Registered Charity Number 1124533Registered Charity Number 1124533

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Medical Detection DogsMedical Detection Dogs aka Cancer and Bio-detection Dogs aka Cancer and Bio-detection Dogs

Dr Claire Guest MSc BSc

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Formation of Charity in 2008Formation of Charity in 2008

• Training dogs to detect human Training dogs to detect human disease and medical conditions, disease and medical conditions, through the detection and through the detection and recognition of specific odours recognition of specific odours

• In addition to the training of In addition to the training of dogs the charity is committed to dogs the charity is committed to publishing peer reviewed publishing peer reviewed research papersresearch papers

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StructureStructure

Cancer and Cancer and Bio-detectionBio-detection

Cancer and Cancer and Bio-detectionBio-detection

Medical Detection DogsMedical Detection Dogs

Medical AlertMedical Alert

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Canine OlfactionCanine Olfactionthe act or process of smellingthe act or process of smelling

A dog's sense of smell is estimated to be a 100,000 times more sensitive than humans.

They have 250-300 million sensory receptors

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Canine Olfactory Canine Olfactory Detection of CancerDetection of Cancer

• 1st Lancet letter, Williams & Pembroke (1989)1st Lancet letter, Williams & Pembroke (1989)

• Series of anecdotal storiesSeries of anecdotal stories

• 2nd Lancet letter, Church & Williams (2001)2nd Lancet letter, Church & Williams (2001)

• Claims of successful dog trainingClaims of successful dog training

• Buckinghamshire partnership - late 2002Buckinghamshire partnership - late 2002

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Aim of study published in the Aim of study published in the BMJ in 2004BMJ in 2004

• A “Proof of Principle” to prove that dogs can be trained A “Proof of Principle” to prove that dogs can be trained to identify people with bladder cancer on the basis of to identify people with bladder cancer on the basis of urine odour more successfully than would be expected urine odour more successfully than would be expected by chance aloneby chance alone

• To train dogs to recognise an odour, or combination of To train dogs to recognise an odour, or combination of odours (an “odour signature”) characteristic of bladder odours (an “odour signature”) characteristic of bladder cancer but distinct from those associated with cancer but distinct from those associated with secondary effects of the tumour such as bleeding, secondary effects of the tumour such as bleeding, inflammation, infection and necrosisinflammation, infection and necrosis

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The AlertThe Alert

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Cancer Detection DogsCancer Detection Dogs

The BMJ study in 2004 The BMJ study in 2004 provided proof dogs could provided proof dogs could identify a unique odour that was identify a unique odour that was associated with cancer.associated with cancer.

The scientific basis of this The scientific basis of this ability is believed to be linked ability is believed to be linked to volatiles produced by to volatiles produced by malignant cells.malignant cells.

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Canine Olfactory Detection of Human CancerCanine Olfactory Detection of Human Cancer•Scientific basis of ability of dogs Scientific basis of ability of dogs

to detect cancer believed linked to detect cancer believed linked to VOCs produced by malignant to VOCs produced by malignant cells. Established that during cells. Established that during tumor growth protein changes in tumor growth protein changes in malignant cells lead to malignant cells lead to peroxidation of the cell peroxidation of the cell membrane components that membrane components that produce VOC’s that can be produce VOC’s that can be detected in the headspace of the detected in the headspace of the cells.cells.

•2010 study published in journal 2010 study published in journal ‘Urology’ ‘Urology’ Cornu et al, ‘Olfactory Cornu et al, ‘Olfactory Detection of Prostate Cancer by Detection of Prostate Cancer by Dogs Sniffing Urine: A Step Dogs Sniffing Urine: A Step Forward in Early Diagnosis’, Forward in Early Diagnosis’, achieved good results, sensitivity achieved good results, sensitivity and sensitivity for PCa 0.99.and sensitivity for PCa 0.99.

Cancer Detection Dog Daisy at work

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Canine Olfactory Detection of Human CancerCanine Olfactory Detection of Human Cancer• 2011 study by Senoda et al on 2011 study by Senoda et al on

colorectal cancer using breath colorectal cancer using breath (sensitivity 0.91 specificity 0.99) (sensitivity 0.91 specificity 0.99) and faecal samples(sensitivity and faecal samples(sensitivity 0,97 specificity 0.99) published in 0,97 specificity 0.99) published in ‘Gut’‘Gut’ equally promising . equally promising . Indication that cancer volatiles Indication that cancer volatiles may appear on the breath at an may appear on the breath at an early stage in the disease early stage in the disease process. process.

• Additional evidence published in Additional evidence published in the the European Respiratory JournalEuropean Respiratory Journal carried out in Schillerhoehe carried out in Schillerhoehe Hospital Germany, first to be Hospital Germany, first to be published showing that sniffer published showing that sniffer dogs can reliably detect lung dogs can reliably detect lung cancer from a breath sample.cancer from a breath sample.

Cancer Detection Dog Daisy at work

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Canine Olfactory Detection of Human CancerCanine Olfactory Detection of Human Cancer

•2011 the charity published in the 2011 the charity published in the journal ‘journal ‘CancerCancer Biomark’Biomark’ ‘Volatile organic compounds as ‘Volatile organic compounds as biomarkers of bladder cancer: biomarkers of bladder cancer: Sensitivity and specificity using Sensitivity and specificity using trained sniffer dogs’. Specificity trained sniffer dogs’. Specificity ranged from 92% for urine ranged from 92% for urine samples obtained from healthy, samples obtained from healthy, young volunteers down to 56% young volunteers down to 56% for those taken from older for those taken from older patients with non-cancerous patients with non-cancerous urological diseaseurological disease

Cancer Detection Dog Daisy at work

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Canine Olfactory Detection of Human CancerCanine Olfactory Detection of Human Cancer•Now focusing in conjunction with Now focusing in conjunction with

Professor Karol Sikora, mass Professor Karol Sikora, mass spectrometry scientists and spectrometry scientists and medical statistician in detection medical statistician in detection of cancer from human breath. of cancer from human breath.

•This work opens the door of This work opens the door of VOC detection for cancer VOC detection for cancer diagnosis and suggests that the diagnosis and suggests that the conditioned dog should be used conditioned dog should be used in the near future to validate in the near future to validate candidate molecules emerging candidate molecules emerging from metabolomic screening. from metabolomic screening. Evidence base building Evidence base building indicating that dogs could assist indicating that dogs could assist in improving current diagnosis of in improving current diagnosis of the ‘Big Four’.the ‘Big Four’.

Cancer Detection Dog Daisy at work

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International PartnershipInternational Partnership• We are now working in We are now working in

collaboration with Italian collaboration with Italian partners and have recently partners and have recently carried out demonstrations carried out demonstrations in Italy. in Italy.

• Our dogs have recently Our dogs have recently screened urine samples in screened urine samples in a test scenario in an Italian a test scenario in an Italian hospital.hospital.

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Cancer Detection our aimCancer Detection our aim

• To identify the volatiles To identify the volatiles that dogs are sniffingthat dogs are sniffing

•Use this information to Use this information to help develop a help develop a non-invasive early non-invasive early detection systemdetection system

Early cancer diagnosis would save countless lives and so benefit people hugely

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Bio-detection DogsBio-detection Dogs•The charity’s bio-detection work has grown The charity’s bio-detection work has grown

rapidly and there is ever increasing demand and rapidly and there is ever increasing demand and application for our work, in a range of different application for our work, in a range of different bio material. bio material.

• We are now working on a three year olfaction We are now working on a three year olfaction study in collaboration with Royal Canin and study in collaboration with Royal Canin and Lincoln University. This study seeks to establish Lincoln University. This study seeks to establish whether we are able to influence detection and whether we are able to influence detection and olfactory thresholdsolfactory thresholds. .

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Bio-detection DogsBio-detection Dogs•We have a team of 12 Bio-detection dogs We have a team of 12 Bio-detection dogs

working on this project. This research will working on this project. This research will undoubtedly provide interesting and undoubtedly provide interesting and valuable information about canine olfaction valuable information about canine olfaction and detection thresholdsand detection thresholds..

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Medical Assistance DogsMedical Assistance Dogs• In addition to our specialist dogs

trained to recognise and detect the distinctive odour of human disease from samples, we also train medical assistance dogs to alert clients who are managing life threatening conditions on a daily basis

•The medical assistance dog programme continues to progress and we recently passed our Assistance Dogs International Accreditation.

BBC Health ShowBBC Health Show

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Assisting children with diabetesAssisting children with diabetes

• An inability to detect a hypo is An inability to detect a hypo is common in young children and common in young children and adolescentsadolescents

• We have now successfully placed We have now successfully placed two alert dogs with young two alert dogs with young children and their familieschildren and their families

• Blood Sugar Detection Dog, Blood Sugar Detection Dog, Shirley has been placed with Shirley has been placed with Rebecca and her family. Rebecca and her family. Rebecca was frequently Rebecca was frequently have dangerous hypos and was have dangerous hypos and was in need of emergency assistancein need of emergency assistance

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Rebecca and Shirley

Assisting children with diabetesAssisting children with diabetes• Medical Alert Dog Medical Alert Dog

Shirley is the first dog Shirley is the first dog in the UK to be in the UK to be present in a present in a mainstream primary mainstream primary school. school.

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Implications of Our WorkImplications of Our Work• Our Data indicates high accuracy in hypo-alert Our Data indicates high accuracy in hypo-alert

detection and reduction in paramedic attentiondetection and reduction in paramedic attention

• Assists individual in reducing hyperglycaemic Assists individual in reducing hyperglycaemic associated conditionsassociated conditions

• There is growing evidence of improved stability of There is growing evidence of improved stability of client’s HBa1C client’s HBa1C . Nine billion pounds a year is spent on . Nine billion pounds a year is spent on treating diabetes and its complications. This figure treating diabetes and its complications. This figure accounts for about 10 per cent of total NHS spending. accounts for about 10 per cent of total NHS spending. 

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Current work in ProgressCurrent work in Progress

• We are now working We are now working with endocrinology with endocrinology specialists at Bristol specialists at Bristol hospital and hospital and researchers at researchers at Bristol University to Bristol University to assess and publish assess and publish the dogs sensitivity the dogs sensitivity and accuracyand accuracy

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New ProjectsNew Projects

• We have trained a dog to assist an individual We have trained a dog to assist an individual with severe narcolepsywith severe narcolepsy

• Plans for the future include the training of dogs Plans for the future include the training of dogs to detect substances that result in severe to detect substances that result in severe allergic response in atopic clientsallergic response in atopic clients

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Addison’s Crisis Alert DogAddison’s Crisis Alert Dog

• We have also successfully We have also successfully trained the first Medical trained the first Medical Assistance Dog to alert a client Assistance Dog to alert a client to an oncoming Addison’s crisis to an oncoming Addison’s crisis (life threatening due to (life threatening due to dangerously low levels of dangerously low levels of cortisol)cortisol)

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www.medicaldetectiondogs.org.ukwww.medicaldetectiondogs.org.ukTelephone: 01296 655888Telephone: 01296 655888

ReferencesReferences

• Cornu J-N et al.Olfactory Detection of Prostate Cancer Cornu J-N et al.Olfactory Detection of Prostate Cancer by Dogs Sniffing Urine: A Step Forward in Early by Dogs Sniffing Urine: A Step Forward in Early DiagnosisDiagnosis. Eur Urol (2010). Eur Urol (2010)

• Currie CJ 2004. Evaluation of the impact of Currie CJ 2004. Evaluation of the impact of hypoglycaemia on health care resource use, hypoglycaemia on health care resource use, productivity, fear of hypoglycaemia and health utility in a productivity, fear of hypoglycaemia and health utility in a UK population. UK population. DiabetologicaDiabetologica 47 : A323 2004. 47 : A323 2004.

• Kirton A, Winter A, Wirrell E, et al.  2008. Seizure Kirton A, Winter A, Wirrell E, et al.  2008. Seizure response dogs: Evaluation of a formal training response dogs: Evaluation of a formal training program,  program,  Epilepsy & BehaviorEpilepsy & Behavior 13 (3)  499-504. 13 (3)  499-504.

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ReferencesReferences

• Pickel D, Manucy GP, Walker DB, Hall SB, Walker JC Pickel D, Manucy GP, Walker DB, Hall SB, Walker JC 2004 Evidence for canine olfactory detection of 2004 Evidence for canine olfactory detection of melanoma melanoma Applied Animal Behaviour ScienceApplied Animal Behaviour Science, 89(1-2): , 89(1-2): 107-116107-116

• Sonoda H, Kohnoe S, Yamazato T, et al 2010 Sonoda H, Kohnoe S, Yamazato T, et al 2010 Colorectal cancer screening with odour material by Colorectal cancer screening with odour material by canine scent detection Gut (2011) doi canine scent detection Gut (2011) doi 10.1136/gut.2010.218305  10.1136/gut.2010.218305  

• Wells DL, Lawson SW, Siriwardena AN  2008. Canine Wells DL, Lawson SW, Siriwardena AN  2008. Canine Responses to Hypoglycaemia in Patients with Type 1 Responses to Hypoglycaemia in Patients with Type 1 Diabetes  Diabetes  Journal of Alternative and Complementary Journal of Alternative and Complementary MedicineMedicine 14 (10 ):  1235-1241. 14 (10 ):  1235-1241.

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ReferencesReferences

• Willis CM, Church SM, Guest CM, Cook WA, McCarthy N, Willis CM, Church SM, Guest CM, Cook WA, McCarthy N, Bransbury AJ, Church MRT, Church JCTBransbury AJ, Church MRT, Church JCT 20042004. . Olfactory Olfactory detection of human bladder cancer by dogs: proof of principle detection of human bladder cancer by dogs: proof of principle studystudy,, British Medical JournalBritish Medical Journal, 329: 712., 329: 712.

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