19 July 2010

Prof. Anton Amann: "Breathing gas analysis is a non-intrusive lung cancer detection method that can save more lives"

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Thousands of lives could be saved if tumour cells in the lung are detected earlier with the breathing gas analysis. Today most lung tumours are discovered too late for a successful treatment. But when lung cancer is diagnosed early, the chance to be cured increases to up to 80 per cent

Cancer – one of the most widespread diseases of the industrialised West. Lung cancer is the most common among these. It is caused by smoking, air pollution and genetic predisposition – killing 240.000 people in the 27 EU member states annually (Source: EUPHIX: European Union Public Health Information System). In most cases, late diagnosis fatal.

Professor Anton Amann together with a team of medical scientists at the University of Innsbruck have developed a revolutionizing procedure for an early diagnosis of lung cancer, namely, the very gas we breath out. Researchers have started working on this new detection method during the BAMOD (Breath Analysis Detection of Lung Cancer) project funded by the European Union.

How revolutionary is the diagnosis method that you have developed?
Well, this simple yet effective method of diagnosis dates back to 500 years BC, when Hippokrates analysed the breath of his patients. A fruity-sweet smell, he claimed, indicates diabetes, ammonia-like smell hints at kidney problems while the smell of decay points to an abscess in the lung. Today we no longer work with odours – instead the most minute particles in the breath we exhale are analysed. The astonishing benefit of breath-gas analysis is that it is so easy to collect samples from patients. They can easily be collected from babies, people under anesthetic during an operation – even the elderly give gas samples willingly. This method could revolutionize medical diagnostic methods.

How is the breathing analysis performed?
The breathing gas is sealed in an airtight bag and then sent to the laboratory where we analyse the sample. These particles are then compared to existing substances. The breath samples are slowly heated to 40°C in order to prevent condensation. In this way the moisture lining the bag evaporates and the sample can be analysed in its full content. After this the warm air is passed to the mass spectrometer through a system of tubes. The high precision proton transfer reaction mass spectrometer is able to analyse breath samples offline, as well as online by patients exhaling into the machine directly. The system monitor allows us to check which substances are present in the breath sample. In smokers, for example, the organic solvent acetonitrile is commonly found. If someone stops smoking today, we would still be able to detect that the person was a smoker one month later. The toxic substances that are contained in cigarette smoke remain detectable for a considerable period of time. The different substances in the breath are then drawn into a specific map. It’s a snapshot of the patient’s state of health.

Which have been the results of your research efforts?
During the BAMOD pioneering project our team of researchers compiled a database of over 350 substances; a number of substances are key indicators for lung-cancer. We have a core set of about 8 substances and a larger set of 60 substances. We work with these substances and study the patterns of prevalence and concentration. We than analysed the breath of 450 lung cancer patients and compared them with 500 samples of a healthy test persons. The efficacy rate lies at an astonishing 85-90%! This has opened up a vista of new opportunities. No longer do we have to take blood or tissue samples from patients – this is a big step forward.

Which are the impacts of your research achievements on future diagnosis activities?
The implications for this research are huge: in future this method of analysis could mean a complete revolution of the medical profession. We predict that within the next 5 to 6 years breath-gas analysis will be widely used in lung cancer detection. It might even prove useful in the detection of other forms of cancer. In the USA, studies with breast-cancer patients are already showing successes.

And which are the impacts for patients?
Lung-cancer is the most common cause of cancer-related deaths in men. This demonstrates the severity of the problem. For women, it is the second most common after breast-cancer. Despite significant medical advances, the prognosis for advanced stages of cancer still remains dire. This makes prevention and early diagnosis imperative. We have hope for this project, as it also sets its goal in finding methods of early detection of lung-cancer through non-intrusive methods. The main problem with lung-cancer is that it is often diagnosed too late. Patients only consult their physician once they begin coughing up blood. In cases like these, patients have few hopes of healing through chemotherapy or operation. Life expectancy may be reduced to about 1 or 2 years. With the help of the breathing gas analysis many lives may in future be saved.


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