"A single breath may be all it takes to identify the return of lung cancer after surgery according to a study posted online today by The Annals of Thoracic Surgery. Exhaled breath contains thousands of volatile organic compounds VOCs that vary in composition and pattern depending on a persons health status. A subset of four VOCscalled carbonyl compounds because of their carbon basehave been discovered in the exhaled breath of lung cancer patients. Being able to identify this lung cancer signature through a simple breath test has emerged as one of the most promising ways to diagnose the disease. Now the test is being used to monitor for disease recurrence.  Erin M. Schumer MD MPH Victor van Berkel MD PhD and colleagues from the University of Louisville analyzed breath samples collected before and after surgery from  lung cancer patients and compared their carbonyl VOCs levels with samples from  healthy patients. The researchers found a significant decrease in overall carbonyl VOC levels following surgery in fact three of the four carbonyl VOCs normalized after surgery matching levels in the control group. The rapid normalization of almost all of the four compounds after surgery provides strong evidence that they are directly produced by the tumor environment said Dr. Schumer. This study confirms that the technology is accurate.  Lung cancer is the leading cause of cancer death. The American Cancer Society ACS estimates that more than  Americans will be diagnosed with lung cancer this year and more than  lung cancer patients will diethat translates to  lung cancer deaths per day in the United States.  Dr. Schumer said those grim statistics underscore the need for early detection We hope that breath analysis will allow us to diagnose patients with primary or recurrent lung cancer long before they suffer from symptoms when we have more options for treating them giving them the best chance for cure.  Currently lung cancer patients are followed after surgery with chest computed tomography CT scans which can be inconvenient expensive and expose the patient to radiation. We hope that the breath analysis can serve as the primary screening tool for cancer recurrence and a CT scan ordered only if the breath test suggests that there has been a change said Dr. van Berkel.  How the Breath Test WorksThe process of breath analysis is relatively simple. The patient blows a single breath into a specialized balloon. The balloon is then connected to a pump that pulls the breath over a small microchip smaller than a quarter trapping the chemicals. The microchip is sent to the lab where the chemicals are analyzed within hours. Breath collection can be performed in the doctors office. The pump is reusable the balloon microchip and lab test together cost around  all supporting the increasing acceptance of breath tests as a costeffective easytoperform noninvasive and rapid option for the diagnosis of lung cancer.  The great potential with breath analysis is detecting lung cancer at any point both as a primary screening tool and to follow patients after disease has been treated said Dr. van Berkel. The technology is pretty robust. Our next step is getting approval from the FDA. Schumer E Black M Bousamra M Trivedi J Li M Fu X van Berkel V. Normalization of Exhaled Carbonyl Compounds Following Lung Cancer Resection. Ann Thoracic Surg  DOI .j.athoracsur....  Note This work was supported by the Coulter Foundation V Foundation National Science Foundation and Bill and Melinda Gates Foundation. In addition Drs. Bousamra van Berkel and Fu disclose a financial relationship with Breath Diagnostics Inc.  For a copy of The Annals article contact Jennifer Bagley at  or jbagleysts.org. Founded in  The Society of Thoracic Surgeons is a notforprofit organization representing more than  cardiothoracic surgeons researchers and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart lung and esophagus as well as other surgical procedures within the chest. The Societys mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education research and advocacy.  The Annals of Thoracic Surgery is the official journal of STS and the Southern Thoracic Surgical Association. It has a year impact factor of . the highest of any cardiothoracic surgery journal worldwide."