Surface acoustic wave (SAW) sensor technology is a promising approach to diagnosing cancer through the detection of cancer biomarkers due to its high sensitivity, potential label-free operation, and fast response times, and, fundamentally, because it is a non-invasive technique in comparison with the current traditional diagnostic techniques for cancer. This review focuses on this application, and for this purpose, the recent literature on cancer biomarkers detected by this advanced technology has been compiled, including that on volatile organic compounds (VOCs) from exhaled breath and larger biomolecules such as proteins, DNA, and microRNAs in body fluids, which demonstrates its great versatility. The conventional techniques for cancer biomarker detection in biofluids, such as ELISA, PCR, SPR, and UV absorbance, exhibit limitations including high costs, slow response times, a reduced sensitivity, the need for specialized instrumentation, and the requirement for highly trained personnel. Different SAW sensor configurations are discussed with attention paid to their specific properties, wave propagation modes, and suitability for different environments. Detailed studies are reviewed, highlighting biomarkers for lung, colorectal, prostate, breast, and ovarian cancer diagnostics, as well as the detection of circulating tumor cells and cancerous cell growth. This review identifies current challenges, including optimizing sensitivity, addressing environmental interferences, and the need for clinical validation. Finally, future research directions are proposed, emphasizing the use of VOC biomarkers and the integration of SAW technology into hybrid systems and microfluidic platforms to enable the creation of scalable, non-invasive diagnostic tools for the detection of cancer in early stages, and, in this way, to minimize the morbidity and mortality associated with this disease.
