What does it mean when your breath smells like mothballs?

Mothball Breath: Causes and Solutions

Mothball breath is so-called because one’s breath can smell overpoweringly like mothballs. This musty, benzene-like odour can be unpleasant both for you and your network of friends and family.

Interestingly, mothball breath may arise slowly over a period of weeks or months, or may suddenly appear within the space of days. In more severe cases the smell of mothballs can be quite severe, requiring rapid treatment to avoid unnecessary embarrassment.

Oddly, while many instances of bad breath have quite obvious cures, mothball breath is rather different to most cases of halitosis and may stem from a wide range of potential causes. Therefore, it is important to address the potential causes in order, so as to eliminate one potential impact after another.

Causes of Mothball Breath

There is no single cause of mothball breath; instead it may be caused by a range of different issues. While some of these may be oral in origin, a number of different medical conditions and dietary impacts may also lead to the musty smell of mothballs on the breath.

In contrast to popular opinion, there appears to be no evidence that lactose intolerance can lead to breath that smells like mothballs.

Here are some of the most common causes:

Poor Oral Hygiene

Mothball breath may be caused by bacteria in the mouth. These sulphur-producing bacteria thrive on food particles and sloughed mouth cells. As they digest these food items they produce volatile sulphur compounds (VSCs) which can smell like mothballs.

One of the most common sources of halitosis is therefore a lack of oral hygiene – or associated dental problems such as tooth decay or calculus.

Under such conditions the bacteria are able to rapidly replicate, and in doing so the volume of VSCs produced increases. This can cause the breath to smell like mothballs.

Sinus problems have long been linked to the issue of bad breath – especially in the case of mothball breath.

An infection of the sinuses results in the production of excess proteins, which the body struggles to break down, yet act as an ideal food source for bacteria. The secretions themselves may also have an unpleasant odour to them.

These two elements mean that VSCs can be breathed out in considerable volumes, making for malodorous breath.

“Keto breath” is a well-known phenomenon among those partaking in a low-carb diet. In place of burning carbohydrates for food the body burns stored fat – and in doing so releases chemicals called “ketones”.

While ketones tend to smell quite rich and fruity (akin to nail polish), some dieters have found that their breath comes to resemble the smell of mothballs.

Kidney Conditions

Less commonly, some kidney conditions are known to cause halitosis. Heavy drinkers, in particular, may be impacted by this potential cause.

Acid Reflux

While acid reflux (GERD) most commonly makes its presence felt in the form of a sour or bitter taste in the mouth (thanks to the improper placement of stomach acids) there is some evidence to suggest that GERD may also be a causal factor in mothball breath.

Certain Foods

Lastly a range of spicy or pungent foods may also be to blame for halitosis.

Elements such as onions and garlic, or spicy foods like curry, can all have a significant impact on the breath.

How to Get Rid of Mothball Breath

As you can see, based on the wide range of potential causes of mothball breath it also follows that getting rid if it isn’t always easy. That’s not to say it’s impossible; just that you’ll need to be methodical about ticking off one potential cause after another.

Here are some of the most effective solutions we’ve come across:

Implement an Effective Oral Hygiene Routine

Let’s start off with the basics; to rule out the most common cause it is wise to start with a thorough and highly-effective routine of cleaning and sterilising your mouth.

Start off by brushing and flossing twice a day, for at least two minutes at a time.

Add to this daily scraping of your tongue, where many sulphur-producing bacteria are to be found.

Lastly be sure to use an effective anti-bacterial mouth rinse which will fight the bacterial load in your mouth. This is in contrast to standard deodorising mouth rinses which simply mask the smell; instead treat the root cause with a product such as UltraDEX Daily Oral Rinse.

Visit Your Dentist

Just because you’re not experiencing any discomfort doesn’t necessarily mean that there aren’t any issues in your mouth. If you suffer from mothball breath it is a wise idea to consult your local dentist for a check-up.

Your dentist will be able to check for any issues – such as minor tooth decay or tartar – and propose effective solutions.

Visit Your Doctor

Due to the fact that many potential causes of mothball breath are health-related – such as sinus infections or kidney problems – it also pays to visit your General Practitioner. Explain the issue you’ve been experiencing, and ask them to check for any obvious causes.

On many occasions, for example, individuals struggling with significant halitosis find that they’re suffering from sinusitis. After a short course of medication, they’re soon back to their former fresh-breathed self.

Consider Your Diet

Have you changed your diet recently? For example, have you switched to a calorie-reduced diet or have you begun to enjoy more spicy foods as of late? If so, consider eliminating these factors one-by-one to see if your mothball breath goes away in time.

Drink More Fluids

The sulphur-producing bacteria which give off unpleasant odours are naturally kept under control by your saliva. The pH of this helps to fight the build-up, and so keep your breath fresh during the day.

However, if your salivary rate drops, so does the body’s ability to control oral bacteria. This is one of the most common causes of so-called “morning breath”, as the flow of saliva drops while we’re asleep at night.

One of the best ways to counteract a lack of saliva is to sip gently on plain water.

So keep a bottle with you at all times and aim to keep yourself properly hydrated throughout the day. Avoiding alcohol and cigarettes can also help to keep the mouth properly lubricated.

Chew Sugar-Free Gum or Mints

One final trick, which not only improves salivary flow but also provides a pleasant masking effect, is to consider the use of gum or mint. Alternatively consider the use of a breath spray or mouthrinse sachet which can be discretely kept in a pocket or bag.

Note, however, that masking your mothball breath should only be considered a short-term solution; we would advise you to seek the appropriate medical advice to help deal with the root cause of the problem.

7 things your breath is trying to tell you

Not-so-minty-fresh breath? It’s most likely down to something you ate or because you haven’t brushed your teeth properly, you’d think. But occasionally, particular smells carried on the breath point to serious health problems.
Almost all bad breath odours are caused by anaerobic bacteria living in the back of the tongue, throat and tonsils, which break down the proteins in our food as part of their daily job. However, when someone isn’t entirely healthy, it can be harder for these bacteria to break down these proteins as they should, leaving particular chemical smells behind.
Go through this checklist before you approach your GP or dentist for an opinion.
IF YOUR BREATH SMELLS OF PEAR DROPS IT COULD BE: DIABETES
One of the tell-tale signs of undiagnosed Type 1 diabetes is the faint smell of pear drops, or ammonia, on the breath. This occurs because a lack of insulin means the body can’t use sugar for energy and starts to break down the fat instead.Waste products called ketones build up and are exhaled.Freshen up: See your GP for a urine test, particularly if you have excessive thirst, extreme tiredness, unexplained weight loss and the need to pass urine more frequently.
IF YOUR BREATH SMELLS OF MOTHBALLS IT COULD BE: SINUS
People with sinus problems often emit a scent reminiscent of mothballs. This is because the mucus formed when you have a stuffy nose or congested throat contains very dense proteins. It is these proteins, which are hard for the body to break down, that contain that very distinctive odour.Freshen up: Try over-the-counter decongestants or see your GP if you think you may have sinusitis.
IF YOUR BREATH SMELLS OF SOUR MILK IT COULD BE: DUE TO DIET
High-protein, no-carb diets can leave you with foul-smelling breath.Again, as with diabetes, it’s those ketones that are to blame. As the body has fewer carbs to turn into energy, it begins to burn fat and proteins. In this instance, the proteins consumed from a no-carb diet produce this unpleasant smell. Freshen up: No amount of brushing, flossing or mouthwash can get rid of this particular smell, so you might want to reintroduce more carbs into your diet.
IF YOUR BREATH SMELLS OF ROTTING FLESH IT COULD BE: TONSILLITIS
When tonsils are infected and inflamed, it makes it difficult for the anaerobic bacteria at the back of the tongue to break down chemicals as usual. Sulphur-producing bacteria breed deep in the tonsils, and the infected ones can’t break it down.It’s this sulphuric smell that makes the breath smell so bad when someone is suffering from tonsillitis or tonsil stones. In rare cases, this smell could also indicate cirrhosis of the liver.Freshen up: Most cases of tonsillitis clear up without treatment within a week. In the meantime, drink plenty of water and try gargling with a mild antiseptic solution.
IF YOUR BREATH SMELLS OF MORNING BREATH IT COULD BE: XEROSTOMIA (DRY MOUTH)
No one’s mouth smells as fresh as a daisy when they wake up, but if normal brushing doesn’t alleviate the problem, then there might be another underlying cause. Some people suffer from Xerostomia, or dry mouth, where the saliva isn’t flowing as it should. A lack of saliva can cause bacteria to build up, leading to bad breath. Unless saliva levels are brought back to normal, the consequences of Xerostomia are potentially long term and serious, usually involving tooth decay and gum disease.Freshen up: People suffering from dry mouth will often experience other symptoms, such as unrelenting thirst, chapped lips andor cracked mouth corners, sore throat and a burning sensation on the tongue.If you have these, see your GP and make sure you drink plenty of water.
IF YOUR BREATH SMELLS OF FISH IT COULD BE: KIDNEY PROBLEMS
Nitrogen is the main culprit when it comes to giving out fishy smells.If your breath has a fishy odour, your kidneys might be to blame. If your kidneys are not functioning properly, there will be a build-up of nitrogen.Freshen up: See your GP who can arrange a kidney function test.
IF YOUR BREATH SMELLS OF FAECES IT COULD BE: INFECTED GUMS
Rotting tissue can mimic the smell of faeces because of the production of chemicals by anaerobic bacteria.“The number-one infection in modern humans is infected gums. So the smell of faeces can just as easily come from a lack of flossing as from a blockage in the bowel.Freshen up: Make sure you floss and brush carefully twice a day. Visit your dentist or hygienist regularly.
HOLD YOUR BREATH, DARLING
By the time, Clark Gable was 32, he had dentures thanks to acute gum problems during child hood. The pin-up star struggled with stubborn halitosis, putting off his leading ladies. “Kissing Clark Gable in Gone with the Wind was not that ex citing,“ co-star Vivian Leigh once said.

Chances are, you already know the basics when it comes to keeping your breath minty-fresh (or at least non-offensive to those in whiffing distance). You brush, floss, and maybe do a quick rinse with mouthwash a few times a day. You wouldn’t dream of ordering garlic bread on a first date, and you always pop a stick of sugar-free gum shortly after downing your morning coffee. But let’s say you do all those things, yet your breath still stinks.

MORE: 7 Breath Mints That Aren’t Packed With Chemicals

That’s the case more often than you might think, as poor oral hygiene is not the most common cause of bad breath, says Harold Katz, DDS, a dentist, bacteriologist, and founder of the California Breath Clinics. Most chronic bad breath is actually due to dry mouth: When you don’t have enough moisture, the bacteria that live in your mouth thrive. “When you sleep at night there’s little or no saliva production. That’s what causes dryness and morning breath,” explains Katz.

If morning breath is your only issue, you don’t really have a problem (just brush!). But many people have dry mouth (and the accompanying bad odor) that lingers all day, often thanks to a medication they’re taking. “Seventy-five percent of prescription drugs, including antidepressants, antihistamines, and blood pressure drugs, have dry mouth as a side effect,” says Katz. So if you find people frequently backing away when you’re talking, ask your doc if your meds might be to blame. If so, sipping more water, chewing sugarless gum, or maybe switching to a different drug could help. (Discover how to heal 95+ health conditions naturally with Rodale’s Eat for Extraordinary Health & Healing.)

In other instances, chronic bad breath could signal that something is amiss elsewhere in your body. And—believe it or not—the specific scent may provide clues that can help your doctor or dentist figure out what’s wrong.

MORE: 11 Natural Solutions For Bad Breath

The Girl Who Smelled Like Pennies

She asked her husband if she smelled like anything unusual. “Your breath smells like a big bag of pennies,” he said.

And for her, the metallic taste was horrible.

Then she read about candida overgrowth syndrome, the controversial diagnosis in which a yeast organism (candida albicans) starts flourishing everywhere there are mucous membranes. For women, the main symptom is a vaginal discharge, the body’s attempt to rid itself of the candida. With serious overgrowth, candida can occur in your mouth (called thrush in infants) and intestines and even on your skin. The result is a constellation of apparently unrelated symptoms: from digestive issues (including bloating), itchy ears, and food sensitivities to sugar cravings and a bad taste in the mouth.

Although Dr. William Crook’s pioneering book The Yeast Connection, first published in 1986, awakened the public to candida overgrowth, during the decades that followed the medical profession was openly hostile to this diagnosis. To me, it’s part of the larger physician tunnel vision I recently wrote about. But the anger candida has generated among doctors over the years is breathtaking. One medical licensing board in the southwest actually recommended punishing any physician who diagnosed candida overgrowth by taking away her license to practice medicine.

Of course, asking a doctor to actually read The Yeast Connection and make up her own mind is sort of like asking ISIS to listen to some Grateful Dead tracks before issuing a fatwa on the audience.

“The Yeast Connection describes my symptoms”
The girl who smelled like pennies read everything she could about candida, and made an appointment at WholeHealth Chicago.

I thought her self-diagnosis was a reasonable one. In addition to the bad taste in her mouth, she had a persistent vaginal discharge and she also mentioned food sensitivities, sugar cravings, bloating, and nasal congestion. It was almost like she’d memorized Dr. Crook’s symptom list.

I had her fill out his Candida Questionnaire, created for the original edition of his book at a time when resources for diagnosing candida overgrowth were limited. You can see the questionnaire here. Even now, it’s a fairly reliable tool.

I ordered a stool culture for candida and a diagnostic blood test for candida. To the patient who smelled like pennies and me, this diagnosis made so much sense that I agreed to start her on the antifungal medication ketoconazole even before the test results were back from the lab. The drug is safe and she could always contact me if she noticed any unusual side effects.

No improvement
Unfortunately, she was back a month later with no improvement at all. Same awful taste in her mouth, same discharge, same aura of pennies. (Listening to her, I was reminded of the painting The Birth of Venus, her seashell now a huge sack of pennies.) Her blood test and stool culture were both negative for candida.

“Okay,” I said. “We were wrong. Back to square one.”

Since it was a metallic taste, I asked if she happened to be taking anything regularly she hadn’t told me about. For example, the sleeping pill Lunesta can cause a pretty awful metallic taste in some people.

“No.”

Was she in contact with anything at work or in her home that could be a source of metal exposure (an old house, water pipes, and so on).

“No. I’ve thought about all of this!”

Since pennies are made of copper, was she using any copper cookware? No. Is there any copper in her life, anywhere? Anything she can think of, no matter how remote?

Silence. Something was dawning on her. I repeated “Anywhere? Anything?” Then her eyes opened wide.

“My IUD (intrauterine device)! Paragard, it’s called. Isn’t it made of copper?”

Googling for confirmation
If you look at the list of side effects from copper IUDs, everything is pretty much limited to a woman’s pelvic area (cramps, backache, and yes, vaginal discharge). But if you use my favorite diagnostic tool, Google, and type in “copper IUD metallic taste” you hit pay dirt in the patient chat rooms.

Here, see for yourself what I found in five seconds (I type f-a-s-t):

To say I have a love affair with patient chatrooms is not an exaggeration. In chatrooms, I can be the fly on the wall, listening as patients ask each other for the help they can’t get from their doctors. Maybe the doctor simply doesn’t know, or doesn’t take the problem seriously, or the patient’s too embarrassed to ask about. Once you say you’re having problems in these chatrooms you’ll get help, if not an actual answer at least a sympathetic ear. The chatroom advice may not always be correct, but at least you’ll know you’re not alone.

I turned my laptop around and simply said “Here…read.”

I saw her nodding her head, smiling, and she looked up at me. “Well, that does sound completely correct. And, if that’s it, my problem is over.”

“Why?”

“I had the thing taken out two days ago. I simply couldn’t stand it.”

Then she paused. “And that explains what happened when it was removed. As the doctor pulled it out there was this…kind of explosion…of metallic taste in my mouth. That’s the only way to describe it. An explosion.”

My guess was that her body had been trying to reject the IUD from day one. The persistent vaginal discharge probably was acidic, part of her body’s attempt to dissolve what it perceived as a foreign invader. But the IUD was firmly in place, constantly releasing copper, which she could taste and which her husband could actually smell.

Google, along with the patient chatrooms it leads me to, is an extraordinary diagnostic tool. I should have checked it sooner.

Be well,
David Edelberg, MD

Does your mouth have the taste of old pennies? The condition is more common than you might think.

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A metallic taste can indicate serious illness, such as kidney or liver problems, undiagnosed diabetes or certain cancers. But these reasons are not common and usually are accompanied by other symptoms.

If you are otherwise healthy, the cause for that metallic tang typically is benign, says family medicine physician Michael Rabovsky, MD.

If a metallic taste in your mouth is your only complaint, the cause might be one of several, including prescription drugs or a medical condition. Here, according to Dr. Rabovsky, are eight causes of a metallic taste in your mouth.

  1. Poor oral hygiene – If you don’t brush and floss regularly, the result can be teeth and gum problems such as gingivitis, periodontitis and tooth infection. These infections can be cleared up with a prescription from your dentist. The metal taste typically goes away after the infection is gone.
  2. Prescription drugs – These medicines include antibiotics such as tetracycline; the gout medicine allopurinol; lithium, which is used to treat certain psychiatric conditions; and some cardiac medications. Your body absorbs the medicine and it comes out in the saliva. Also, medicines that can cause a dry mouth, such as antidepressants, can be a culprit. These can affect your taste because they close your taste buds.
  3. Over-the-counter vitamins or medicines – Multivitamins with heavy metals (such as copper, zinc or chromium) or cold remedies (such as zinc lozenges) can cause a metallic taste. So can prenatal vitamins, and iron or calcium supplements. Usually the taste will go away as your body processes the vitamins or medicine. If not, check your dosage and make sure you are not taking too much.
  4. Infections – Upper respiratory infections, colds and sinusitis change your sense of taste. This is temporary and usually ends when the infection does.
  5. Cancer treatment – Patients being treated for cancer with chemotherapy or radiation may experience a metallic taste.
  6. Pregnancy – During the early stages of pregnancy, some women find that their sense of taste changes. One of those changes may be a metallic taste.
  7. Dementia – People with dementia often have taste abnormalities. The taste buds are connected by nerves to the brain. Taste abnormalities can occur when the portion of the brain related to taste is not working properly.
  8. Chemical exposures – If you are exposed to mercury or lead, inhaling high levels of these substances often can produce a metallic taste.

Dr. Rabovsky says that if you experience a metallic taste, it’s best to talk with your doctor, who can then determine if you have a serious illness or condition.

Using body odor to detect disease is not new. Patients with full-blown, uncontrolled diabetes produce a condition called ketoacidosis, in which their skin not only tastes sweet, but also gives off a strong, recognizable odor that smells like nail polish remover.

Someone with chronic kidney failure may have breath that has a fishy odor; and patients with bowel obstructions have breath that literally smells like feces.

Now doctors have taken the art of diagnosing disease from smell one step further by creating devices that analyze breath odor to detect certain types of cancer.

The first of these is a tester developed by Dr Peter Mazzone of The Cleveland Clinic in Ohio working in conjunction with ChemSensing of Champaign, Ill. This hand-held device, which is roughly about the size of a quarter, uses a “colorimetric sensor array” to detect early stage lung cancer. A colorimetric sensor array is composed of a number of thin, polymer films, each of which is coated with a different dye. The dyes change color as a result of the chemical interactions between molecules.

Patients with lung cancer have volatile organic compounds (VOCs)– mainly alkanes and benzene derivatives– in their breath. Because air passes through the lungs, the breath will pick up bits of these VOCs. When the lung cancer patient breathes into the testing device, the dye that is sensitive to VOCs automatically changes color. Since the dye will react to even the slightest presence of VOCs, this methodology has a 75 percent success rate.

Lung cancer isn’t the only form of the disease that can be detected through breath. Researchers at the University of Michigan are perfecting a device to test breath for the presence of metabolites associated with breast cancer.

Metabolites are the products of the body’s metabolism. They are directly involved in the growth, development, and reproduction of normal cells. The basic principle behind the breast cancer detection device is to separate normal metabolites from those that result from the presence of breast cancer.

The tester’s surface has been designed with tiny pockets that contain oil and water. The cancer-causing metabolites are attracted to the oil and water pockets. When a woman breathes into the device, any cancer-indicating metabolites are collected in the pockets. This causes the tester’s surface to fill up and become dense. When this happens, an electrical charge is applied and the metabolites are ejected so that multiple tests could be performed on them in the same device.

The goal is to create a tester that is a non-invasive and inexpensive over-the-counter method to screen for breast cancer.

Inanimate devices aren’t the only methodologies being tried in the detection of lung and breast cancer. Man’s best friend may now become men and women’s best way to detect for these two types of cancer in the early stages.

In a study headed by Michael McCulloch of the Pine Street Foundation in San Anselmo, Calif., and Tadeusz Jezierski of the Polish Academy of Sciences, Institute of Genetics and Animal Breeding, researchers tested to see if dogs can detect cancers by sniffing the exhaled breath of cancer patients. Five dogs were given three weeks training to learn to detect lung or breast cancer by sniffing the breath of cancer patients. They were trained that when they positively identified a cancer patient, they were to sit or lie down directly in front of the test station containing the patient’s sample. They were also trained to ignore the test stations that contained healthy breath samples.

After training was completed, the dogs were presented with tubes that contained breath samples from 55 patients with lung cancer, 31 with breast cancer, and a control sample of 83 healthy individuals. All the cancer patients had confirmed their diagnosis either through a mammogram, or CAT scan and had not received any chemotherapy. The study showed that the dogs were able to detect breast and lung cancer with an accuracy rate of between 88 and 97 percent. The test also indicated that the dogs could detect both early and late stages of the diseases.

All of these studies have one vital factor in common. They prove that analyzing human breath has the potential to provide a non-invasive and more cost-effective method of testing for cancer that is more accurate than current diagnostic techniques. Making cancer screening cheaper and more available means it will increase the incidences of early detection when the prognosis for recovery is good.

Bad Breath From Lungs: Oral Hygiene May Not Be the Cause

Have you (or has someone close to you) ever had bad breath and struggled to find a cause because you knew it was not due to poor oral hygiene? You might have tried everything from brushing to flossing to rinsing, but to no avail.

Surprisingly, breath malodor has a variety of causes, including bad breath from lungs due to respiratory conditions. When your bad breath won’t blow over, the first step to alleviating it is to determine the cause of the problem.

1. Infections That Cause Bad Breath

When bad breath emanates from the lungs, sometimes the cause is a short-term infection. Some conditions like bronchitis, sinusitis and even pneumonia can cause foul breath. When parents notice bad breath in children, it may be because they are coming down with something. The only good aspect of foul breath caused by these respiratory conditions is that once a person recovers, the bad breath goes away, too.

2. Chronic Conditions That Cause Bad Breath

Sometimes, the cause of bad breath from lungs is a life-long affliction. Individuals with cystic fibrosis (CF) can experience bad breath as a symptom of the disease, according to the American Rhinologic Society. This condition causes thickened mucus in the lungs, and as a result many CF patients have recurrent airway infections and post-nasal drip. This disease is inherited and has no cure, so the thickened mucus and difficulty breathing may always be a concern.

Asthma is another respiratory condition that can cause bad breath, explains Delta Dental. People with asthma often breathe through their mouths, which dries out oral tissues. Many of the bacteria that cause bad breath flourish in a dry mouth. Additionally, medicated inhalers can also have a side effect of dry mouth, further compounding the problem.

Lung cancer is another condition that has a distinctive odor and can be even identified by the specific combination of gases in a person’s breath, MIT News reports. A group of students from MIT and Harvard developed a smartphone-connected sensor that detects these compounds and provides a safe and inexpensive way to detect the disease.

How to Resolve Bad Breath From Lungs

When you have a sinus infection, allergies or post-nasal drip, the bacteria in your mouth can convert the proteins found in mucus to a substance called skatole, which can make your breath smell like mothballs. Rinsing your sinuses with warm water will help clear the mucus from the area. Taking allergy medication or an antibiotic, if prescribed by your physician, may help alleviate any respiratory conditions as soon as possible.

For CF patients, treatment may include nasal irrigation or taking antibiotics. In addition, nasal steroids may be recommended by a physician. Patients with asthma should focus on staying well hydrated to combat the effects of dry mouth.

When to Address Concerns with Your Dentist

Sometimes people are uncomfortable with bringing up the issue of bad breath during their dental visit, but dental professionals are accustomed to hearing about this concern (and maybe smelling it). If you are brushing and flossing properly at home and getting regular six-month cleanings and are still having breath problems, seek professional medical advice. Your dentist will be able to tell if dental hygiene changes can help with breath malodor or if you should talk with your physician.

Stop and smell the volatile organic compounds in lung ca

SAN FRANCISCO—Studies have identified specific volatile organic compounds in the breath of lung cancer patients, but the origin of those compounds is still ambiguous: Are they from the tumor itself, the tumor micro-environment, or a reaction to the tumor by the human body? A group from the Technion-Israel Institute of Technology in Haifa, led by Hossam Haick, PhD, has developed a nanotechnology that detects patterns of volatile organic compounds that are unique to cancer.

“When exhaled breath is tested using gas chromatography/mass spectrometry, there are significant differences between breath of people who are healthy and those with cancer,” said Nir Peled, MD, PhD, at the 2009 World Conference on Lung Cancer. Dr. Peled is a researcher and a Fulbright scholar at the University of Colorado in Denver who works in tight collaboration with Dr. Haick.

“Exhaled breath is going to become a medium that will be prominent in the next few years in medicine,” he predicted. “We can trap these volatile organic compounds with high sensitivity these days. The sensing nanotechnology we used in our research can now detect one part per billion of these compounds.”

The group set out to show that the source of the cancer’s smell print is probably the cancer cells themselves. “We took different types of cancer cell lines: non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), and pancreatic cancer cell lines,” Dr. Peled explained.

“We put the cells in a dish and put a solvent around the head space to collect the odor-print over several days. Then we sent the samples to Dr. Haick’s laboratories in Israel where they disrobed the odor-print and carried out analysis by their “electronic nose” device based on nanosensors and, also, gas chromatography/mass spectrometry.

“Using this ‘electronic nose’ we detected a signal with different electrical signals, allowing us to differentiate between the different groups of cancer,” Dr. Peled said. The researchers found that lung cancer cells share five unique volatile organic compounds (see Table).

Three of these compounds occurred in the exhaled breath of more than 90% of NSCLC patients, indicating that the compounds are transferred to the breath via a metabolic pathway of the tumor cells (abstract B3.5).

“We are really excited about these results,” Dr. Peled said. He added that a practical device, which is capable of determining different types of cancers before they become symptomatic, might be possible in the next several years.

Hot Breath Could Signal Lung Cancer

MUNICH, Germany — A preliminary study of exhaled breath suggests that temperatures higher than 34°C may be a strong indicator of the presence of lung cancer. In a sample of 82 patients who presented with clinical suspicion of lung cancer, 96% of patients had the disease.

“Airway inflammation and angiogenesis play a key role in the pathogenesis of lung cancer,” Giulia Scioscia, MD, a fellow in pulmonary medicine at Hospital Clínic i Provincial de Barcelona, said at a news conference here at the European Respiratory Society (ERS) International Congress 2014. “Exhaled breath temperature has been proven to be an indicator of airway inflammation and increased vascularity. The aim of our research is to determine possible correlations of exhaled breath with progression, metastasis or other clinical outcomes of patients with cancers.”

The researchers aimed to find breath temperature values that correlate with lung cancer. They analyzed 82 consecutive participants with a radiologic suspicion of lung cancer using the X-Halo (Delmedica Investments) breath thermometer. Lung cancer was later diagnosed in 40 people. A total of 42 did not have lung cancer and served as controls. All patients underwent standard diagnostic and staging procedures.

The team compared breath temperatures in patients with lung cancer and controls in various categories, including by sex, age, smoking habit, and the presence or absence of chronic obstructive pulmonary disease. In each category, people with cancer had statistically significantly higher breath temperatures than controls.

The researchers then used a receiver operating characteristic curve to determine an ideal temperature threshold for signaling lung cancer. That analysis showed that values above 34°C would be a good cutoff. Most — 96% — who had breath temperatures in that range were found to have lung cancer.

Pilot Study

The researchers stressed that this was a pilot study. “It’s not sensitive enough,” coauthor Giovanna Elisiana Carpagnano, MD, from the University of Foggia in Italy, said at the news conference. However, Dr. Carpagnano added that it could eventually become part of a screening panel. The researchers plan to explore the test in patients with other inflammatory conditions to get a better idea of its performance.

“I think the data are quite interesting,” chair of the ERS lung cancer group Fernando Gamarra, MD, from Klinikum St. Elisabeth Straubing in Germany, told Medscape Medical News. It’s also novel. “I’m not aware that anybody has done it before,” he added. Dr. Gamarra said he thinks that the researchers will have to account for other factors that could affect breath temperature, such as whether the person is currently smoking, the velocity with which a person exhales, or overall size. Large people may have higher breath temperatures, he pointed out.

It also remains to be seen if the approach could work consistently in early-stage cancers, which is the population that would most benefit from screening. The current study drew from patients already presenting at a hospital, and so they tended to have more advanced disease, although the researchers did note higher temperatures even in early cancers. “I would like to see a study in a limited group, say just in patients with stage 1 or 2,” Dr. Gamarra said.

Dr. Scioscia, Dr. Carpagnano, and Dr. Gamarra have disclosed no relevant financial relationships.

European Respiratory Society (ERS) International Congress 2014: Abstract 1928. Presented September 8, 2014.

To try this, you will need:

  • several drinking straws
  • a sheet of notebook paper
  • a mirror

First, hold your hand about 3 inches in front of your mouth. Purse your lips, as if you were going to blow out a candle and instead, blow on your hand. What do you feel? Quite cool, right?

Keep your hand at the same distance. Open your mouth wide and breath on your hand again. Does it feel cool this time? No, instead it feels warm. How can that be?

My first thought was that it had something to do with air speed, so I tried both ways at different speeds. Holding your hand at the same distance, purse your lips and blow gently. Then blow faster. Try the same thing with your mouth open. No good. Slow or fast, with your lips pursed, it feels cool and with an open mouth it feels warm.

After quite a bit of thought, the only thing I could see that was different was the size of the opening the air was coming through. Let’s check to see. We will simulate pursing your lips by blowing through a straw, since it also has a small opening. Hold your hand about 3 inches from the end of the straw and blow through it. OK, it still feels cool.

Next, roll the sheet of paper into a tube about the same diameter as your mouth was when it was open wide. Again holding your hand about 3 inches from the end, blow through it. Ah, it feels warm. We are making progress.

At this point, I was thinking that with a thin stream of air, it was cooling quickly as it moved through the surrounding air, and that a thicker stream of air was cooling at it outer edge but staying warm in the center. If that was true, then blowing through pursed lips or a straw at very close range should feel warm, as the air would not have had time to cool. Try it. If you hold your hand about half an inch from your lips, it feels warm even with pursed lips. Looking at things in reverse, the air from an open mouth should feel cool if it is far enough away. You may have to blow very hard, but you will see that this is also true.

Taking that one step farther, I used a bundle of drinking straws. As a bundle, it carries the same amount of air as the tube of paper, and it works the same way. Holding your hand about 3 inches away, the air feels warm when you blow through it, but if you hold the back of a finger at the same distance, you can find more detail. If it is hit by the air from one of the center straws, it feels warm, but the straws on the outside give a breeze that feels cool.

That just leaves the cause of the warm and cool sensations. Try repeating each of the experiments using a mirror instead of your hand. For the tries that made your hand feel warm, your breath fogs the mirror. For the ones where you felt cool, there is no fog, and if some was already there, it goes away quickly. As moisture condenses, it gives up heat, making the air around it warmer. The air from your lungs is already warm. Condensation causes it to warm up a bit more. At that point, it feels warm on your hand.

As your breath moves along, it mixes with the surrounding air. It begins to cool and gives up some of its humidity. At that point it is just like the air from a fan. It moves across your hand and evaporates some of the moisture on the skin. That causes it to feel cool.

That sounded logical, so I wrote it up and sent it to Dr. Kim Aaron, an aerodynamicist friend at NASA’s Jet Propulsion Lab. He helps with experiments now and then, and he always comes up with interesting angles to things. He confirmed that I was on the right track, making several suggestions that made it easier to write this. So easy that this is getting far too long, so I will stop here. On the other hand, you are free to continue exploring as long as you want. Just don’t huff and puff so much that you start seeing satyrs.

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