Lung Cancer Diagnosis and Medical Malpractice

As with all cancers, the sooner lung cancer is diagnosed and treated, the better the prognosis. Lung cancer is one of the most common types of cancer. People over the age of 50 are at an increased risk of lung cancer. According to the American Cancer Society, tobacco use causes more than 80 percent of all lung cancers because cigarettes, cigars and other tobacco products contain many dangerous carcinogens. Other causes include inhalation of asbestos and radon, among other chemicals and pollutants including arsenic, chromium, silica and beryllium. People with a history of tuberculosis and other lung diseases, including emphysema and asthma, have an increased risk of developing lung cancer.
Lung cancer is sometimes misdiagnosed as something less harmful, making lung cancer the 4th most claimed malpractice injury. For example a patient with a chronic cough may be diagnosed with bronchitis, without running the proper diagnostic test.
Some symptoms and signs of lung cancer:

• Persistent bouts of coughing.
• Persistant back pain, shoulder pain, or chest pain that worsens with deeper breathing.
• Shortness of breath.
• Hoarse voice.
• Coughing up blood or bloody mucus.
• Neck or facial swelling.
• Swallowing with difficulty.
• Weight loss or appetite loss.
• Feeling fatigue or weak.
• Periodic respiratory infections.

To diagnose lung cancer, a doctor should look for enlargement of the lymph nodes, liver and abdomen, and for other symptoms of a lung mass. A complete diagnosis requires a chest x-ray to look for growths, and a sputum test, involving coughing up phlegm, for lung cancer cell detection, and a spirometry, which tests a patient's pulmonary function to determine if there is an obstruction or narrowing of the airways. A diagnosis of lung cancer may include a biopsy, of which there are two kinds, bronchoscopy and percutaneous needle biopsy, for tissue examination. Bronchoscopy involves insertion of a bronchoscope, a flexible lighted tube, into the patient's mouth or nose and guiding it to the bronchi. A percutaneous needle biopsy involves inserting a needle into the lung through the skin. After a lung cancer diagnosis is made, a doctor will determine the stage of the cancer in order to establish the proper course of treatment.
There are four types of lung cancer:

• Small lung cancer, accounts for about 20 to 25 percent of all lung cancer cases. It is found predominantly in people who are heavy smokers and most often develops in the bronchial submucosa. This form of lung cancer spreads rapidly and is more likely to metastasize than the other three forms of lung cancer.
• Squamous cell carcinoma, also called epidermoid cancer, makes up 25 to 30 percent of all lung cancer cases and is the most common form of lung cancer. It often begins in the bronchi and may remain in the lungs without spreading for a longer period of time than the other forms of lung cancer.
• Adenocarcinoma is a form of lung cancer with cancerous cells shaped as cubes or columns, which usually grow in patterns in the glands, along the tissue that lines the bronchi and along the outer edges of the lungs. It makes up 25 to 30 percent of all lung cancer cases.
• Large cell carcinoma is the rarest form of lung cancer, making up approximately 10 to 20 percent of cases. It is found most often in the bronchi and is made up of cancer cells that are not small lung cancer, squamous, or adenocarcinoma.

If a doctor or other health care provider should have suspected lung cancer, but did not follow-up appropriately, the consequences can be severe.  Delays in diagnosis can result in delays in treatment and further spread of the disease or even wrongful death.  If you or one of your loved ones presented with early symptoms of lung cancer, but the physician missed the diagnosis or caused other delays, please contact Utah attorney Ryan Springer for a free legal consultation about your legal rights and a confidential case evaluation.

Stages of Breast Cancer

One of the first things to understand about a breast cancer case is staging.  Breast cancer stages range from 0 to IV, with many subcategories. Lower numbers indicate earlier stages of cancer, while higher numbers reflect late-stage cancers.  If a doctor waits too long to order the appropriate tests, the disease can progress without treatment.  This delay in diagnosis is a common form of medical malpractice.


Stage 0
This stage describes noninvasive (in situ) breast cancer. Ductal carcinoma in situ (DCIS) is an example of stage 0 cancer.

Stage I
This stage is an early stage of invasive breast cancer in which:

• The tumor measures no more than 2 centimeters (cm), or about 3/4 inch, in diameter
• No lymph nodes are involved — the cancer has not spread outside the breast

Stage II
This stage describes invasive breast cancers in which one of the following is true:

• The tumor measures less than 2 cm (about 3/4 inch) in diameter but has spread to lymph nodes under the arm.
• No tumor is found in the breast, but breast cancer cells are found in lymph nodes under the arm.
• The tumor is between 2 and 5 cm (about 3/4 to 2 inches) in diameter and may or may not have spread to lymph nodes under the arm.
• The tumor is larger than 5 cm (2 inches) in diameter but hasn't spread to any lymph nodes.

Stage III
Stage III breast cancers are subdivided into three categories — IIIA, IIIB and IIIC — based on a number of criteria. By definition, stage III cancers haven't spread to distant sites.
For example, a stage IIIA tumor is larger than 5 cm (2 inches) and has spread to one to three lymph nodes under the arm. Other stage IIIA tumors may be any size and have spread into multiple lymph nodes. The lymph nodes clump and attach to one another or to the surrounding tissue.

In stage IIIB breast cancer, a tumor of any size has spread to tissues near the breast — the skin and chest muscles — and may have spread to lymph nodes within the breast or under the arm. Stage IIIB also includes inflammatory breast cancer, an uncommon but aggressive type of breast cancer.
Stage IIIC cancer is a tumor of any size that has spread:

• To 10 or more lymph nodes under the arm
• To lymph nodes above or beneath the collarbone and near the neck
• To lymph nodes within the breast itself and to lymph nodes under the arm

Stage IV
Stage IV breast cancer has spread to distant parts of the body, such as the lungs, liver, bones or brain.

• The size of your tumor
• Whether cancer cells have spread to lymph nodes under your arm (axillary lymph nodes)
• Whether cancer cells have spread to other parts of your body

In its earliest stages, breast cancer may not cause any symptoms. A lump may be too small to feel or cause unusual changes. Often, an abnormal area turns up on a screening mammogram (x-ray of the breast), which leads to further testing.
In some cases, however, the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But sometimes cancers can be tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.
According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:

• swelling of all or part of the breast
• skin irritation or dimpling
• breast pain
• nipple pain or the nipple turning inward
• redness, scaliness, or thickening of the nipple or breast skin
• a nipple discharge other than breast milk
• a lump in the underarm area

These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst. It’s important to get any breast changes checked out promptly by a doctor.
If you reported symptoms like this to your doctor, but did not run necessary tests to rule out breast cancer, the cancer can spread.  If you or one of your loved ones presented with early symptoms of breast cancer, including palpable lumps, nipple retraction, or other early signs of cancer, but the physician overlooked them, please contact Utah attorney Ryan Springer for a free legal consultation about your legal rights and a confidential case evaluation.

Medical Malpractice: Colorectal Cancer Misdiagnosis

In the United States, only lung cancer claims more lives than colorectal cancer, which encompasses cancers of the colon, rectum, anus and appendix. Out of the more than 130,000 people in the United States who receive a colon and rectal cancer diagnosis each year, more than 50,000 people die.

Although colon and rectal cancers develop slowly, they are often not detected until they are life-threatening. Symptoms include changes in bowel habits, ranging from diarrhea, constipation, narrowing of the stool and rectal bleeding to cramping, steady stomach pain, and weakness and/or tiredness. Such symptoms can be evident even if the growth is in an early pre-tumor state, known as a "polyp."

Screening for Colorectal Cancer: Patients presenting to a doctor or medical professional should be given a cancer screening. Early screening can greatly increase the chance of survival. The two most typical types of screening for colorectal cancer are a flexible sigmoidoscopy, in which a doctor inserts a sigmoidoscope in the rectum and searches for growths, and a colonoscopy, in which a doctor uses a larger tube, a colonoscope, in the rectum and is able to examine the entire colon.

Early sigmoidoscopy or colonoscopy can allow a doctor to find a polyp and remove it before it becomes malignant. The American Cancer Society Colorectal Cancer Screening Guidelines state that beginning at age 50, both men and women should have a flexible sigmoidoscopy every 5 years, along with a yearly blood stool test. The guidelines also recommend a full colonoscopy every 10 years.

If you or a loved one is suffering from painful treatments for colon or rectal cancer, or if you have a loved one who has passed away because of the condition, it is possible that your doctor misdiagnosed the condition or made some other crucial error. Medical negligence attorney Ryan Springer works closely with medical experts to examine medical records and discover whether negligence or misdiagnosis led to otherwise avoidable surgery, pain, suffering, or wrongful death.

To determine whether you, or a loved one, suffered from an incorrect diagnosis or other medical error, please contact malpractice lawyer Ryan Springer at (801) 424-9088 for a free, no-obligation initial consultation.  Ryan helps malpractice victims throughout the State of Utah, including Salt Lake City, Provo, Ogden, Logan, St. George, Moab and Price.

Breast Cancer Awareness

For the past twenty five years, October has been recognized as Breast Cancer Awareness Month.  Efforts to increase awareness and raise funds for research include everything from Facebook memes to athletic events (shameless plug: join me for the Trek Bikes Breast Cancer Awareness Ride on October 9).  Although early detection has reduced mortality rates, data suggest that at least 1 in 8 women will be diagnosed with breast cancer.  Mothers, wives, sisters and daughters are all at risk.

Since there is no cure, successful treatment depends on early detection and prompt medical intervention.  Women should regularly perform self-examinations and get regular medical check-ups.  Most physicians are attentive, especially if there are attendant risk factors such as age or family history.  Some doctors, however, will rely solely on preliminary studies or dismiss complaints--especially among young women.  If this happens, breast cancer diagnosis can be missed, and the results of the delay can be devastating.

There are a number of circumstances where breast cancer can be missed.  For instance, when a woman discovers a lump on examination, reports it to her doctor, who then orders a mammogram that comes back negative.  Some doctors will incorrectly advise their patient that all is well.  But not all breast cancers are detected on mammography.  The standard of care for medical professionals requires additional clinical follow-up where there is a palpable mass and a negative mammogram.  The standard of care requires an ultrasound, and if that mass still persists, a biopsy.

Another scenario was discussed recently in the New York Times, where doctors regularly misdiagnose a type of breast cancer called ductal carcinoma in situ, or D.C.I.S., particularly in its earliest stages. According to the article, "17 percent of D.C.I.S. cases identified by a commonly used needle biopsy may be misdiagnosed."  Recent research reveals that women with dense breast tissue are at higher risk for D.C.I.S., requiring further vigilance.

Patients and their families must be their own advocates.  The stakes are too high, and women deserve to have their health carefully addressed.  As a medical malpractice attorney, I've seen far too many cases where women have presented to their physicians with complaints of breast lumps, only to have these concerns dismissed because they're "too young" to get cancer or because of a negative mammogram.  These cases have resulted in women having to undergo radical treatment that could have been avoided if the cancer had been detected sooner.  Most tragically, in some cases, the cancer wins and families lose their wives and mothers to the devastating disease.

During this month of increased awareness, take control of your health care.  Recommendations for getting good professional care are available HERE.  They include talking candidly with your doctor; following up with any recommended testing, and if necessary, getting a second opinion.

If you reported your concerns to a doctor, and he or she ignored them until it was too late, you may have a claim for medical malpractice.  You should contact a lawyer that will hold the doctor accountable.