The breath test for cancer

As medical technology improves, it is increasingly possible to diagnose many illnesses with a simple breath test. That’s great news for investors in small-cap biotech firms, says Tom Bulford.

This may not be a great time to be British – you’ll know that if you’ve seen the new MoneyWeek documentary – but things could be worse. We could be French. France has a prime minister whose economic policy is to do whatever seems like a good idea at the time. French motorists – and foreign visitors, in case you are thinking of taking your car across the Channel – are now obliged to carry disposable alcohol breathalyser kits, presumably because the French police cannot be bothered.

This is a nice bit of business for penny share Akers Biosciences (AKR). It is to supply millions of these little breathalyser tubes, the vast majority of which will sit in the glove box and never be used. But this has got me thinking about breath tests. And, talking of cars, Dr Peter Mazzone of the Cleveland Clinic in Ohio reckons that breath is a function of the body that works pretty much like the exhaust system of a car – what comes out gives a pretty good indication of what is going on inside.

What we can learn from our unique cocktail?

Every minute, you breathe in and out about fourteen times. That adds up to 21,000 breaths a day, or ten and half million every year. Every time you breathe out you exhale oxygen, nitrogen, carbon dioxide, chemicals that have their origin inside the body, molecules of paint, furniture and carpet fibres and a host of microscopic proteins, antibodies, peptides and DNA.

Every person delivers a unique cocktail of these ingredients into the atmosphere and, as we sometimes know too well, this mixture and the resultant odour can be determined by what we eat, whether we brush our teeth or by the medicines we take. But researchers such as Dr Peter Mazzone are not interested in whether we had curry for dinner or garlic bread. They want to know what our breath can tell us about our medical condition.

Diagnostics is a huge growth industry. Through better diagnosis we can more accurately establish whether people are ill, and from what. We can spot diseases early, and with point-of-care tests we can take these measurements at the patient’s home, saving a trip to the GP or the hospital. Easy to use diagnostic tests are seen as a way of heading off problems before they become too serious or before patients start to occupy doctors’ valuable time. These diagnostic tests come in many forms. We are all familiar with blood or urine tests, but nothing is easier than giving a breath sample, and modern technology makes it possible to detect even the most microscopic of elements.


Breath tests a billion times more sensitive than those used by police

Most breath tests are based on a method of analysis called mass spectrometry, which is a billion times more sensitive than the breath analysers used by police to detect blood alcohol levels. But the future could lie with sensor arrays that can recognise patterns in exhaled breath in the same way that animals can identify familiar smells without knowing the specific chemical compounds that create them.

Whatever the means, breath tests are easy to administer, and overcome any squeamishness about taking pin pricks of blood. And they can be highly sensitive. According to Professor Raed Dwelk of the Pulmonary Vascular Program at the Cleveland Clinic in Ohio, hi-tech sensors can detect differences of one part per billion in a person’s chemistry. “To give you a concept, if you have a baseball field filled with white ping pong balls and only one red one, that is one part per billion.”

Professor Dwelk reckons that breath testing is the new frontier of medical testing. A lot of stuff, good and bad, makes its way from your body tissues to your blood and then through the lungs. The trick is to identify the particular components in any breath sample that could give clues to an underlying illness. Already breath tests are used to identify lactose intolerance or an abnormal growth of bacteria in the intestine. Researchers are working on breath tests for blood glucose, and others that could detect liver, kidney and heart disease. In Italy, researchers have been able to identify patients with colorectal cancer with 75% accuracy by analysing samples of their breath.

Researchers from Israel and Colorado have reported that breath analysis could distinguish between benign and cancerous lumps on the lung. Dr Christina Davis of the University of California is developing a portable paediatric asthma monitor. This would allow children to breath into a tube connected to a mobile device that would analyse the extent of the asthma and transmit the data to doctors so that they could regulate the medication.

Each week in my Red Hot Biotech Alert, I explain how the frontiers of medicine are being pushed back by developments such as these. One day we could monitor our health just by breathing.

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