Man Discovers He Has Advanced Prostate Cancer Following Years Of Physicians Not Doing A Follow Up Biopsy

Prostate cancer is a dreadful disease. Although not 100% accurate there are diagnostic tests that help doctors to verify if the cancer is present in a patient. Still as a consequence of the chance of false negatives (a negative test result despite the fact that the patient in reality has cancer) physicians should follow up and repeat tests as appropriate when patient complaints and screening tests keep showing the possibility of cancer. The failure to do so may reslt in a malpractice claim.

In one published claim a patient communcated to his primary care doctor that he was suffering from urinary frequency and burning. The doctor began the man on antibiotics and refered the man to a urologist. The urologist conducted a cystoscopy which showed that the man had an enlarged prostate. The urologist additionally ordered a PSA blood test which registered a 16.3 (a level higher than a 4.0 is ordinarily accepted as abnormal). Consequently the urologist performed a biopsy 2 months later. The biopsy was interpreted by a pathologist as benign.

The next year the patient returned to the urologist. On this occasion the PSA blood test was a 2.9 (ordinarily accepted as in normal range). The urologist concluded that the individual had BPH (a benign enlargement of the prostate). After 3 months the individual consulted the PCP for fever and nocturia (needing to urinate during the night). The doctor put him on another round of antibiotics. A follow up urine culture showed up negative. The PCP hence referred the individual back to the urologist. The urologist did a PSA test which came back a 6.4 (again, high).

A biopsy analyzes portions of the prostate. Thereby, it is possible for a biopsy to not catch the cancer. But, the urologist decided to depend 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 man’s complaints and elevated PSA. The next year the patient went back to his family doctor. His symptoms continued to include nocturia. On physical examination the physician noted that the patient had a markedly enlarged prostate. Yet, the physician failed to order a PSA or re-refer him to a urologist. Regular blood testing four months subsequently showed that the man’s PSA was at 7.4 Neither doctor followed up in any way.

One more year goes by at which time the family doctor recorded that the PSA level was 9.8 Once more, no follow up or referral to a urologist. Yet another year and the individual continues to have problems with nocturia. On this occasion the PSA was 9.7 No follow up and no referral. Five years after the man’s earliest claims of urinary problems the family doctor again documented a considerably enlarged prostate gland and a PSA that had reached a 31. The doctor at last refered the individual back to the urologist.

The urologist verified that the patient’s prostate was enlarged and started the man a 2 week regimen of antibiotics to be followed by another PSA test. Once the PSA test was repeated 2 weeks afterwards it recorded a 33. A biopsy was then at last done which revealed cancer every sample taken.

Testing subsequently uncovered that the man had prostate cancer which had spread to the lymph nodes, the liver and bone. Notwithstanding a course of both hormone therapy and radiation therapy the man died around eighteen months following his diagnosis. The law firm that represented his family published that a settlement for $1,000,000 was reached in the case.