Could Breath Analysis Predict Lung Cancer Recurrence?

The analysis of exhaled carbonyl compounds (ECCs) may allow for the detection of recurrent disease after surgical resection for lung cancer, according to a new study.

“The normalization of our cancer markers after resection served as validation of the markers specificity for cancer, as well as suggest that we could use the markers to monitor the effectiveness of therapy for lung cancer,” said study coauthor Victor van Berkel, MD, PhD, of the Department of Cardiovascular and Thoracic Surgery at the University of Louisville in Kentucky. “Breath analysis may, in the future, serve as a means to quickly and cheaply diagnose and follow lung cancer,” he said.

Study: PET Scans Overused in Lung Cancer Patients
Some Lung Cancer Tumors May Be Harmless

The researchers performed breath analysis on lung cancer patients before and after surgical resection of their tumors. One liter of breath from a single exhalation was collected and evacuated over a silicon microchip. The researchers captured carbonyls by oximation reaction and analyzed them with mass spectrometry. The investigators measured concentrations of 4 cancer-specific ECCs (2-butanone, 3-hydroxy-2-butanone, 2-hydroxyacetaldehyde, and 4-hydroxyhexenal) and compared them using the Wilcoxon test. A given cancer marker was considered elevated at 1.5 or more standard deviations greater than the mean of the control population.

The study involved 34 cancer patients with paired samples and 187 control subjects. The researchers found that the median values after resection were significantly lower for all 4 ECCs and equivalent to the control patient values for 3 of the 4 ECCs.

“While no recurrences have been documented in our post-operative group so far, we are continuing to follow these patients and are interested in seeing what happens to their cancer markers if they recur,” Berkel said. “In addition, we are in the process of planning a large multicenter trial to evaluate the effectiveness of breath analysis for identifying the presence of lung cancer. We are very excited about our results but understand that much larger trials are going to be needed to ensure the safety and efficacy of our test.”

—Mike Bederka


Schumer E, Black M, Bousamra M, et al. Normalization of exhaled carbonyl compounds following lung cancer resection [published online June 9, 2016]. Ann Thorac Surg. doi:10.1016/j.athoracsur.2016.04.068.