Failure to diagnose cancer

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Failure to Diagnose Cancer and Other Medical Conditions

Cancer is a leading cause of death in the United States, killing over 600,000 people a year. In 2022, there were an estimated 1.9 million new cancer cases in the U.S. A misdiagnosis can happen with any kind of cancer from prostate to breast cancer.

With new treatments and early detection, cancer deaths have been decreasing for years. However, some patients are not timely or accurately diagnosed. Failure to diagnose cancer greatly increases their risk of death.

If you or a loved one has been diagnosed with cancer at later stages, contact our office to see if a physician may have breached the standard of care in not ordering proper tests. If you were in a high-risk category and your physician failed to order appropriate testing, he or she may be liable for medical malpractice. Consider the following types of cancers and whether you were at high risk.

Time Limits – Statute of Limitations & filing requirements

Every failure to diagnose cancer is subject to a time period in which you must file suit. That period is two years in Virginia and three years in Maryland.

In most states including Virginia, before a case can be filed it must be reviewed and certified or supported by a qualified expert in the same or similar discipline as the alleged defendant doctor. Selecting the right expert could be the difference between winning and losing your case, so hire a medical malpractice Law Firm with over 30 years of experience handling such cases.

Breast Cancer

Breast Cancer is the most common cancer affecting woman in the U.S. and is the second leading cause of death amount woman. In 2023 there will be over 300,000 people diagnosed with breast cancer.

Back woman and woman over 50 have a higher risk of breast cancer. Patients who smoke or who have a family history of breast cancer are also at increased risk. It is believed that some 90% of all cancers have are due to a genetic alteration, which is often inherited. Rarer causes of cancer include chemical or environmental agents, hormone imbalances, infections, inflammatory responses, and radiation.

Early detection and treatment greatly improves one’s chance of a full recovery. Since breast cancer may not show symptoms, it is vitally important that all women over 50 receive regular mammograms. Other tests that will detect breast cancer include ultrasounds, MRIs and breast imaging tests.

Potential symptoms of breast cancer include:

Swelling of part the breast (even if there is no lump felt)
Breast or Nipple pain
Skin dimpling (sometimes looking like an orange peel)
Nipple skin that is red, flaking or thick
Nipple retraction (turning inward)
Nipple discharge (other than breast milk)
Swollen lymph nodes under the arm(This can be a sign that breast cancer has already spread)

Prostate Cancer

Over 288,000 men are diagnosed with prostate cancer each year in the United States. Proper screening and early diagnosis is essential to save lives and extend the patient’s quality of life. However, despite available and inexpensive screening tools, patients die from cancer that could have been detected and successfully treated early if they had been properly screened and diagnosed. [Clark, R.; Vesprini, D.; Narod, S.A. The Effect of Age on Prostate Cancer Survival. Cancers 2022, 14, 4149. https://doi.org/ 10.3390/cancers14174149]

Prostate cancer is the second most common cancer in men and the second leading cause of cancer death in men in the United States. Approximately 34,700 American men die from prostate cancer each year. When caught early, prostate cancer is very treatable. An estimated 80% of all prostate cancers are detected when the cancer is confined to the prostate or the region around it (the capsule). When detected early the 5-year survival rate is greater than 99%. Generally, the earlier the cancer is caught and treated, the more likely the patient will remain disease-free. [

Failure to Diagnose

An early diagnosis is critical in properly treating prostate cancer. When a healthcare provider delays diagnosis or misdiagnoses the condition, it can have devastating consequences.

Screening tests are used to diagnose cancer before a person has any symptoms. Doctors should begin screening men for prostate cancer, even if the patient is in good health, because most types of prostate cancer are successfully treated when they are found early, before symptoms appear.

Common Screening for Prostate Cancer

Prostate cancer screening should start at 45 (40 if you are Black and/ or have other high risk factors for prostate cancer). A family history of prostate cancer puts most men at a higher risk. Screening is important because it can detect cancer earlier in its progression, before it has spread. This increases the chance of successfully treating the cancer before it progresses too far, which in turn increases a patients changes of survival

The two most common prostate cancer screening tests are a Prostate-specific antigen (PSA) test, a simple and inexpensive blood test, and the Digital rectal exam (DRE). The other biomarker tests, like the 4K Score—a more sophisticated blood test, can also be used for screening. Abnormal PSA or DRE results require further testing to determine if the patient has prostate cancer. For most men, a PSA of ≤ 4 is not a cause for concern. Values greater than 4 should lead to further evaluation, preferably by a urologist. Men with a PSA level between 4 and 10 (often called the “borderline range”) have about a 1 in 4 chance of having prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%. [ Atan A, Güzel Ö. How should prostate specific antigen be interpreted? Turk J Urol. 2013 Sep;39(3):188-93.]

Diagnosis

Although multiple tests can show potential prostate cancer, only a biopsy can make a definitive diagnosis. Typically, such a procedure is done by urologist, and the lab will assign a Gleason Score. In general, Gleason scores at or below 6 have a very good prognosis. Whereas cancers with a Gleason score of 7 or typically mean that the patient’s cancer is not curable, and treatment options are more limited.

The Failure to Diagnose Prostate Cancer may be actionable

As any attorney handling prostate cancer cases can tell you, delayed diagnosis is very common with prostate cancer. Delayed diagnosis or failure to screen for prostate cancer could be an indication of medical malpractice. If you want to find out if you have a medical malpractice case for the failure to diagnose Prostate cancer, call the Law Office of Jeffrey J. Downey for a free consultation today.

Colon or Colorectal Cancer

It is estimated that in 2023 over 150,000 people in the U.S. will be diagnosed with colorectal cancer and some 52,000 patients will die from the condition.

African Americans and patients with a family history of colorectal cancer are at increased risk for the condition.

The following are risk factors for colorectal cancer:

Family history of colorectal polyps or cancer
Being overweight or obese
Physical inactivity
Smoking
Alcohol use
Consuming diets high in red meats, pork and lamb
Type two diabetes
History of inflammatory bowel disease

Diagnosis of Colorectal Cancer

Medical history and physical exam

A physician should ask about your medical history to learn about possible risk factors, including your family history. Your healthcare provider should also question about your risk factors identified above.

As part of a physical exam, your physician or nurse practitioner should feel your abdomen for masses or enlarged organs, and also examine the rest of your body. You may also have a digital rectal exam (DRE). During this test, the doctor inserts a lubricated, gloved finger into your rectum to feel for any abnormal areas.

Tests to look for blood in your stool

If you are being evaluated by a physician anemia or symptoms like bleeding from your rectum a stool test is often recommended to check for blood that isn’t visible to the naked eye (occult blood), which might be a sign of cancer. These types of tests – a fecal occult blood test (FOBT) or fecal immunochemical test (FIT) – can be done at home. A stool blood test should not be the next test done if you’ve already had an abnormal screening test. In that situation your provider should oder a diagnostic colonoscopy,

Blood tests

Your physician may order various blood tests to diagnose colorectal cancer. These tests also can be used to help monitor your disease after you have been diagnosed.

Complete blood count (CBC): This test measures the different types of cells in your blood. It can show if you have anemia (too few red blood cells). Some people with colorectal cancer become anemic because the tumor has been bleeding for a long time.
Liver enzymes:You may also have a blood test to check your liver function, because colorectal cancer can spread to the liver.
Tumor markers:Colorectal cancer cells sometimes make substances called tumor markers that can be found in the blood. The most common tumor marker for colorectal cancer is carcinoembryonic antigen (CEA). Blood tests for this tumor marker can sometimes suggest someone might have colorectal cancer, but they can’t be used alone to screen for or diagnose cancer. This is because tumor marker levels can sometimes be normal in someone who has cancer and can be abnormal for reasons other than cancer. Tumor marker tests are typically used in combination with other tests to monitor patients who have already been diagnosed with colorectal cancer.

Diagnostic colonoscopy

A diagnostic colonoscopy is just like a screening colonoscopy, but it’s done because a person is having symptoms, or because something abnormal was found on another type of screening test. For this test, the doctor looks at the entire length of the colon and rectum with a colonoscope, a thin, flexible, lighted tube with a small video camera on the end. It is inserted through the anus and into the rectum and the colon. Special instruments can be passed through the colonoscope to biopsy or remove any suspicious-looking areas such as polyps, if needed.

Proctoscopy This test may be done if rectal cancer is suspected. For this test, the doctor looks inside the rectum with a proctoscope, a thin, rigid, lighted tube with a small video camera on the end. It’s put in through the anus. The doctor can look closely at the inside lining of the rectum through the scope. The tumor can be seen, measured, and its exact location can be determined. For instance, the doctor can see how close the tumor is to the sphincter muscles that control the passing of stool.

Biopsy

Usually if a suspected colorectal cancer is found by any screening or diagnostic test, it is biopsied during a colonoscopy. In a biopsy, the doctor removes a small piece of tissue with a special instrument passed through the scope. Less often, part of the colon may need to be surgically removed to make the diagnosis. See Testing Biopsy and Cytology Specimens for Cancer to learn more about the types of biopsies, how the tissue is used in the lab to diagnose cancer, and what the results may show.

MSI and MMR testing: Colorectal cancer cells are also typically tested to see if they have high levels of gene changes called microsatellite instability (MSI). Testing might also be done to check for changes in any of the mismatch repair (MMR) genes (MLH1, MSH2, MSH6, and PMS2). EPCAM, another gene related to MSH2, is also routinely checked.

Changes in MSI or in MMR genes (or both) are often seen in people with Lynch syndrome (HNPCC). Most colorectal cancers do not have high levels of MSI or changes in MMR genes. But most colorectal cancers that are linked to Lynch syndrome do.

There are 2 possible reasons to test colorectal cancers for MSI or for MMR gene changes:

To determine if certain immunotherapy drugs might be options for treatment.
To identify people who should be tested for Lynch syndrome. People suffering Lynch syndrome are typically at a higher risk for some other cancers, so they are often advised to get other cancer screenings.

Imaging tests to look for colorectal cancer

Imaging tests use sound waves, x-rays, magnetic fields, or radioactive substances to create images of the your body. They are done for several reasons, including:

To examine at suspect lesion that might be cancer
To learn if the cancer has spread
To evaluate the effectiveness of treatment
To look for signs of cancer coming back after treatment

Computed tomography (CT or CAT) scan

A CT scan uses x-rays to make detailed cross-sectional images of your body. This test can help tell if colorectal cancer has spread to nearby lymph nodes or to your liver, lungs, or other organs.

Ultrasound

Ultrasound uses sound waves and their echoes to create images of the inside of the body. A small microphone-like instrument called a transducer gives off sound waves and picks up the echoes as they bounce off organs. The echoes are converted by a computer into an image on a screen.

Abdominal ultrasound: For this exam, a technician moves the transducer along the skin over your abdomen. This type of ultrasound can be used to look for tumors in your liver, gallbladder, pancreas, or elsewhere in your abdomen, but it can’t look for tumors of the colon or rectum.

Endorectal ultrasound: This test uses a special transducer that is inserted into the rectum. It is used to see how far through the rectal wall a cancer has grown and whether it has reached nearby organs or lymph nodes.

Intraoperative ultrasound: This exam is done during surgery. The transducer is placed directly against the surface of the liver, making this test very useful for detecting the spread of colorectal cancer to the liver. This allows the surgeon to biopsy the tumor, if one is found, while the patient is asleep.

Magnetic resonance imaging (MRI) scan

Like CT scans, MRI scans show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. A contrast material called gadolinium may be injected into a vein before the scan to get clear pictures. This test can examine abnormal areas in the liver or the brain and spinal cord that could be cancerous.

Chest x-ray

An x-ray might be done after colorectal cancer has been diagnosed to see if cancer has spread to the lungs, but more often a CT scan of the lungs is done since it tends to give more detailed pictures.

Positron emission tomography (PET) scan

For a PET scan, a slightly radioactive form of sugar (known as FDG) is injected into the blood and collects mainly in cancer cells. PET scans are not routinely done in people diagnosed with colorectal cancer. CT scans and MRIs are used more often.

Angiography

Angiography is an x-ray test for looking at blood vessels. A contrast dye is injected into an artery, and then x-rays are taken. The dye outlines the blood vessels on x-rays.

If your cancer has spread to the liver, this test can show the arteries that supply blood to those tumors. This can help surgeons decide if the liver tumors can be removed and if so, it can help plan the operation. Angiography can also help in planning other treatments for cancer spread to the liver, like embolization.

Contact the Law Office of Jeffrey J. Downey today for a free consultation. You pay no attorney’s fees unless there is a successful recovery.

We handle medical malpractice cases in Virginia, Maryland and Washington D.C.

Contact Information:

The Law Office of Jeffrey J. Downey, P.C.

8300 Greensboro Drive,

Suite 500

McLean, VA 22102

Telephone: 703-564-7318

Fax: 703-556-7700

Website: https://www.jeffdowney.com/

Email: Jdowney@jeffdowney.com