A single breath may be all it takes to identify the return of lung cancer after surgery, according to study results published in The Annals of Thoracic Surgery.1

Breath analysis offers an option for both primary screening and postsurgery monitoring of patients with lung cancer. Exhaled breath has certain carbonyl volatile organic compounds (VOCs) that indicate the presence of lung cancer. Researchers hope the new process will receive FDA approval.

The thousands of VOCs in exhaled breath vary in composition and pattern depending on a person’s health status. This research team focused on 4 VOCs found in the exhaled breath of patients with lung cancer. The ability to identify this lung cancer signature through a simple breath test has emerged as one of the most promising ways to diagnose the disease. The test also demonstrates potential as a monitor for disease recurrence.

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Erin M. Schumer, MD, MPH, Victor van Berkel, MD, PhD, and colleagues at the University of Louisville, Louisville, Kentucky, compared carbonyl VOC levels in breath samples collected before and after surgery from 31 patients with lung cancer with samples collected from 187 healthy patients.

The researchers found a significant reduction in overall carbonyl VOC levels following surgery; in fact, levels of 3 of the 4 carbonyl VOCs normalized after surgery, matching levels in the control group.

“The rapid normalization of almost all of the 4 compounds after surgery provides strong evidence that they are directly produced by the tumor environment,” said Schumer. “This study confirms that the technology is accurate.”

Grim statistics for patients with lung cancer underscore the need for early detection. The hope is that breath analysis will allow diagnosis of primary or recurrent lung cancer before patients experience symptoms, when more options for treating the disease are available, giving patients the best chance for cure, explained Schumer.

The process of breath analysis is relatively simple. The patient blows a single breath into a specialized balloon. The balloon is then connected to a pump that pulls the breath over a microchip smaller than a quarter, trapping the chemicals. The microchip is sent to the lab, where the chemicals are analyzed within hours.

Breath collection can be performed in the doctor’s office. The pump is reusable; the balloon, microchip, and lab test together cost approximately $20. A cost that supports breath tests as a cost-effective, easy-to-perform, noninvasive, and rapid option for diagnosing lung cancer.

“The great potential with breath analysis is detecting lung cancer at any point, both as a primary screening tool and to follow patients after disease has been treated,” said van Berkel. “The technology is pretty robust. Our next step is getting approval from the FDA.”


1. 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.