Study Begins to Develop Breath Test for Mesothelioma Early Detection
June 18, 2019
As an occupational medicine specialist for more than 30 years, Dr. Michael Harbut has spent much of his career combating asbestos-related disease.
Rarely has he felt this energized.
Harbut is the lead investigator in a new, high-tech study of breath-based biomarkers that could save lives through novel, early detection of mesothelioma cancer.
“This study has terrific significance and could be extremely important,” Harbut, clinical professor of internal medicine at Wayne State University and Michigan State University, told The Mesothelioma Center at Asbestos.com. “We’re going after this one with great guns.”
The study is part of a new partnership between Owlstone Medical — the Breath Biopsy inventor in the United Kingdom — and the International Association of Heat and Frost Insulators and Allied Workers, a building trade union that covers the United States and Canada.
Early Diagnosis Still a Rarity
The first part of the study will focus on identifying volatile organic compounds found in the breath of those already diagnosed with mesothelioma.
The second phase will involve verifying the specificity, sensitivity and negative and positive predictive values of the selective volatile organic compound biomarkers.
The goal is to develop a formula where easy-to-get breath samples can become reliable identifiers of early stage disease, a time when mesothelioma can be more successfully treated.
“One of the biggest problems with mesothelioma is that we don’t know how to identify it early,” Harbut said. “It’s a very difficult diagnosis to make.”
Typical symptoms of pleural mesothelioma — the most common type — include dry cough, tightness in the chest, night sweats, fatigue and shortness of breath. Early symptoms often mirror less serious illnesses.
It usually takes a combination of X-rays, CT scans, PET scans, blood tests and a tissue biopsy to positively identify the cancer.
This study could change that problem, even identifying those who are predisposed to developing the cancer.
US Lagging in Mesothelioma Early Detection
Although some progress has been made in using breath tests to identify various cancers in high-risk people, the United States has lagged behind Europe in developing the exact science.
In 2017, researchers in Belgium published a study highlighting the potential of breath analysis for asbestos disease, but it rarely has been used within the United States.
Owlstone Medical recently developed the Breath Biopsy for the early diagnosis of pulmonary hypertension and its subtypes.
“People don’t think of asbestos insulators here as being in tune with the latest scientific and medical trends,” Harbut said. “But I think it’s time to change that with this study.”
Mesothelioma, which is caused by the inhalation or ingestion of microscopic asbestos fibers, typically is not diagnosed until the later stages of disease when palliative care becomes the only treatment option.
Median survival for pleural mesothelioma is only nine to 18 months after diagnosis. Less than 25% of those diagnosed are even eligible for aggressive surgery with a curative intent.
Union Support Strong for Study
James McCourt, general president of the International Association of Heat and Frost Insulators and Allied Workers union, is excited about the possibilities of the study.
“Too many brothers and sisters have been taken far too early in life by mesothelioma,” McCourt told The Mesothelioma Center at Asbestos.com.
The union has more than 23,000 members today, many of whom are regularly exposed to asbestos products in the building trades and considered high risk for mesothelioma.
The study is being supported financially by the Heat and Frost Insulators Tissue Bank Asbestos Research Charitable Trust.
An estimated 3,000 people are diagnosed with mesothelioma in the U.S. each year. The vast majority of those cases are related to occupational exposure to asbestos.
“The hope is, this study proves that we can utilize a method for early detection,” McCourt said. “Instead of our members having to go to a hospital and doing CT scans, one day we may be doing breath tests at the local union hall.”
Although the use of asbestos has decreased significantly in recent decades, it remains a serious problem because of its legacy, still prevalent in older commercial and residential structures.
“If we succeed in developing this, we’ve reached an enormous humanitarian, medical and economic milestone,” Harbut said. “So yes, it’s important.”