Small Ear-Wax Sample, Big Diagnostic Clues
Cerumen Profile
The primary function of cerumen is to keep the external auditory canal clean and lubricated, preventing invasion by bacteria, fungi, and insects. Beyond this, cerumen may reflect systemic metabolism by concentrating a broader array of compounds than blood, urine, sweat, and tears. Its relative stability allows the accumulated cerumen to provide long-term snapshots of metabolic changes.
Disease Associations
Researchers have defined genetically determined wet and dry cerumen phenotypes. In the US, Caucasian, African American, and German women with wet cerumen faced roughly four times the risk of dying from breast cancer compared with Japanese and Taiwanese women with dry cerumen. The study found that Japanese women with breast cancer were more likely to carry the wet-cerumen allele than were healthy controls. However, large-scale studies in Germany, Australia, and Italy failed to confirm these associations.
A recent analysis reported that patients with Ménière's disease had lower levels of three fatty acids in the cerumen compared with healthy controls — the first biomarker identified for that disorder.
In a 2019 study led by Nelson Roberto Antoniosi Filho, PhD (Federal University of Goiás Goiânia in Brazil), researchers analyzed cerumen samples from 52 patients with lymphoma, carcinoma, or leukemia and 50 healthy volunteers, using a method that identifies volatile organic compounds (VOCs). The researchers identified 27 VOCs that served as diagnostic fingerprints for cancer, predicting the cancer status with 100% accuracy. The assay could not distinguish among cancer types, indicating that these VOCs represent a general response to malignant cells.
Another investigation by the same group showed that cerumen analysis can detect metabolic disturbances in premalignant stages when cells exhibit dysplastic changes that may lead to cancer but remain nonmalignant, potentially enabling much earlier intervention. The team is also investigating whether metabolic alterations caused by neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease, can be detected in the cerumen.
Diagnostic Tool
Antoniosi Filho and colleagues proposed that cancer, as a mitochondrial metabolic disorder, releases VOCs that accumulate in cerumen, allowing differentiation between healthy and cancerous individuals via an assay they call the cerumenogram. The aim was to develop a cerumenogram as a diagnostic tool to accurately predict certain cancers from a small cerumen sample.
Clinical Adoption
Hospital Amaral Carvalho in Jaú, São Paulo — a national reference center for oncology and bone marrow transplantation — has recently implemented cerumenograms for cancer diagnosis and monitoring.
Future Directions
An April 2025 paper in Scientific Reports by Antoniosi Filho concluded that the cerumenogram could:
1. Identify oncologic risk by detecting premalignant cells before cancer onset, introducing a novel screening modality
2. Show that mitochondrial impairment in premalignant cells — such as hypermetabolic inflammation and dysplasia — produces the same VOC biomarkers as malignant cells, distinct from those in benign lesions, opening new paths for risk management and early intervention
3. Correlate cerumenogram findings with established imaging techniques such as 2-deoxy-2-[fluorine-18] fluoro-D-glucose PET/CT (18F-FDG PET/CT) and gallium-68 PSMA PET/CT, demonstrating alignment with clinical results while offering a noninvasive, lower-cost alternative
4. Monitor treatment response and cancer remission, supporting assessment of therapeutic efficacy and cellular return to normal
5. Confirm metabolic indicators of malignancy to guide clinical decisions alongside imaging and biopsy
6. Drive the development of targeted therapies aimed at metabolites overproduced in malignant conditions.
In conclusion, the cerumenogram may serve as a valuable assay for evaluating precancerous indicators, cancer progression, and remission, with the potential to reduce mortality, alleviate patient suffering, and lower disease-related costs.
Congratulations to Nelson Roberto Antoniosi Filho, PhD, and his team.
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Tips to Enjoy Nuts While nuts are a tasty, convenient snack on their own, there are loads of ways to add more of these healthy treats to your meals and snacks. These dietitian-approved tips can get you started. Toss them into trail mix. Whether you're at your desk or on a long hike, trail mix makes a satisfying snack. Make your own by combining nuts with dark chocolate, no-sugar-added dried fruit and seeds. Blend them into smoothies. Nuts are an easy way to add protein and healthy fats to your smoothie. Softer nuts like pecans and walnuts work particularly well. But almond, cashew and peanut butters are also fantastic ways to add creamy, nutty goodness to your smoothie. Add them to your snack plate. Think charcuterie board with crunch! For a tasty, well-balanced snack plate, arrange nuts, cheese, whole-wheat crackers and fruit on a platter and enjoy! Sprinkle them on cereal and yogurt. Enhance a bowl of yogurt, cereal or overnight oats with a sprinkling of chopped or sliced nuts. 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Your gut is in constant communication with your brain via an internal superhighway called the brain-gut axis. So, when your gut is healthier, your brain thrives, too. Legumes. 'Beans, lentils and chickpeas are high in fiber and plant-based protein, which can help lower cholesterol and support gut health,' says Manaker., They're also central to eating patterns linked to longevity, like the Mediterranean diet. Berries. 'Blueberries and other berries are beneficial, as they provide antioxidants to prevent cellular damage and aging and are associated with a stronger gut microbiome,' says Andrews. One study found that frequent berry eaters were less likely to die from any cause compared to people who rarely consumed berries. Our Expert Take Nuts have loads of health benefits and may add years to your life. They've been linked to brain and heart health, less muscle loss, fewer chronic diseases and a longer lifespan overall. Don't just save them for snacks, though. Crunchy, tasty nuts are a fantastic addition to trail mix, yogurt, smoothies, cereal or overnight oats. As healthful as nuts are, it's important to remember that one food alone won't make or break your health. 'Think of nuts as a small but mighty part of a much larger lifestyle approach to wellness,' says Manaker. For even more benefits, include them in an eating plan rich in other foods linked to longevity, like whole grains, leafy greens, legumes and berries. Read the original article on EATINGWELL
