Abstract for Prime Minister’s Research Fellowship 2019

Title: Early detection of lung cancer using breath biomarker

By:
Name: Vishal Kumar Upadhyay
College: National Institute of Technology, Tiruchirappalli
Lung cancer is the most prevalent cancer that causes the death. Lung cancer kills 1.5
million people worldwide every year. Early detection of cancer helps to increase the
survival rate of the subjects who are suspected with lesions. The conventional cancer
detection techniques are time consuming, involve complex sampling process, incur high
cost, exposure to radiation and bear inconvenience. Clinical breath analysis has been
recognized for years, to detect the disease in humans. The exhaled breath consists of
volatile organic compounds (VOC) which reflect the health status of an individual. The
molecules that exist in the individual’s breath are of two types: exogenous and
endogenous; the source of endogenous molecules is from normal and abnormal
physiological processes and it has diagnostic value. Such an inference gave rise to an
insight on electronic nose, a low-cost and a less complex prototype model with an array
of sensors sensitive to specific biomarker in breath which is to be developed to detect
the early stage of lung cancer through human breath providing real-time analysis. Sensor
based VOC detection techniques become a potential screening tool for the better
prognosis of the cancerous tumours.

Differentiation w.r.t. Existing Techniques

Existing Technique Advantage Disadvantage
Chest X Ray Non-invasive Exposed to radiation
CT (Computed Non-invasive Exposed to radiation and
Tomography) High false positive results
MRI (Magnetic Resonance Non-invasive Expensive, Complex
Imaging) Installing procedures.
Sputum test Simple, quick and High false negative results
Inexpensive
Tissue Biopsy Reliable & definite Invasive and Prone to
diagnosis Infection
Gas Chromatography It shows good separation of Tedious Sampling process,
volatile markers when time consuming, offline
couple with Mass analysis and expensive
Spectrometry

From the above table, it is very clear that existing technologies are employed very well
to detect the early stage of Lung Cancer, but it has its own limitations. All the existing
devices involve complicated installing procedures and set up. With the above
cognizance, the proposed technology Clinical Breath Analysis, which is in its infancy
state employs an array of sensors to detect the volatile biomarkers in low cost and
present several advantages like portability, easy accessibility, non-invasiveness and
real-time analysis. It involves no complex installing and operating procedures when
compared with conventional analysing techniques.
  Why early Detection??

1. Patients require a promising screening tool to diagnose the nodules before

it has become clinically evident carcinoma (metastasis).
2. Require reliability and accuracy of the device to detect the tumour in early
stage before it turns into non-curable lesions (to improve the survival rate).
3. Non-Invasive, easy to use and interpret, inexpensive, no skilled technician
is required to operate the device.
4. Recurrence of lung cancer in the patients after treatment can be identified
through a single breath.

 Impact of this research

1. The topic is very closely related to the medical sector. Healthcare services should
be made available to all. Hence, it becomes a necessity to deliver this type of
product so that it is available to all economic sections of the society.
2. So, if this product is developed, it will be useful for all economic background and
it will be cheap and will make the product available at a cost that is affordable to
all.
3. Since the already available techniques are either costly or it cause discomfort, this
product will overcome those deficiencies and be a success in the market.

Who are my customers & users??

Customer –
1. Medical equipment manufacturers and suppliers
2. Healthcare institutions (hospitals and outpatient clinics)
3. Distributors and suppliers of electromedical equipment and services Research
and consulting firms

User –
The public belonging to any economic section of the society, specifically, subjects
who are suspected to have lung nodules.
Advantages to Customers & Users

Customer User

1. Simple to use 1. Not exposed to radiation

2. Easy Maintenance 2. Non-Invasive
3. Reliable recognition of lesions 3. No discomfort
4. Less Installation procedures to setup 4. Real time data analysis (disease
the device. diagnosis in a single breath)
5. Affordable

Proposed Design
Objective
 To design an indigenous standalone prototype model using electronic nose that
senses the specific volatile organic compounds (biomarkers) in the exhaled breath
which act as a screening test for the identification and recognition of risk factors
of lung cancer in a most effective way.
Proposed Solution
Block Diagram:

Gas Signal
Collection Gas Sensor Processing Display
Bag Unit

Gas Collection Bag:

The Tedlar bags are the material which has been commonly used for breath gas
sampling technique. It is made of a polymer called PolyVinylFlouride.
Characteristic of Tedlar bags:
 It should be inert
 Losses from the breath sample should be less.
Gas Sensor:
An array of sensors to detect the VOC emitted from the lung cancer subjects. It shows
the responses to the interaction between a breath sample and the sensing elements of
the sensor. Calibration is to be done.
Signal Processing Unit:
The measured electronic signal is interfaced to PC using DAQ for the detection of
lung cancer using classification/ pattern recognition algorithms. The signal is then
analysed and processed to obtain the relevant information.
Display:
To display the presence and absence of lung cancer in terms of breath biomarker and
its range present in the exhaled breath.
Innovativeness of the Proposed Solution
Among diverse cancers the rate of lung cancer survival is the lowest. Furthermore, lung
cancer imposes a tremendous economic, social and emotional burden on the society.
The estimated number of lung cancer patients is about 1.14 lakhs during 2016 and it is
expected to be 1.4 lakh cases in 2020. It is clear from the literature that Acetaldehyde,
Formaldehyde, Methanol, Toluene, Undecane, etc. are the putative breath biomarker of
lung cancer and the trace of those present in the breath can be detected using an array
of gas sensors with pattern recognition algorithms which can act as a screening device.
The pervasiveness of smoking has resulted in lung cancer which causes high death rate.
Now the inclusion of Carbon monoxide (CO)and Nitric oxide (NO) as a candidate
breath biomarker helps to know the source of lung cancer. The proposed solution is not
just about the screening test for the presence and absence of lung cancer but also to find
out the factors that induce lung cancer.
Impact of the proposed solution
Impact of the proposed solution for User: The Indian Council of Medical Research
(ICMR) report suggests that lung cancer is the second most common cancer after breast
cancer in women. It also states that India is likely to have over 17.3 lakh new cases of
cancer and over 8.8 lakh death due to the disease by 2020 with cancers of breast, lung
and cervix, tops the list. National Cancer Registry states that colorectal, breast and lung
cancer are the most common in the cities like Bangalore, Chennai and Delhi. To improve
the survival rate of lung cancer, early detection of the lesions plays a vital role. Exhaled
Breath Analysis to detect lung cancer and to find the causes of lung cancer can act as a
promising screening tool which offers a real time data monitoring, portability, non-
invasiveness and it is affordable. Owing to its affordability, people from different
financial backgrounds can access the test and it helps medical professionals to provide
proper guidance and medication that decrease the fatality rate. Impact of the proposed
solution for Customer: Since the prototype model to be developed is cost effective,
portable and requires, less installing procedures or no skilled technicians to setup this
product, the customer can profitably market the product in both rural and urban areas
and thus impact every part of the society positively.