Many men have little, if any, understanding of value of screening for prostate cancer. They trust that their doctor will do whatever is appropriate to keep catch the cancer early and cure them. But, far too often, doctors diagnose the cancer only after it is past the early stages.
There are several different circumstances that can result in a delayed diagnosis. This article will consider the following patters: the doctor (1) orders a PSA blood test, (2) learns that the patient has an elevated PSA level, but (3) does not inform the patient, does not refer the patient to a urologist, and does not order a biopsy to determine whether the elevated PSA is due to prostate cancer.
Consider the following case, for example: A doctor, an internist, found that his male patient had a PSA of 8.0 (anything above a 4.0 is normally considered to be high). The doctor said nothing to the patient. The doctor did not refer the patient to a urologist. The doctor did not order a biopsy. Two years later the doctor repeated the PSA test. This time it had risen to 13.6. Again, the doctor said nothing to the patient. Again, the doctor did not refer the patient to a urologist. Again, the doctor did not order a biopsy. Two years later the doctor repeated the PSA test.
It was not until three years after first learning of the patient’s elevated PSA level that the doctor finally advised him that he probably had cancer. Further testing revealed that at this point the patient had advanced prostate cancer. A prostatectomy was no longer an option. Treating physicians instead recommended radiation therapy and hormone therapy. Neither of these would cure the cancer but they might slow the cancer’s progress and further spread. The law firm that handled this matter reported that they took the case to mediation where they were able to obtain a settlement of $ 600,000.
This case illustrates a type of error that can result in the delayed diagnosis of a patient’s prostate cancer. It occurs when the doctor actually follows the guidelines and screens male patients for prostate cancer but does not follow through when the test results are abnormal.
At a minimum a doctor who notes abnormal prostate cancer screening results should inform the patient of the possibility that he may have prostate cancer and refer the patient to a urologist. The doctor can also recommend diagnostic testing, such as a biopsy in order to determine whether the abnormal screening test results are due to prostate cancer. But doing nothing after noting abnormal test results creates a situation in which those patients who do in fact have prostate cancer may not learn they have it until it has spreading outside the prostate, limiting the patient’s options for treatment, and substantially decreasing the likelihood that the patient will be able to survive the cancer.
As the case shows a doctor who commits this type of error may be liable for medical malpractice.