Lung cancer and pregnancy

Lung cancer during pregnancy is rare. However, the number of cases may be growing due to the combined effects of increased cigarette consumption in young women and delayed child-bearing. The incidence of lung cancer complicating pregnancy is unknown. The presenting signs and symptoms associated with lung cancer and pregnancy are similar to the nonpregnant state and depend mainly on the stage of the lung cancer. Symptoms related to the growth of the tumor, such as blood-streaked sputum, persistent cough or change in cough pattern, wheezing, decreased appetite with poor weight gain during pregnancy, along with other locoregional symptoms (with or without a detectable pleural effusion) are commonly seen. Delays in the diagnosis may occur due to reasons such as low index of suspicion, tendency to attribute symptoms such as fatigue and dyspnea on the pregnant state; and physician reluctance to order a chest radiograph during pregnancy. A detailed history and accurate physical examination remain the most important steps in the evaluation of these patients, including assessment of risk factors. Plain anteroposterior and lateral chest radiographs are the most valuable tools in the diagnosis of lung cancer [1]. Ultrasound and MRI studies are probably appropriate for metastatic work-up, especially in subdiaphragmatic sites [2].Diagnostic evaluation consists of histologic confirmation and staging. The former can be achieved by sputum cytology, percutaneous fine needle aspiration, bronchoscopy with biopsy or bronchoalveolar lavage. In patients with metastatic disease, biopsy of other readily accessible sites (i.e., palpable nodes) is also a reliable and relatively noninvasive procedure.