Advancements in Cancer Detection
- A recent study from researchers at the University of Pennsylvania and Penn’s Perelman School of Medicine showed that a new technology that works like our own noses can detect hard-to-detect cancers such as ovarian and pancreatic cancer.
- Pancreatic cancer is an aggressive disease that is difficult to detect because symptoms – including jaundice and weight loss – typically present at a later stage in the cancer’s development.
- Ovarian cancer, the cancer that whispers, can be difficult to recognize with its subtle symptoms. Women should seek assistance from a medical team if any potential symptoms are present or if something seems off.
Researchers have found that a tool developed at the University of Pennsylvania and Penn’s Perelman School of Medicine can distinguish between benign and malignant cells by ‘sniffing’ out vapors emanating from blood samples in a manner similar to how a human nose works.Read More
The e-nose system uses a pattern recognition approach that is similar to the way the human sense of smell works in that a distinct mixture of compounds tells our brain what it’s smelling. Similarly, this system uses artificial intelligence and machine learning to evaluate the molecules in the ‘smells’ that come from the plasma samples. The human nose cannot detect these smells, technically called volatile organic compounds (VOCs), but the sensors used in the system respond differently when exposed to the VOCs from the cancer samples compared to the non-cancer samples (controls). In this study, the system was able to discern VOCs from ovarian cancer samples with 95 percent accuracy and pancreatic cancer samples with 90 percent accuracy.
Co-author of the study Erica L. Carpenter, Ph.D., director of the Circulating Tumor Material Laboratory and research assistant professor in the Perelman School of Medicine, explains how the system works to SurvivorNet.
“The e-nose detects volatile organic compounds (VOCs) that are emitted into the so-called head space of a vial of plasma,” she wrote in a statement for SurvivorNet.
After collecting a tube of blood, the researchers extract the plasma from the blood with a centrifuge and then store it in a vial. From there, the system analyzes the gases within the few millimeters of space, or headspace, between the level of the plasma and the top of the vial.
“Perhaps an analogy would be the way you can inhale the scent of a perfume when you open the bottle briefly and from the gases that have accumulated in the head space of the perfume bottle,” Carpenter explained. “[The] technology can then tell us whether there are differences detected between the VOCs in the vial headspace coming from one individual versus another.”
Carpenter says the findings of the study are positive because it explores a new way to detect cancer, and to detect it early. The results are also promising because the e-nose system could serve as a screening technique for harder-to-detect cancers such as pancreatic and ovarian cancer.
“If validated, the other exciting piece is that it’s non-invasive,” Carpenter wrote. “In other words, this can be done from a simple blood test and does not require an actual tissue biopsy or surgical procedure. Of course, if this test – once validated – were to come up positive, that would probably lead to a need for a confirmatory biopsy. However, it could eventually be used as a screening test as part of routine blood work ordered during a routine physical exam.”
This study has been a part of an ongoing research project since 2014 when the inventor of the system, Charlie Johnson, PhD., first started using the technology to detect ovarian cancer. This recent study points to the efficacy of this system, but Carpenter stresses that we won’t see e-nose ready for regular use right away.
“Many steps would have to be taken to make this a reality, and our results are very preliminary, but this would be the cause for excitement,” she wrote.
Pancreatic Cancer Detection
Pancreatic cancer is an aggressive disease that is difficult to detect because symptoms – including jaundice and weight loss – typically present at a later stage in the cancer’s development. In a previous interview with SurvivorNet, Dr. Anirban Maitra, the co-leader of the Pancreatic Cancer Moon Shot at MD Anderson Cancer Center, explains what he typically sees when patients develop this disease.
“Because the pancreas is inside the abdomen often doesn’t have symptoms that would tell you that something is wrong with your pancreas,” he says. “By the time individuals walk into the clinic with symptoms like jaundice, weight loss, back pain or diabetes, it’s often very late in the stage of the disease.”
Dr. Maitra added that about 53,000 patients get pancreatic cancer in the United States each year, and the prognosis is not always great.
“And unfortunately, most will die from this disease within a few months to a year or so from the diagnosis,” Dr. Maitra said.
Parents, siblings and children of someone with pancreatic cancer are considered high risk for developing the disease because they are first-degree relatives of the individual. PGVs (pathogenic germline variants) are changes in reproductive cells (sperm or egg) that become part of the DNA in the cells of the offspring. Germline variants are passed from parents to their children, and are associated with increased risks of several cancer types, including pancreatic, ovarian and breast cancers. Germline mutations in ATM, BRCA1, BRCA2, CKDN2A, PALB2, PRSS1, STK11 and TP53 are associated with increased risk of pancreatic cancer.
Jessica Everett, a genetic counselor at NYU Langone’s Perlmutter Cancer Center, encourages people in this category to look into possible screening options.
“If you’re concerned about pancreatic cancer in your family, start by talking to a genetic counselor to learn more about your risk and what options you have,” Everett said.
Ovarian Cancer Detection
Ovarian cancer is known as the cancer that whispers because symptoms are vague and can be similar to regular menstrual cycle fluctuations. Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, says that ovarian cancer can be difficult to recognize with its subtle symptoms.
“Ovarian cancer does not have any specific symptoms,” Karlan said in an earlier interview with SurvivorNet. “It’s often referred to as the cancer that whispers, in that it has symptoms that are really very vague… and nothing that may bring your attention directly to the ovaries.”
But Dr. Karlan still wants women to keep an eye out for a variety of possible symptoms.
“The symptoms include things like feeling full earlier than you usually would when your appetite is strong… Feeling bloated,” she added. “Some changes in your bowel habits. Some pain in the pelvis. These are symptoms women may have every month. These are not very specific. But what we’ve found from multiple studies, it’s this constellation of symptoms.”
Recent findings suggested that screenings, unfortunately, do not save lives, but it is important to note that they can still detect tumors at an earlier stage. And if a screening helps detect a tumor sooner, it is possible that an earlier diagnosis could potentially alleviate the severity of treatment for women.
Currently, the best course of action is for women to seek assistance from a medical team if any symptoms are present or if something seems off.