Biology of dying

We think there may be a physiological process to dying. Recognising when someone is in the last weeks or days of life is difficult. No diagnostic test is available and little is known about how people die from disease. This knowledge is crucial for providing the best care possible. We performed a small study to establish the feasibility of collecting urine samples from patients in the last weeks and days of life, protocol for gas chromatography-mass spectrometry analysis of volatile organic compounds (VOCs) from urine and the discovery of VOC biomarkers which may predict the dying process as well as preliminary evidence of potentially important changes in DNA repair/DNA damage signalling activity.

This pilot study will identify VOCs as potential prognosticators for dying patients with advanced cancer, create a model to predict the dying process and investigate biomarkers of a range of cellular phenotypes to include: DNA damage and stress responses, cell proliferation, cell cycle/sensesence, DNA repair and apoptosis. We will also plan and design a full study to validate our findings.

This work has the potential to have a profound impact on the understanding of human biology and on patient care.