The need for screening even symptomatic patients for colon cancer when they are 50 or older and for testing patients who exhibit certain symptoms such as blood in the stool is generally accepted within the medical community. A failure to do so may lead to a delay in the diagnosis of colon cancer which in turn may allow the cancer to spread. Below we examine a documented case involving a woman over the age of 50 whose doctors not only failed to screen her when she was as symptomatic but continued to not test her even after she developed a number of symptoms.
In this case the woman treated with her primary care physician from the time she was 50 years old to the time she was 55. During that time her medical history included obesity, a hernia and hypertension. Her doctor, however, never performed or recommended that she undergo screening for colon cancer.
When she was 55 she experienced vomiting as well as diarrhea with blood clearly visible in her stool. She went to the emergency room where the attending physician diagnosed her as having gastroenteritis. She followed up with a doctor a few days later. This doctor made a note of the fact that she now had up to three bowel movements a day, all of which contained a blood. The doctor recommended a wait-and-see approach and thought that she would need a lower G.I. endoscopy if her condition did not improve. The doctor's differential diagnosis was for colitis. The doctor apparently never considered colon cancer as part of the differential diagnosis. A year later she again saw this doctor complaining of abdominal issues and at least 50 pounds of unexplained weight loss. The doctor concluded that her weight-loss was the result of a change in her diet and even though she had a history of blood in her stools that doctor again did not order or perform any tests to rule out colon cancer.
A month later the woman again goes to the hospital with complaints of pain in her abdomen and continuing diarrhea. Also, by now there was blood present when she vomited. Her stool was now a dark brown color and testing revealed blood present in the stool. The doctor at the emergency room diagnosed her as having a gastrointestinal bleed. The doctor next ordered an x-ray which revealed a partial obstruction of the bowel. The doctor then admitted her to the hospital. Blood tests revealed that her CEA, a marker for colon cancer, was abnormally high.
Initially a gastroenterologist performed an upper G.I. endoscopy and took several biopsies. The gastroenterologist, however, failed to a colonoscopy. It was not until a covering physician at the hospital noted that her history was suggestive of cancer and that additional testing was required that a sigmoidoscopy was finally performed approximately 2 weeks later. The sigmoidoscopy revealed a large obstruction and a follow-up CAT scan showed a large tumor. During surgery it was discovered that her cancer had already spread to both her uterus and her bladder. In addition the pathology report of the material removed during the surgery found cancer in 13 lymph nodes. The diagnosis - stage IV colon cancer.
She commenced treatment with chemotherapy and after experiencing intolerance for the chemotherapy along with bowel obstructions and even renal failure, the woman died less than a year later. She was only 58 years old at the time of her death. She was married and had two adult children. Her family pursued a claim against the doctors for the delay in the diagnosis of her cancer. The law firm that handled this lawsuit documented a settlement in the case for $950,000 on behalf of the family.
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