Male patients tend to have a scant awareness of prostate cancer, their own chances for the cancer, and the methods available for detecting whether they have prostate cancer. Most male patients are not aware of what it means to screen for prostate cancer or that screening needs to be done before they begin to show symptoms. Yet, far too often, physicians detect the cancer only after it is past the early stages because of deficient of screening.
There are several different circumstances that may result in a delayed diagnosis. This article will consider the following pattern: the doctor (1) orders a PSA blood test, (2) finds that the man has a high PSA level, but (3) fails to inform the patient, does not refer the patient to a specialist, and fails to get a biopsy to confirm whether the elevated PSA is due to prostate cancer. The case below illustrates this situation.
A physician, an internist, found that his male patient had a PSA of 8. (anything above a 4.0 is generally viewed as high). The doctor said nothing to the patient. The physician did not refer the patient to a specialist. The doctor failed to order a biopsy. Two years later the physician repeated the PSA test. This time the PSA level had gone up to 13.6. Again, the physician did not inform the patient. Again, the doctor did not refer the patient to a urologist. And again, the physician did not order a biopsy. Two years later the doctor repeated the PSA test. It was not until three years after first knowing about the patients raised PSA level that the physician finally advised him that he most likely had cancer. By the time he was diagnosed he had metastatic prostate cancer and surgery was not among the treatment options. Treating doctors alternatively recommended radiation therapy and hormone therapy. Neither of these would eliminate the cancer but they might slow the cancers advancement and additional spread. The law firm that handled this matter reported that they took the lawsuit to mediation where they were able to obtain a settlement of $600,000.
But not following up after noting abnormal test results brings about a situation in which those patients who do in fact have prostate cancer may not discover they have it until it has spread outside the prostate, restricting the patients choices for treatment, and substantially decreasing the possibility that the patient will be able to survive the cancer.
This lawsuit illustrates a sort of error that can lead to the delayed diagnosis of a patients prostate cancer. It comes about when the doctor actually follows the guidelines and screens male patients for prostate cancer yet does not follow through when the test results are abnormal.