Novel noninvasive technique successfully discriminates between prostate cancer and benign disease in proof of principle study, paving the way for easy and early diagnosis, reports the Journal Of Urology
We may soon be able to make easy and early diagnoses of prostate cancer by smell. Investigators in Finland have established that a novel noninvasive technique can detect prostate cancer using an electronic nose. In a proof of principle study, the eNose successfully discriminated between prostate cancer and benign prostatic hyperplasia (BPH) by “sniffing” urine headspace (the space directly above the urine sample). Results using the eNose are comparable to testing prostate specific antigen (PSA), reports the Journal of Urology®.
Prostate cancer is the second most common cancer in males and one of the leading causes of cancer death. The heterogeneity of prostate cancer makes it difficult to diagnose and predict tumor progression. Both of the current cornerstones of diagnosis, i.e. digital rectal examination (DRE) and PSA have limitations, while ultrasound guided biopsies are costly, uncomfortable for the patient, and have a risk of infection. Additionally, significant numbers of diagnosed prostate cancers are of low grade and will not cause symptoms or disease-specific mortality. Therefore, aggressive treatment can lead to decreased quality of life without extending the patient’s life. Thus, there is a need for novel diagnostic tools.
In the 1980s incidental reports of dogs that detected cancer in their owners sparked a number of experimental studies that have since confirmed that trained sniffer dogs can detect cancer. However, variations in the performance of dogs during and between studies have meant that these findings are of limited application. A more promising development is the growth of sensor technology (generally referred to as artificial olfaction) that has led to the invention of numerous new types of olfactory electronic sensors.
eNoses are best suited for qualitative analysis of complex gaseous mixtures of molecules, and are routinely used in food and agricultural quality control and military applications. The eNose used in the current study is a device that consists of a cluster of nonspecific sensors. When the device is exposed to the sample, it produces a profile or a “smell print.”
“eNoses have been studied in various medical applications, including early detection of cancer, especially from exhaled air,” says lead investigator Niku KJ. Oksala, MD, PhD, DSc, of the Department of Surgery, School of Medicine, University of Tampere and Department of Vascular Surgery, Tampere University Hospital, Finland. “However, exhaled air is a problematic sample material since it requires good cooperation and technique from the patient and immediate analysis, while urine is simple to attain and store, and is therefore more feasible in clinical practice. Preliminary data suggested that detection of urologic malignancies from urine headspace was possible. Our own preliminary results on prostate cancer cells encouraged us to launch this prospective clinical study.”
The ChemPro® 100–eNose (Environics Inc., Mikkeli, Finland) was tested on 50 patients who had been diagnosed with prostate cancer confirmed by biopsy, and 15 patients with BPH. Both groups were scheduled for surgery. The patients provided urine samples before surgery and those with benign disease also provided samples three months after surgery to be used as a pooled control sample population. Patients with prostate cancer underwent robotic assisted laparoscopic radical prostatectomy, while the benign disease group underwent transurethral resection of prostate.
Results with the eNose confirmed that using urine headspace, the eNose is able to discriminate prostate cancer from BPH. The eNose achieved a sensitivity of 78%, specificity of 67% and AUC of 42.0.
“The performance with the eNose matches that of PSA results in previous literature and the results are achieved rapidly and in a completely noninvasive manner,” comments Dr. Oksala. “PSA is known to correlate positively with prostate volume, which is a potential source of diagnostic error when comparing prostate cancer with benign disease. According to our current analysis, prostate volume did not affect the eNose results, potentially indicating high specificity of our sensor array to cancer. We also studied whether eNose signal correlates with the size of the tumor. No such correlation was found. Further studies are now warranted to enhance current technology and to identify the molecules behind the distinct odors.”
The electronic nose used tot detect cancer has advanced cancer research. Cancer could be treated and possibly cured if it detected early. Prostate cancer has not been easily detectable and the development of the electronic nose and devices alike can save many lives.
The use of the electronic nose will be helpful tool in the medical industry, seeing that prostate cancer is not easily detectable, and according to the author the methods that are available now ” have limitations, are costly, and they are also uncomfortable for the patient. This new technology will help check for prostate cancer in a simple way. I think this equipment will go a long way in improving and saving the lives of people by early detection of the cancer tumor. Many people do not go for regular check ups because they may feel it is costly or it is just a hassle and takes too long. With the electronic nose the check up process has been simplified so more people should be open to it.
Wow I never thought I would see such… A nose that can detect cancer is really astonishing yet simply amazing. Prostate cancer is one of the leading causes of death among men, older to be specific; earlier detection of the cancer by this nose will really help in decreasing the deaths caused by prostate cancer.Early detection of this cancer will give a chance at a better life for the cancer patients!
I was also interested to see how the eNose could work in situations outside of urine samples. Although it does say that “exhaled air is a problematic sample material since it requires good cooperation and technique from the patient and immediate analysis” (ScienceBlog, 2014), it has been tested in Australia to detect lung cancer. The eNose differentiated volatile organic compounds from lung cancer patients from those with a 30-pack year smoking history with 86% accuracy.It did not distinguish between different types of lung cancer. (Dent et al. 2011) Although this use of the eNose may not be as effective when analysing exhaled air as opposed to urine samples, I think it would still be very useful in detecting more forms of cancer than just prostate cancer.
This is a great advancement in scientific research. This discovery of the eNose will provide a platform that will help in the prevention of deaths from prostate cancer and hopefully scientists will be able to advance the this discovery to in aiding medical teams to picking up other forms of cancer. This would one of the greatest breakthroughs the world will ever see if we are able to use the eNose to detect early signs of all forms of cancer so that patients can receive immediate medication.
since the eNose basically sniffs urine, why should it only be able to identify prostate cancer, why can’t it be beneficial to woman as well and sniff for cervical cancer? May be a good thing worth looking into.
As mentions in the article, A more promising development is the growth of sensor technology (generally referred to as artificial olfaction) that has led to the invention of numerous new types of olfactory electronic sensors.
I think this is good to be researched for cancer. Prostate cancer is to be detected and eNose has already accurated.
what intrigues me the most about such reasearch is the way in which human senses are being incorporated into technological advancements that can help detect prostate cancer and benign prostatic hyperplasia and it can even differentiate between the two. with this new discovery, early detection can cause less aggessive treatments to be used as it has been detected early, which can in turn extend the patients life.
I think this is an amazing step forward in cancer research. Prostate cancer is quite difficult to detect in its early stages, and this new development can possibly save millions of lives, because as the article states, prostate cancer is the most common noncutaneous form of cancer in men. The eNose is already quite accurate, but maybe with more research and the necessary work its accuracy can be improved.