Buried amidst the excitement of reports that cancer deaths have again decreased in the United States lies a sobering statistic: Lung cancer in pregnant women is increasing.
A recent journal article takes that statistic we'd like to keep hidden, and brings it to the dinner table. The article tells the story of one woman who heard not only "it's a girl/boy" but "you have lung cancer."
A 34 year old woman who was pregnant had initial symptoms of a cough, shortness of breath, a fever, and fatigue. When she was seen for her symptoms, she was diagnosed with pneumonia and prescribed antibiotics. She delivered early (premature delivery) at only 28 weeks into her pregnancy, and was subsequently diagnosed with lung adenocarcinoma with multiple bone metastases (stage 4 lung cancer.) She was treated with traditional chemotherapy for stage 4 lung cancer (Taxol (paclitaxel) and Paraplatin (carboplatin) but had even more spread of her cancer to bone. She was then treated with Xylori (crizitonib) which resulted in her cancer stabilizing for the next 6 months (we don't have information beyond that point.)
This story -- in addition to being a good place to ask for positive energies and prayers to be sent to this woman and her family - brings up 3 very important points.
1. Lung cancer can happen to anyone. Anybody who has lungs can get lung cancer. Non-smokers can get lung cancer. Young, healthy, pregnant women can get lung cancer.
2. Don't dismiss the symptoms of lung cancer, even if you think there is a plausible explanation. Shortness of breath is common in pregnant women, but it's also a symptom of lung cancer. A persistent cough is a common symptom of lung cancer, but who hasn't had a cough at some time in their lives? Pneumonia may be a sign of lung cancer, but it's also commonly seen without lung cancer. Fatigue may be a symptom of lung cancer, but is also common in pregnancy, and life period, in the 21st century.
3. Despite the dismal survival rates and feeling that we aren't getting anywhere with lung cancer treatments, this is a story that emphasizes that lung cancer research is making a difference. Testing for gene mutations in lung cancer wasn't done routinely a decade ago, or even just a few years ago. Testing allowed physicians to find that this woman's tumor was positive for EML4-ALK mutations. The targeted therapy Xalkori (crizitonib) which is "tailored" for these mutations has only been available a few short years, and resulted in what would have been unheard of a decade ago: 6 months after beginning treatment, the patient's clinical condition was stable. Discarding the clinical terminology: Medical treatment unheard of a decade ago gave this young mother an opportunity to get to know her baby.
Photo: flickr.com, user harinaivoteza
Sariman, N. et al. Lung cancer and pregnancy. Lung Cancer. 2012 Dec 14. (Epub ahead of print).