Cancer Misdiagnosis


Cancer: Misdiagnosis, Mistreatment and Under Treatment

Cancer is the second greatest cause of death in the United States surpassed only by cardiac disease- related deaths. This year alone more than 1.4 million new cases will be identified. That’s 1 in every 4 deaths in this country, or approximately 560,000 people annually. Countless more will go undiagnosed. All told, treatment costs account for 25 per cent of the nation’s annual health care expenditures.

Misdiagnosis of cancer can lead to a poor prognosis. A recent series in the New York Times (“Cancer Patients, Lost in a Maze of Uneven and Complicated Care” Sunday, July 29, 2007 ) exposes in graphic terms what leading lawyers focusing on these issues have known and advocated for years: while cancer rates fall, (1) many people succumb to the consequences of missed or belated diagnosis, with physicians under appreciating the early diagnostic signs of cancer; (2) still others receive treatment which is inadequate to treat and resolve their cancers, or even worse, treatments which are inappropriate or outdated for those cancers; (3) patients remain ill advised and uninformed about treatments available to them, and many are unable to avail themselves to these treatments because insurance may not cover these expenses.

The leading cancers Americans face today include lung. breast, colon and prostate cancers. Ovarian and pancreatic cancers are also on the rise, and early diagnosis and treatment intervention for these, among others is critical.

According to the authors, for example, colon cancer is preventable and one of only of two cancers for which tests can identify and eliminate pre cancerous growths, stopping the development and spread of cancer in its track. Cervical cancer is the other. Yet many people do not regularly receive the proper screening either for fear of the tests (colonoscopy for cancer, pap smear for cervical), ignorance of the existence and necessity of these, or the un-affordability of these tests, which are often not covered by their insurance carriers.

Colon cancer remains the second leading cause of cancer, surpassed only by lung cancer, primarily attributable to smoking.

The Times piece goes on to state that several studies have reported that significant numbers of patients may be missing out on cancer treatments which could treat or prolong their lies. Amazingly, 15 to 25 per cent of breast cancer victims, for example, never receive life saving radiation treatments, and another 20 to 30 per cent fail to take, or do not receive, anti estrogen drugs, considered a mainstay. According tot the authors these failings arise from miscommunication between patient and physician, fear or lack of medical insurance.

Ovarian cancer, one of the deadliest gynecologic cancers, has been the subject of renewed interest of late, because of the devastating toll on American families and economics that this disease causes. Early detection and treatment here is critical, and yet there remains no standardized diagnostic screening, and until only June, 2007, no uniformly recognized identification of symptoms. These cancers are not detectable on pap or routine gynecological exams, although some experts maintain that Trans Vaginal Sonograms can provide earlier detection in some cases. Yet the test is not standardized or routine, and often not covered by insurance. And while surgery remains the only treatment for these women, too many patients, according to Dr. Barbara Goff, a gynecologic Oncologist at the University of Washington in Seattle, do not receive the proper surgery.

The Times also reports men with prostate cancer receive, ironically, too much treatment, with wasted resources and needless pain and risks, the end result. A study of men treated between 2000 and 2002 demonstrated that 10 per cent were over treated with radical surgery and another 45% over treated with radiation.

Colon cancer victims receive chemotherapy only 65 per cent of the time, while studies suggest it has provided beneficial for many victims and is recommended for 80 per cent of all patients.

This reflects an inconsistency in medical standards around the country, with both race and ethnicity coming into play. Last year’s study in the Journal of Clinical Oncology described jarring findings of inequitable surgical treatment among white, black and Hispanic breast cancer surgery patients, with white women receiving the higher standard of care.

As advocates of patients, the legal profession has seen for years the consequences of missed diagnosis and inadequate treatment of cancer patients. Robbed of life expectancy and their quality of life, many victims seek legal redress when the medical and scientific communities have failed them. Oftentimes it is too late for them, and it is the surviving spouse, children and parents who seek answers, and redress for legal compensation from a failed medical system.

For too long the answer has been tort reform, so that higher insurance rates could be avoided. But as Times article demonstrates, the true answer lies in aggressive and proactive diagnostic care and treatment and education of the public.

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Roberta Ashkin, Esq.
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