Sometimes It’s important to know the news behind the news: the comments and the cautions that don’t get into the article that the public gets to read. It’s the sort of thing that keeps me up at night: trying to convey the reality, while realizing what most people want to hear is the hope.
That’s the problem I have with a story posted on a major news network website yesterday, where I have a brief quotation that failed to capture the thoughts I tried to express at the time of the interview. The reporter had very limited time, and the information I wanted to provide was complicated. Instead of the caution I tried to convey to counter the potential “hype” about chewing gum to find cancer early, the report suggests that this is a test that will be available soon—while failing to inform how complicated it would be to achieve that goal.
The topic of the story is about a chewing gum that reportedly can capture volatile (gaseous) compounds excreted by the body, then analyzing that gum to detect the presence of cancer.
It’s not an entirely new concept (see: 1,2). Work using volatiles to detect cancer has been going on for over 15 years. You probably recall hearing about dogs being tested on their ability to detect cancer by smelling samples of body fluids and breath samples, most often in patients with a known diagnosis. The question is whether science can capture the capability that dogs have, given their exquisite sense of smell, to develop a test that could in fact potentially screen for cancer on a large, scalable basis that could be routinely applied to consumers and patients.
That’s the theory, and there is good science to suggest this may be possible. However, notwithstanding the “interest factor” that is associated with this concept, actually making it happen has proven more difficult. Some pretty smart scientists have tried, and we still don’t have a test based on detection of volatile compounds that is proven (key word) to be effective for the early detection of cancer. Some recent reports suggest that some breakthroughs are on the way, however large-scale application remains elusive as I write this.
Which brings us to the interview in question.
A reporter asked me to comment on the story that a company in Alabama is developing such a test. Since no relevant information was made available to me about this company’s test and the research they are conducting, I specifically said I could not comment on this company’s efforts. I tried to explain the background of how we got to where we are, however the time was limited and I couldn’t offer that information in adequate detail.
What I did say was that assuming this particular company—whose website shows that it is involved in doing sophisticated work on analyzing odors—has the “secret sauce” to make this work, it would be years before such a gum could be proven to be effective in detecting cancer and more specifically in detecting cancer early–not to mention how often the test suggested a cancer was present when in fact none was there, or missing a cancer that in fact was present (what researchers call specificity and sensitivity).
Those are pretty important pieces of information that are required to demonstrate effectiveness of an early detection test for cancer—and neither are simple or easy to do. So, the suggestion that such a gum could be available for general use sometime next year simply would be a very high hurdle, and very difficult to achieve.
I would be less than honest if I didn’t share with you that I wondered why this story was being reported in the first place. It was full of audacious goals without supporting foundational evidence which suggests to me it was not ready for reporting by a major news source.
So, imagine my surprise when I read the headline that said “Cancer-detecting gum may soon be available”, and that such a gum which absorbed volatile compounds after it was chewed could in fact distinguish between different types of cancers—which is critically important for an early detection tool.
Without well done studies to show that it works in real life and makes a genuine difference in the lives of people we really don’t know that is in fact the case. There have been too many claims about this approach that haven’t worked out, which results in my “show me” response. Yes, it may work—but the distance between concept and proof is a lot longer than many realize.
So, let’s understand from my vantage point new approaches to addressing a complicated problem such as making a proven difference in saving lives from cancer are critically important and absolutely necessary. Lots of folks are working on a variety of approaches to achieving that goal, such as looking for circulating tumor cells in the blood to fragments of cancer-related genetic proteins in the blood to—yes—chemical signatures of compounds in the blood that may be related to cancer.
However, doing research and making evidence-based, proven claims about a particular effort are not the same thing. Holding out hope to consumers that such tests are just around the corner may lead some folks to believe they don’t have to pursue the more uncomfortable approach, let’s say, of getting a stool test for colon cancer, or a colonoscopy, or a lung CT test or a mammogram since another option will soon be available.
Why we don’t tell the whole story—with the cautions, warts and all—is beyond me. Well, maybe not beyond me because these kinds of stories of unproven hope and promise “sell.”
Maybe we need to concentrate a little less on selling and a lot more on truth and consequences.