Morriston team trials breath test that could detect pancreatic cancer earlier

A potentially game-changing breath test that could detect pancreatic cancer at an earlier stage is being trialled in Swansea Bay.

The health board is the only Welsh centre participating in a clinical study called VAPOR that could save thousands of lives every year.

Patients with confirmed pancreatic cancer and other non-cancer conditions such as diabetes are being recruited to take part.

(Main photo: The trial team (l-r): Renee Pittard, pancreaticobiliary surgery clinical nurse specialist; Melanie Allen, lead pancreaticobiliary clinical nurse specialist; Lisa Jarvis, pancreaticobiliary surgery clinical nurse specialist; Professor Bilal Al-Sarireh, consultant surgeon and VAPOR local principal investigator; Gemma Smith, clinical research specialist nurse; and Jenny Travers, clinical research officer)

A research team at Imperial College London, led by Professor George Hanna, is studying how breath samples taken in a GP surgery could ensure people with non-specific symptoms of pancreatic cancer – often mistaken for less serious problems – can get rapid diagnosis and treatment.

The study is being funded by the charity Pancreatic Cancer UK.

Morriston Hospital consultant general surgeon Professor Bilal Al-Sarireh, an expert in pancreatic surgery, is the local principal investigator. He had heard about VAPOR and asked for Swansea Bay to be involved.

To date, 10 patients have agreed to take part and the hope is to increase this to 30 by the time the study closes later this year.

One of those patients is Kay Jelley, from Cimla in Neath, who was diagnosed with pancreatic cancer last October.

Surgeons were unable to remove the tumour because it was attached to an artery, so Kay is having chemotherapy instead.

“The cancer is terminal,” said Kay. “I don’t know how long I’ve got. It could be one year or five years.

“I was asked if I wanted to take part in the trial. I didn’t hesitate. Hopefully the test will work and help others in the future.”

Pancreatic cancer mainly affects people aged 50-80. It has a lower survival rate than other cancers. Around 80 per cent of people with it are diagnosed too late for treatment that could save their life.

This is because it rarely causes symptoms in the early stage. When patients do develop symptoms such as indigestion, loss of appetite or fatigue, these are just as common in people who do not have the disease.

VAPOR is one of a series of clinical trials investigating whether a breath test can detect different types of cancer.

Gemma Smith is the lead research nurse for the VAPOR study in Swansea Bay, working closely with Professor Al-Sarireh.

“We are screening patients who have a confirmed pancreatic ductal adenocarcinoma,” she said.

“Then we have the control groups which are newly diagnosed diabetics, patients with chronic pancreatitis and patients with a healthy pancreas.

“I'll go round and either book an appointment or see them on the ward. I'll complete the breath test, as long as they're happy to consent. And most people are like – wow, this is amazing.”

Gemma said 10 patients had been recruited since last September, with the aim of recruiting a total of 30 by the time the trial closes.

She explained finding eligible patients was not straightforward, as there were specific requirements that had to be met.

“You’re not allowed to have had antibiotics in the previous eight weeks, and they have to be nil by mouth for at least six hours before we take the breath sample,” she said.

“So I usually catch them before they go to for their theatre. So as soon as they come in the clinical nurse specialists will send me a message.

“Professor Al-Sarireh will check they are eligible. I'll ask them if they want to do the study, and then I'll come and see them before their theatre.

“With the diabetics, I get a list from the diabetic unit in Morriston. Professor Al-Sarireh will screen those patients and, once he's told me who's eligible, I will approach them.

“If the registrars on the surgical team have any patients come in with chronic pancreatitis, I'll try and catch them as well. But, again, antibiotics can be an issue, especially over the winter.”

Health and Care Research Wales funds Swansea Bay’s research and development teams, including cancer, non-cancer and maternity.

As VAPOR has been adopted onto its portfolio, the study was eligible for research nurse support – provided by Gemma – within the health board.

Nationally, the study aims to recruit 771 patients. If the findings support it, a second, much larger study will follow.

Gemma, who has travelled to London to meet the Imperial College team, said the hope was that it would ultimately allow GPs to check for cancer when patients with the common symptoms attend a surgery.

“That would be amazing,” she said. “There are no needles involved. All you have to do is blow into a bag.”

Dr Nicola Williams, National Director of Research Support and Delivery at Health and Care Research Wales, said: “This innovative trial has the potential to improve early diagnosis of pancreatic cancer which as we know is often sadly caught too late for effective treatment.

“I am particularly moved by Kay’s involvement in VAPOR. She is an inspiration and a powerful reminder of the vital role that trial participants have in research.”