Lung cancer in pulmonary fibrosis: no room for nihilism!

Bad luck rarely comes unaccompanied. It was advocated for more than a decade to view idiopathic pulmonary fibrosis (IPF) as a “malignant disease” from looking at its clinical course and prognosis, which is worse than for most common malignancies, except lung and pancreatic cancer [1]. What happens to the unfortunate individuals who develop lung cancer on top of IPF (figure 1) and who may ask their physician “what will bring me down first?”. Strong epidemiological evidence indicates that the fibrotic lung is a preneoplastic condition [2]. More research is needed regarding lung cancer development in patients with lung fibrosis