Investigating the mechanistic pathways of augmented volatile organic compounds related to the oesophagogastric cancer microbiome

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Oesophagogastric cancer (cancer of the food pipe and stomach) is the fifth most common cancer in England and Wales with 16,000 new cases diagnosed every year. Currently only 15 out of every 100 patients diagnosed with this type of cancer live beyond 5 years. When oesophagogastric cancer is detected it is often in an advanced late stage. This is because symptoms associated with early disease are typically vague and common to a number of benign (non-cancer). It is not possible for GPs to send all patients who present with such symptoms for endoscopy, a 'camera test' to confirm the diagnosis of cancer, as this test is expensive and uncomfortable for patients. It is therefore important to develop new acceptable, accurate and affordable tests to help detect oesophagogastric cancer at an early stage.To address this problem, we are developing a non-invasive breath test for oesophagogastric cancer. The test is based on the detection of small molecules in exhaled breath called volatile organic compounds (VOCs). Our research has suggested that bacteria within the stomach of patients with oesophagogastric cancer are at least partly responsible for increased production of VOCs.This study intends to investigate the role of stomach bacteria in VOC production in oesophagogastric cancer. We will grow bacteria collected from cancer patients and measure their production of VOCs using mass spectrometry. We will conduct further experiments exploring what factors affect the production of VOCs from bacteria including the effects of growing bacteria and cancer cells together. Studying VOC production in this way will help us to understand how they are produced.This research is important because it can explain the underlying science behind a potentially innovative, non-invasive and cost-effective breath test to detect patients at risk of oesophagogastric cancer. Early diagnosis and treatment will lead to improved survival rates with global economic and societal benefits.