow slowly.
"The reported breath test in this study could have significant impact on reducing unnecessary investigation and reducing the risk of procedure-related morbidity [death] and costs,” said the authors. “In addition, it could facilitate faster therapeutic intervention, replacing time-consuming clinical follow-up that would eventually lead to the same intervention."
Breath tests to identify lung cancer are not new. dailyRx News reported last December on a Cleveland Clinic study of a breath test that had a better than 80 percent accuracy in detecting the presence of lung cancer. The technology could also identify the subtype of cancer in nearly 90 percent of cases.
The authors recommend that a larger patient study be conducted to confirm their results.
The study was published in the October issue of the International Association for the Study of Lung Cancer's (IASLC) Journal of Thoracic Oncology.
