A study of patients with incurable lung cancer suggests that volatile organic compounds may be useful, objective indicators of how soon someone may die.
Is it possible to confidently predict how close a patient with lung cancer may be to death?
Although research has identified commonalities in advanced cancer, such as elevated levels of markers of inflammation, that might define a “dying process,” validated prognostic tools are no more accurate than an expert clinician, with an overall accuracy of 61%, say Elinor Chapman and colleagues from the University of Liverpool. Chapman is now at Bangor University in Wales.
Elinor Chapman and her colleageus investigated the relationship between volatile organic compounds in the urine and how soon patients with incurable lung cancer might die.
In their study published in the International Journal of Molecular Sciences, they tested the hypothesis that changes in volatile organic compounds— indicators of metabolic processes — might be used to objectively gauge how soon a lung cancer patient might be die.
At six hospital and hospice sites in northwest England, they collected 144 urine samples from patients with incurable lung cancer. (Urine samples have “intricate and comprehensive“ metabolomic profiles, they note.) The team used headspace gas chromatography mass spectrometry to analyze two datasets: acidified or alkalinized urine. They also divided the samples into two group: one from the last three weeks of life and the other from the last week.
The tests identified 37 VOCs that changed as death neared: 12 increased and 25 decreased within the last three weeks of life. A regression model using eight VOCs predicted dying with an AUC of 0.77 at 30 days, 0.78 at 20 days, and 0.85 at 10 days. Median survival was 50 days in the medium risk-group and 10 days in the high-risk group.
The researchers cite five papers that have reported urinary VOCs in lung cancer and named 51 as potential biomarkers of cancer. In this study, the five VOCs that increased towards death were also potential biomarkers of lung cancer.
Predicting when a patient with advanced cancer is likely to die can be a practical, intellectual, and emotional challenge. But the information from VOCs can make the difference between an extensive, invasive process with “burdensome and unnecessary interventions” and allowing the patient and family a more peaceful end-of-life preparation, Chapman and her colleagues note. “The early recognition that a person may be dying,” they said, “is central to all the priorities for improving peoples’ experience of care in the last days and hours of life.”
Medicaid Expansion Linked To Timelier Lung Cancer Surgery and Access to High-Volume Hospitals
April 17th 2025New research shows that Medicaid expansion was linked to a 2.1% increase in timely lung cancer surgeries and a 2.8% rise in procedures at high-volume hospitals, highlighting how policy changes can impact cancer care access.
Read More
Chest X-rays Linked to Earlier Lung Cancer Detection and Improved Outcomes
April 7th 2025A new study in England shows a strong link between higher rates of chest x-ray referrals in general practice patients with symptoms, such as persistent cough, and earlier lung cancer diagnoses, along with improved outcomes.
Read More
Study Finds Adherence to Annual Lung Cancer Screening Linked to Higher Detection Rates
March 18th 2025Researchers found that adherence to the first and second annual screenings was 61% and 51%, respectively, with higher lung cancer detection rates observed in those who followed through on these screenings.
Read More
Regeneron Canada Reaches New Agreement Deal for Cancer Drug Libtayo
March 7th 2025The agreement was signed in a letter of intent March 3 to set the groundwork for whether government health programs in different provinces and territories will cover the drug's cost for patients, according to a news release by Regeneron Canada.
Read More