Treatment, Misdiagnosis, and Delayed Diagnosis
Cancer treatment is a complicated and hazardous process. Most treatment must do damage to the body in order to kill or remove the cancer. Medical decisions regarding treatment are based on the interpretation of various tests and image results that show where the cancer is, how it is developing, and what types of treatment might be effective. If the cancer has advanced due to misdiagnosis or delayed diagnosis, treatment becomes more difficult.
Cancer is generally classified into five stages, as follows:
- Stage 0 means the cancer is in one place and has not spread to any nearby tissue;
- Stage I indicates a local tumor that has not grown very far into nearby tissue and has not spread to any lymph nodes;
- Stage II and III describes cancer cells or tumors that have grown deeply into nearby tissue and may have spread to lymph nodes, but it has not spread to other parts of the body; and
- Stage IV means that the cancer has “metastasized’ to other parts of the body or organs.
The three primary treatments for cancer are surgery, radiation, and chemotherapy. These methods may be used alone or in combination with one another. The choice depends largely on the type and stage of the cancer, but it also should take into account the age, health, and medical history of the patient.
Surgery is often used with stage 0 and I cancers where cancer is localized, has not spread, and is in an organ or tissue that can be removed without other complications. It offers the best hope for a cure. Radiation may also be used with localized tumors that can be targeted.
At stages II and III, surgery may still be an option, but it is more invasive and severe, such as complete breast removal. Radiation can be used at these stages to target cancer cells and tumors that have regionalized, so to speak. Chemotherapy may also be used at these stages, either alone or to augment surgery and radiation.
At stage IV, chemotherapy is the primary treatment. At this stage, cancer has spread to the extent that there is too much to extract surgically or to treat with radiation. Chemotherapy can be effective because it moves through the bloodstream to the distant parts of the body to find and kill cancer cells.
Unfortunately, treatment options are not usually clear-cut. Diagnostic tests may not always clearly show the extent of the cancer, and doctors may not interpret the test results correctly. This can lead to decisions based on misdiagnosis, resulting in ineffective or even damaging treatment.
One of the key considerations in treatment decisions is the stage of the cancer. The number and size of tumors, whether the cancer cells have invaded lymph nodes, and whether they have spread to other parts of the body are all considered when establishing the stage. This is an area of diagnosis that is prone to medical error.
Naturally, patients will expect a recommendation from their doctors as to the treatment for their cancer. While patients are encouraged to ask appropriate questions and attempt to understand the options, prognoses, side effects, risks, and other details, the fact remains that all of that information is only as good as the doctor’s diagnosis.
The far majority of patients cannot read imaging and laboratory results to decide whether the doctor’s recommendation makes sense. Consequently, while much is made in cancer treatment literature about patient rights to participate in treatment decisions, they are in no real position to decide the best route to take to treat their disease. Patients cannot make their own diagnoses, and, likewise, cannot determine the appropriate treatment.
The best that a patient can do in making a treatment decision is to get a second opinion. This can serve as a quality control check of the treating physician’s recommendation. The important thing with second opinions is to make sure that the reviewing doctor is not relying on the diagnosis of the treating physician. The second opinion should include a separate diagnosis, as well as a treatment recommendation. If the second opinion differs from the first, a third opinion may be necessary.
A question that some patients should ask is whether there are clinical trials available for participation. Clinical trials involve the treatment of cancer patients with drugs or procedures that are not yet approved for general use. The purpose of trials is to determine whether the new treatments work and to help researchers improve them if possible. Patients who may want to consider a clinical trial include those with a cancer that is not expected to respond well to available treatments, such as a late stage cancer.
There are risks associated with a clinical trial, not the least of which is that it may not work. Testing of the drug or procedure prior to a clinical trial is typically in the laboratory on animals, so there is no record of successful human treatment. That is the role of the clinical trial. There is also the risk of unknown side effects.
Self-Advocacy, Misdiagnosis and Failure to Diagnose
Cancer patients can help avoid being a victim of misdiagnosis or failure to diagnose by practicing self-advocacy. Self-advocacy is learning to assert oneself. It sounds easy, but it can be difficult in dealing with a life-threatening medical condition, particularly with well-educated, busy medical personnel. Many patients feel unqualified to question what their doctors say and feel it is disrespectful to do so.
Still, it is important for patients to demonstrate that they do not take everything they are told as being unquestionable.
Doctors who are faced with patients likely to ask questions are apt to be more deliberative in their approach to diagnosis and treatment. On the other hand, doctors whose patients express complete faith in everything they say and do may become more complacent in their approach.
Doctors face various obstacles within the health care delivery system. Policies restricting referrals of patients, insurance coverage and reimbursement decisions, and other issues may cloud doctors’ thinking when evaluating treatment of patients. Self-advocacy can help push doctors back onto the right path and make them think about the potential adverse consequences to them of a misdiagnosis, delayed diagnosis, or error in crafting a treatment plan.
Side Effects and Legal Damages
Side-effects of cancer treatment, particularly radiation and chemotherapy, can be serious. Chemotherapy is introduced into the bloodstream with the mission of finding and destroying rapidly dividing cells. The problem is that cancer cells are not the only ones rapidly dividing. Many healthy cells rapidly divide constantly, and these are destroyed by chemotherapy drugs.
Radiation therapy is the use of X-rays to kill cancer cells. Although it can be focused on a limited part of the body, it also affects healthy cells as well as cancer cells, although not on the scale of chemotherapy.
Chemotherapy and radiation have both short-term side effects that go away, as well as the potential for long term, later occurring effects. Both carry the possibility of a secondary cancer developing later in life, typically lymphoma or leukemia. Both treatments can cause long-term damage to the lungs, heart, kidneys, and reproductive organs, resulting in other serious health conditions. Infertility can result in both men and women.
The risk of these later effects of chemotherapy and radiation cannot necessarily be avoided, assuming the treatments are necessary, but mistakes are made that can increase the chance of serious later effects. There are many chemotherapy drugs, and some are more dangerous than others. The misapplication of a drug because of misdiagnosis of a patient’s cancer type or stage, or ignoring attributes of the patient’s health or medical history, can have devastating effects.
Likewise, radiation doses must be closely monitored to ensure too much is not applied and that it is not applied to excessive areas of the body. There are medically established maximum lifetime doses of radiation that a human can endure without suffering increasingly severe bodily harm. A doctor’s failure to recognize prior radiation exposure in a patient’s medical history is one mistake that can lead to serious adverse health consequences.
Cancer is a serious illness that requires severe treatment that is, in and of itself, damaging to the body. Doctors who prescribe and deliver these treatments must be vigilant in their assurance that no more damage is inflicted than is absolutely necessary to treat the cancer. A misdiagnosis or delayed diagnosis can cause a need for more damaging chemotherapy or radiation than might have otherwise been necessary. In some cases, a proper and timely diagnosis might have allowed surgery to be the primary treatment of the cancer.
Holding doctors accountable for misdiagnosis or delayed diagnosis is essential to the ongoing effective treatment of cancer patients. Part of that accountability involves the payment of damages for the financial and emotional effects of these mistakes. No one wants to think that a doctor would intentionally do something that causes harm, but the complacency that can result from a lack of accountability produces the same result. Consequently, mistakes of complacency are also compensable.
If you or a loved one have suffered from the misdiagnosis or delayed diagnosis of cancer, you may be able to collect damages and send a strong message to health care providers. Contact us today by calling or using our contact form to discuss your case. Your initial consultation is free, and because we work on a contingency fee, you pay nothing if we don’t prevail.