Prostate cancer is a dreadful disease. Even though not perfect there are diagnostic tests that help doctors to establish whether the cancer is present in a patient. But as a consequence of the possibility of false negatives (a negative test result despite the fact that the patient in reality has cancer) physicians have to follow up and redo tests as appropriate if patient complaints and screening tests continue to signal the possibility of cancer. Not doing so may give rise to a lawsuit for medical malpractice. In one published lawsuit a patient told his family physician that he was having urinary frequency and burning. The physician started the patient on antibiotics and refered him to a urologist. The urologist conducted a cystoscopy which revealed that the individual had an enlarged prostate. The urologist also did a PSA blood test which came back a 16.3 (anything higher than a 4.0 is typically considered to be high). Thus the urologist took a biopsy two months later. The biopsy was read by a pathologist as exhibiting no sign of cancer. The next year the individual returned to the urologist. This time the PSA blood test registered a 2.9 (typically accepted as in normal range). The urologist decided that the patient had BPH (a benign enlargement of the prostate). After 3 months the man consulted the family doctor with symptoms of fever and nocturia (needing to urinate over the night). The physician started him on a second round of antibiotics. A follow up urine culture came back negative. The PCP therefore referred the man back to the urologist. The urologist ordered a PSA test which came back a 6.4 (again, high). A biopsy analyzes portions of the prostate. Hence, it is possible for a biopsy to miss the cancer. At this point, the urologist chose to rely on the prior year's biopsy and to not perform another one as a follow up. Rather, the urologist failed to follow up on the male's symptoms and elevated PSA. The subsequent year the patient returned to his primary care physician. His symptoms continued to include nocturia. On physical examination the physician noted that the individual had a markedly enlarged prostate. Nevertheless, the physician did not order a PSA or re-refer the patient to a urologist. Standard blood testing 4 months subsequently showed that the male patient's PSA was at 7.4 Neither doctor did anything to follow up. One more year goes by and now the primary care physician recorded that the PSA level was 9.8 Again, no follow up or referral to a urologist. Yet another year and the individual continues to have problems with nocturia. Now the PSA was 9.7 No follow up and no referral. Five years after the male patient's initial reports of urinary problems the primary care physician once more recorded a significantly enlarged prostate gland and a PSA level that had reached a 31. The physician finally refered the individual back to the urologist. The urologist verified that the patient's prostate was enlarged and began the man on 2 weeksto be followed by an additional PSA blood test. When the PSA test was done 2 weeks afterwards it recorded a level of 33. A biopsy followed which showed cancer every sample taken. Testing later showed that the man had prostate cancer which had spread to the lymph nodes, the liver and the bone. Even with a course of both hormone therapy and radiation therapy the patient passed away close to eighteen months subsequent to his diagnosis. The law firm that handled this matter recorded that a settlement in the amount of $1,000,000 was reached in the case.
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What if you let your physicians know you were showing symptoms that could be caused by prostate cancer for five years; your doctors follow your symptoms and document abnormal screening test results throughout that period; still your physicians failed to redo a biopsy beyond the first time you complained of symptoms. Then contemplate finding out that after that delay you have metastatic prostate cancer. Specifically such a situation and the resulting wrongful death case are analyzed in this ...
Joseph Hernandez is an attorney accepting cancer cases. You can learn about metastatic prostate cancer and other cancer matters including advanced breast cancer visit the websites
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