Exploring treatment options in cancer: tumor treatment strategies
Incredible New Test Could Detect Lung Cancer In Your Pee In World First
SCIENTISTS have created a world-first pee test which could indicate the first possible signs of lung cancer.
The majority of cases of lung cancer in England are diagnosed at later stages, meaning the disease can be harder to treat.
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Groundbreaking test may spot lung cancer through urine in a world-first breakthroughCredit: Getty ImagesHowever, experts hope that early detection could mean that patients get treatments sooner, giving them a better chance of overcoming the disease.
The pioneering test looks for so-called "zombie" cell proteins which could indicate a patient has lung cancer in its earliest stages.
It has been successfully tested on mice and scientists are hoping to start in humans soon.
Scientists at the University of Cambridge's Department of Chemical Engineering and Biotechnology, and the Early Cancer Institute, looked at proteins excreted by senescent cells.
These cells are often referred to as "zombie cells" because they are alive in the body but are unable to grow and divide.
The cells cause tissue damage by reprogramming their immediate environment to help promote the emergence of cancer cells.
Now, scientists have developed an injectable sensor that interacts with zombie cell proteins and releases an easily detectable compound into urine, which signals their presence.
Researcher Professor Ljiljana Fruk said: "We know that before cancer emerges there are changes in the affected tissues.
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"We identified a specific protein released by these cells in lung tissue and designed a probe that is cut into two pieces in its presence. The probe is composed of two parts and the smaller one is released into urine through the kidneys.
I'm a doctor and these 5 changes could be a sign of deadly lung cancer"Once in urine, this part of the probe is too small to be detected, but it can be made visible by adding a bit of silver solution to it - the same silver compound used in photography in the early days of analogue photos.
"By monitoring the colour of urine after the injection of the probe we can say if cells are present in lungs that would indicate the early signs of pathological changes that might lead to cancer."
She added: "Ultimately, we wanted to develop a urine test that could help doctors identify signs of the early stages of cancer - potentially months or even years before noticeable symptoms appear."
Scientists behind the study, which is being funded by Cancer Research UK (CRUK), said they were keen to find a test which was a cheaper alternative to expensive scans.
Prof Fruk added: "We urgently need cost-effective, easy to use and sensitive strategies for early detection of cancer, particularly within high-risk groups or those in danger of cancer recurrence.
"Urine tests such as this could be performed in hospital labs even in the absence of expensive imaging instruments and rely both on specific proteins which can be linked to a particular tissue.
"We worked on the lung, but there are other proteins that will be present in other tissues changing."
WHAT IS LUNG CANCER?
LUNG cancer is the most deadly common cancer in the UK.
It is considered a common cancer alongside prostate, breast and bowel, which together make up more than half of all new cases.
Around 49,000 people are diagnosed with lung cancer every year and 35,000 die from it.
Just one in 10 patients survive for a decade or more after being diagnosed and lung tumours make up 21 per cent of cancer deaths in the UK but only 13 per cent of cases.
The main reason that it is so deadly is that symptoms are not obvious in the early stages.
When signs do appear they may include:
The NHS does not routinely screen for lung cancer but is rolling out more tests to smokers and ex-smokers at high risk, in a bid to catch it earlier. Testing may involve X-rays and chest CT scans.
Smoking is the number one risk factor for lung cancer and accounts for about 70 per cent of cases.
Risk may also be higher for people who have inhaled other fumes or toxic substances at work, such as asbestos, coal smoke or silica.
Experts are hoping to end the pre-clinical stages of clinical trials soon and assess the effectiveness of the test in humans.
"We have proven that urine detection works in mice," Prof Fruk said.
"We now need to move to more pre-clinical validation, identification of specific proteins in other cancers - we are interested in breast, melanoma and pancreatic cancer - and then validate it in patients.
"Of course, parallel to science we need to make sure that we have a kit in place which can be easily used by hospital lab technicians all over the world.
"Lots of progress has been made in the treatment of particular types of cancers, but we need to do more and we need to do it faster."
Dr Iain Foulkes, CRUK executive director of research and innovation, said: "Cancer Research UK has been at the heart of lung cancer progress for more than 50 years, with over half a million lives saved from lung cancer since the mid-1980s.
"The announcement of this project being led by Professor Fruk is another example of our commitment to driving progress so that more people can live longer, better lives, free from the fear of cancer."
Patrick Kelly, CRUK spokesperson for the East of England, said: "With Lung Cancer Awareness Month, we hope people will do what they can to show their support - whether that's backing our Smokefree UK campaign or donating to help our scientists make the next big breakthrough."
Other promising lung cancer treatments
Could A Blood Test Detect Lung Cancer?
AHN and DELFI Diagnostics Inc. Recently announced a collaboration to evaluate the effectiveness of DELFI's "FirstLook" blood test to enhance lung cancer screening.
Lung cancer accounts for 1 in 5 cancer-related deaths in the United States. While doctors say lung cancer is often treatable if caught early, millions of Americans who should be getting screened for the disease each year are not either due to lack of awareness or reluctance to undergo a CT scan.
So, what if a simple blood test could detect lung cancer? That's what researchers and doctors at Allegheny Health Network (AHN) are going to study over the next two years.
AHN and DELFI Diagnostics Inc. Recently announced a collaboration to evaluate the effectiveness of DELFI's "FirstLook" blood test to enhance lung cancer screening. For the next 24 months, researchers at the AHN Cancer, Medicine and Primary Care Institutes will work to determine if the blood test helps doctors to better identify those who are most at risk of this disease and who would benefit from follow-up CT screening. Researchers will also try to determine if the test improves adherence to lung cancer screening guidelines.
How does it work?
The FirstLook blood test uses a breakthrough technology called whole-genome machine learning to analyze fragments of DNA that are markers of cancer in the blood. A previous clinical trial showed that the test has a negative predictive value of 99.8%, meaning that if the blood test is negative, it's highly unlikely a CT scan will identify lung cancer.
"When a patient undergoes testing, the results of the test will let their doctor know if the chance of them having lung cancer is low and they won't need another lung cancer screening until next year," says Dr. Ali Zaidi, medical director of aerodigestive research at AHN Cancer Institute. "Or it will tell the doctor that they need a scan of their lungs to get a closer look. DNA is packaged abnormally in cancer cells, resulting in abnormal fragment patterns when cancer cells die and release their DNA into the bloodstream, compared to normal cells."
Researchers will work over the next two years to determine if the FirstLook blood test helps to boost earlier lung cancer diagnoses and reduce death rates.
"The test will be available via the network's pulmonary and primary care practices where eligible patients will submit a blood sample," says Zaidi. "Ultimately, as a convenient, point-of-care test, we are hopeful that more people in our region will undergo lung cancer screening."
Who should get screened?
The American Cancer Society recommends yearly screening for lung cancer with a low-dose CT scan for people 50 to 80 years old who have a 20-pack per year or greater smoking history and currently smoking or quit fewer than 15 years ago. While early detection is key in fighting the disease, most eligible patients do not undergo screening before signs or symptoms appear.
"Despite being the leading cause of cancer deaths in the United States, lung cancer screening rates remain low at around 5%," says Dr. Amy Crawford-Faucher, chair of AHN Primary Care Institute. "Several factors contribute, including fear of diagnosis, lack of awareness about screening guidelines, scheduling constraints, and concerns about the cost of potential follow-up care."
She adds that with the addition of a documented smoking history, the lung cancer screening recommendation is more complex compared to breast, colon and cervical cancer and hasn't yet made it into the public's consciousness to the same degree.
"Office-based testing boasts significantly higher patient completion rates than tests requiring separate appointments elsewhere," says Crawford-Faucher. "The hope is that easier access would improve overall screening rates and help prioritize those who truly do need a CT scan, which could lead to more timely scheduling of the scan."
Patients who are 50 years and older, have a specific history of smoking as outlined by the American Cancer Society and are interested in undergoing testing should contact their AHN primary care physician or AHN pulmonologist to discuss it. It is also expected to be available via AHN's community-based cancer screening events in the future. Insurance coverage for each person is different and patients can call 1-800-589-2182 to find out how much they may have to pay for the test.
Is A Breath Test Key To Detecting Cancer?
A clinical trial has been launched to see if a breath test could detect the presence of cancer.
Researchers want to find out if signals of different cancer types can be picked up in patterns of breath molecules.
The Cancer Research UK team in Cambridge will collect breath samples from 1,500 people, some with cancer.
If the technology is proven, the hope is that breath tests could be used in GP practices to decide if patients need to be referred for more tests.
They could potentially be used alongside blood and urine tests to help doctors detect cancer at an early stage, the researchers said.
But it will be two years before the results of the exploratory trial are known.
GPs' leaders said the research was exciting but they warned patients that breath tests to detect cancer were "unlikely to be commonplace at their GP practice anytime soon".
How does the test work?
Molecules called volatile organic compounds (VOCs) are released when cells in the body carry out biochemical reactions as part of their behaviour.
But if cancer or other conditions are present, the normal behaviour of cells is altered and they appear to produce a different pattern of molecules - and a different signature smell.
The research team is trying to find out if this pattern or odour can be identified in people's breath, using breath biopsy technology.
Their ultimate aim is to work out if different types of cancer produce different patterns - or signatures - which can be detected at an early stage.
What's the potential for the test?
This is the start of the trial so we won't know for several years whether or not the initial results are promising.
The science behind the test itself is not new.
Many researchers around the world have been working on the possibility of breath tests for a number of cancers, including lung, for a number of years.
There are some promising signs that breath tests could detect pre-cancerous symptoms, but it is not yet clear how accurate they are.
Any breath test used on large numbers of patients would have to be sensitive and accurate to avoid misdiagnoses and false positives.
In short, there is a long way to go and much more research needed on more people before a breath test will be appearing in any GP surgeries.
It is possible that dogs could be also used to sniff out the odours given off by cancers, and other diseases like Parkinson's.
Cancer of the oesophagus may give off a signature molecular smell
Who will take part in the trial?
The trial will start with patients with suspected oesophageal and stomach cancers and then widened to include people with prostate, kidney, bladder, liver and pancreatic cancers in the coming months.
Healthy people will also be included in the trial.
At Addenbrooke's Hospital in Cambridge, participants will be asked to breathe into a face mask for 10 minutes so a sample can be collected.
The samples will then be sent to a laboratory in Cambridge to be analysed.
'Best chance of surviving'
Rebecca Coldrick, 54, was one of the first people to take part in the trial. She has a condition called Barrett's oesophagus and could go on to develop cancer.
"I was very happy to take part in the trial and I want to help with research however I can," she said.
"I think the more research done to monitor conditions like mine and the kinder the detection tests developed, the better."
Prof Rebecca Fitzgerald, lead trial investigator at the Cancer Research UK Cambridge Centre, said: "We urgently need to develop new tools, like this breath test, which could help to detect and diagnose cancer earlier, giving patients the best chance of surviving their disease."
Dr David Crosby, head of early detection research at Cancer Research UK, said breath tests were a technology that had the potential "to revolutionise the way we detect and diagnose cancer in the future".
Cancer Research UK has made research into this area one of its top priorities.
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